COVID-19 wrap-up for healthcare services

Information current at Thursday 17 September

Minister unveils plan for reopening elective surgery in Victoria

The Victorian Government yesterday announced a plan to increase elective surgery immediately in regional Victoria, with an increase in metropolitan Melbourne to occur at the end of the month. This follows Victoria taking its first steps on its roadmap to ‘COVID Normal’ this week, with regional Victoria now at the Third Step due to its low case numbers.

Case numbers have continued to drop, with Melbourne’s 14-day case average dropping to below 50. On one day this week the state only saw a daily increase of 32 cases. This week also saw a dramatic reduction in deaths compared to recent weeks, with Victoria’s success in reducing case numbers finally having an impact. Victoria experienced its first day with no COVID-19 related deaths since 13 July.

COVID-19 by numbers

Between 9 and 16 September:

  • 275 cases were identified in Victoria (19,668) – 19,943 total cases), 169 cases less than the previous week (444). This continues an ongoing trend of decreasing numbers of new cases in recent weeks.
  • As of 16 September, the metropolitan Melbourne 14-day rolling case average is 49.6, down from 74.5 last week. The regional Victorian rolling average is now 3.5, down from 5 last week.
  • Active cases and hospitalisations continued to decrease, while there was a slight reduction in unidentified community transmission cases.
    • There have been over 4,278 Victorian cases of possible community transmission – representing a decrease of 59 cases on last week (4,337). This is the second week in a row where the total number of cases dropped, which hopefully indicates community transmission has dropped. A reduced caseload makes the process of contact tracing easier.
    • There are 991 active cases in Victoria – a decrease of over 600 cases on last week (1,622). This represents total active cases decreasing by nearly 40 per cent in just a week, continuing the recent trend of significant drops in active cases in recent weeks.
    • There are 107 cases in hospital, including 11 in intensive care – a decrease of 89 hospital cases in a week (196), alongside a drop of 9 cases in ICU (20).
    • The total cases in Victoria includes 3,455 healthcare workers with 152 active cases. This represents an increase of 95 on last week’s total cases (3,360), but a reduction of 100 on the number of active cases (252).
  • The number of deaths in Victoria increased to 737, with a further 43 COVID-19 related deaths announced in this past week (694). This is a drastic reduction in the number of deaths compared to the prior week (118).
  • The drop in deaths is starting to reflect the drop over the last few weeks in new cases.
    Over 90,000 tests were processed (2,428,778< – 2,520,887<). This is a decrease in testing of nearly half compared to the previous week (180,000). People are encouraged to get tested if they have any symptoms.

Changes to healthcare delivery

The Victorian Government yesterday announced changes to elective surgeries. Elective surgeries will increase across Victoria’s regional public and private hospitals as soon as today and in metropolitan Melbourne from the end of September. The plan is:

  • Services in regional Victoria can increase to 75 per cent of usual elective surgery activity from today and 85 per cent from 28 September.
  • Hospitals in metropolitan Melbourne will begin to ramp up to 75 per cent of usual activity from the 28 September, when they enter the Second Step of the roadmap, and 85 per cent of usual activity when they move to the Third Step.
  • All Victorian hospitals will move to 100 per cent of usual activity when the state moves to the Last Step, planned for 23 November.

This plan is expected to result in approximately 18,750 additional elective surgeries across private and public hospitals in October and an extra 10,500 surgeries in November. The Victorian Government has also said it will reinstate the elective surgery blitz when safe. Specialist clinic consultations will increase in line with elective surgery activity.

There was also detail on broader health changes, with easing of restrictions for dental and allied health services in metropolitan Melbourne during the Second Step, from 28 September. This will allow the resumption of non-urgent dental procedures such as routine examinations, temporary fillings, simple extractions, preventive procedures like fluoride varnish and hand scaling, and dentures and orthodontic treatments. AHPRA-registered allied health professionals will also be able to see patients for face-to-face services for a broader range of treatments than just preventing hospital admission, such as for pain management or to prevent a deterioration in functional independence.

