Top 3 questions – COVID treatments, close contact rules & COVIDSafe aged care visits

Deputy Chief Medical Officer, Professor Michael Kidd, answers the Top Three questions across our channels.

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Hello, and welcome to this week's Top Three. My name is Professor Michael Kidd, Deputy Chief Medical Officer with the Australian Government Department of Health. I'm speaking to you today from Ngunnawal country and I'd like to acknowledge the Traditional Owners of the lands where you and I are both situated today. We pay our respects to Elders past and present, including 20 Elders who are joining us for today's top three.

This week, my shout-out is to our nation's midwives. On Thursday this week, we've had the International Day of the Midwife. This is a international day to celebrate the work of the nation's 29,000 midwives and registered nurses who are involved in supporting mothers in delivering their babies each year. And I would like to pay tribute to our nation's midwives and say "thank you for all that you do", and particularly "thank you for all that you've done "over the past two years of the COVID-19 pandemic." I know there's been a lot of challenges for everybody involved in the healthcare sector.

So, this week, to your top three, and your first question is about the new treatments available for COVID-19. On Sunday May 1, we had, listing on the Pharmaceutical Benefits Scheme, a new oral treatment for COVID-19 called Paxlovid. This means we now have two oral treatmentswhich can be prescribed by your general practitioner and dispensed through your local community pharmacy. Since March 1, we've had Lagevrio, or so-called Molnupiravir, and now from 1 May, Paxlovid, a new treatment available for people at significant risk of becoming seriously unwell when infected with COVID-19. It's really important that we spread the message about these new treatments, which are available to help prevent at-risk people from becoming seriously unwell if they become infected with COVID-19. Even people who have been double vaccinated, had their booster, and had their winter booster shot can still become seriously unwell with COVID-19 if they have other serious risk factors. So a little bit about these two treatments, Paxlovid and Lagevrio. Firstly, they're available to people who are aged 65 and above who have at least two risk factors, to Aboriginal and Torres Strait Islander people aged fifty and above, with at least two risk factors, and anyone aged 18 and above who has moderate to severe immunocompromised. And I'll provide you... the little bit more detail about what these risk factors are and who is immunocompromised in just a minute. People need to have had a positive PCR or a positive rapid antigen test in order to be eligible to have their GP write a prescription. And they need to have developed at least one symptom of COVID-19. So if you are aged 65 and above or if you're aged over 18 and have immune compromised, or if you're Aboriginal and Torres Strait Islander, aged 50 and above, and you develop symptoms of COVID-19, very important that you very quickly get a test, ideally a rapid antigen test that you can do yourself at home, and then contact your GP to see if you can get a prescription of one of these two treatments. These treatments help to keep people from becoming seriously unwell with COVID-19 and help to keep people out of hospital, and they can be life-saving. We don't know who is going to become seriously unwell if infected with COVID-19, but we know that the older you are and other medical conditions make people more at risk. Now, those risk factors for people aged 65 and above include people who've received less than two doses of a COVID-19 vaccine so that's no vaccine or only one dose, people who are in residential aged care or in disability care, people aged 75 and above, people who may have had a neurological condition such as a stroke or dementia, people with respiratory conditions, including obstructive airways disease and moderate to severe asthma requiring steroid therapy, people with congestive heart failure, people with diabetes, either type one or type two, requiring medication, people who have obesity, with a body mass index more than 30, people with renal failure, people with cirrhosis or severe liver disease. So it's a large group of people aged 65 and above or Aboriginal and Torres Strait Islander aged 50 and above, who are going to be eligible for one of these oral treatments, either Paxlovid or Lagevrio. And if you do fall into this category, it may be an idea, talking to your GP in advance and say, "If I do get COVID-19, what should I do to make sure "I can rapidly get access to these treatments?" Now, once you test positive for COVID-19, it's going to be really important that you start taking these treatments very quickly and ideally within the first 12 to 24 hours after testing positive. So you may need to do a telehealth consultation with your GP and then arrange for delivery of the treatments from your local community pharmacy. In any case, people need to have started on these treatments within five days of developing symptoms in order for them to work. But as I say, the earlier people can start on treatments, the better. A reminder about those aged 18 and above who are immune-compromised. There's a very long list of people who may be at risk of being immune-compromised. It includes people with active cancers, particularly people with lymphoma, leukaemia, and multiple myeloma, and Myelodysplastic syndrome. It includes people who've had organ transplants or recent bone marrow transplants. It includes people with immune deficiency, for example, people with HIV/AIDS. It includes people currently taking chemotherapy or radiotherapy for cancer, and it includes people on a number of medications which can suppress your immune system. It also includes people who have severe intellectual or physical disability, requiring residential care, and it includes people with Down Syndrome and cerebral palsy, with thalassemia and other haemoglobinopathies, with sickle cell disease, and with congenital heart failure. So again, a large number of people aged 18 and above who may be eligible for these treatments. The new treatment Legavri...sorry, Paxlovid does have a number of contraindications. So your GP is going to need to review all the medications that you're currently taking because this drug cannot be taken if you're on one of a large number of medications. It also can't be used if you have severe kidney or liver disease, and it can't be used if you're pregnant or breastfeeding. And if you are sexually active, of childbearing age, it's important that you use contraception while taking these treatments. So that's a lot to remember. But there's a lot of information about both of these oral treatments on the website. And most importantly, please share the news with the older people and people with immune deficiency in your family and among your friends so that people know about these treatments because, as I say, these treatments can save lives.

Your second question this week is about the lifting of quarantine requirements for people who are deemed to be close contacts of someone who has been diagnosed with COVID-19. Each of the states and territories in Australia is moving to lift the requirement for seven days of quarantine at home for people who are close contacts of someone with COVID-19. We do know, however, that probably at least a third of people who are close contacts are likely to develop COVID-19 so it's very important that if you are a close contact, you continue to follow the guidance from your state and territory. Many states and territories are requiring people who are close contacts to do a daily rapid antigen test. Many states and territories are preventing people who are close contacts from coming in contact with people who may be vulnerable and at increased risk, for example, people in residential aged care facilities or people who are in hospitals. And of course, all the states and territories require you to be very careful when you're mixing with other people.  Recommended that you wear a mask when you're out in public, particularly in crowded settings and on public transport. Keep washing your hands rigorously as we've all become so used to doing over the past two years. And if you develop any sign or symptom that you may have COVID-19, use your common sense. Stay at home, and arrange to get a test. Now, if you do develop symptoms and you're a close contact, it is highly likely that you have COVID-19. And you may have a negative rapid antigen test the first time you do one that may very well turn positive the next day or the day after. So if you develop symptoms of runny nose, cough, sore throat, fever, aches and pains, malaise, change in your sense of smell, change in your sense of taste, nausea, diarrhoea, all these symptoms can indicate that you are developing COVID-19. You should stay at home if you're a close contact and arrange to get tested. These lifting of restrictions for people who are close contacts is a sensible part of our continuing approach to COVID-19, now that we have so many people vaccinated and protected against COVID-19, now that we've made sure that our hospitals are not going to be overwhelmed with large numbers of very seriously ill people because so many people are vaccinated, and now that everybody is hopefully taking personal responsibility to make sure they're not at risk of transmitting COVID-19 to others. Any doubt, stay at home. Arrange to get tested.

Your third question is about Sunday, this week, and Sunday, this week, is, of course, Mother's Day. And there's a question about "How do I protect my elderly mother on Mother's Day?" Now, of course, Mother's Day is one of those very important days of the year, a day when we like to spend time with our mums or, if you're lucky enough, with your grandma, or even with your great-