The Victorian Government this week also urged people to continue to access normal medical care if they require it. Emergency department visits have fallen by at least 25 per cent compared to the same time last year. Presentations for heart attack are down by 18 per cent and strokes by 24 per cent. Reporting for the five most common cancers (colorectal, prostate, breast, melanoma and lung) have reduced by about a third, with an even greater reduction in reports for head and neck cancer. This is expected to lead to an increase in cancer diagnoses over the next 12 months and more patients presenting with later-stage incurable disease.

The Victorian Government has also announced that the COVID-19 Omnibus (Emergency Measures) and Other Acts Amendment Bill 2020 will be introduced into the Victorian Parliament today. It extends a range of temporary changes made by the previous Omnibus Bill, introduced in April, for another six months.
The Bill being introduced also includes new temporary emergency measures to strengthen the state’s health response to COVID-19. These measures include broadening the types of people who can be appointed as Authorised Officers to enforce public health interventions, and clarifying powers to ensure people who test positive for COVID-19, or are close contacts, comply with a direction to self-isolate. These measures would expire on 26 April 2021. The VHA will monitor the progression and detail of the Bill.

Victorian restrictions easing

The past week has seen Victoria take a number of steps to reduce restrictions.

On Sunday, the state took its first steps on its roadmap to ‘COVID Normal’. Melbourne moved to the First Step with a slight alteration to Stage 4 Restrictions, with an additional hour of exercise, one less hour of curfew and small social bubbles. Regional Victoria moved to the Second Step of the roadmap.

Victoria’s State of Emergency and State of Disaster declarations were also renewed for another four weeks, ending at 11.59pm on 11 October 2020. This has prompted updates to the directions from the Chief Health Officer, including directions on hospital visitors, care facilities and workplace directions. Services should ensure they are aware and compliant with any changes.

Following these first steps on the roadmap, the Premier then announced on Tuesday that, from today, regional Victoria would move to the Third Step as its 14-day case average met the threshold to ease restrictions. Households can establish a ‘bubble’ with another household, people can gather in groups of ten in outdoor public places, and regional Victorians can travel to anywhere else in regional Victoria.

Commonwealth mental health clinics

The Commonwealth Government on Monday launched 15 new dedicated mental health clinics for Victorians.
The clinics were announced as part of a $31.9 million federal government mental health package in August to support Victorians during the COVID-19 pandemic, and have received $26.9 million to deliver care.

There will be nine HeadtoHelp clinics located in Greater Melbourne and six in regional Victoria. The locations are:

  • Greater Melbourne: Berwick, Frankston, Officer, Hawthorn, Yarra Junction, West Heidelberg, Broadmeadows, Wyndham Vale, Brunswick East
  • Regional Victoria: Warragul, Sale, Bendigo, Wodonga, Sebastopol and Norlane

Of these clinics, 9 are being delivered by VHA members, with 8 being delivered by community health services. Calling on the Commonwealth Government to identify registered community health services in Victoria as key delivery partners of the new mental health clinics was a key recommendation in the VHA’s ‘Pre-Budget Submission Commonwealth 2020-21′.

The clinics are staffed by multi-disciplinary teams of mental health professionals and will provide on-site mental health support, and connections to other mental health services in their region. The establishment of the clinics has been overseen by a joint federal and state Mental Health Pandemic Response Taskforce co-chaired by Dr Ruth Vine, the Australian Government Deputy Chief Medical Officer for Mental Health, and Pam Anders, CEO Mental Health Reform Victoria. Click here to read the press release, while more information on HeadtoHelp is available here.

New resources and information

Over the past week there has been an increase in publicly accessible information on COVID-19 cases.

Alongside releasing broader information on case data and outbreaks, the Victorian Government is now releasing further information on specialised topics. These include:

  • Healthcare worker infection data
  • Contact tracing data
  • COVID-19 average case data

Services should stay up to date with the healthcare worker infection data, which is updated regularly and includes weekly summaries to identify trends. Currently, over 70 per cent of healthcare worker infections were acquired in a health or aged care setting.

The Commonwealth Government has also released the first data snapshot of residential aged care facilities which have recorded COVID-19 infections. The data includes all aged care facilities where there has been more than one case in either a staff member or resident. It shows that of the 2,706 aged care facilities in Australia, 213 – or 8 per cent – have had cases of COVID-19. The snapshot will be updated weekly, and is available here.

As the pandemic continues, a range of new and updated support and resources for services were released in the past week. These include: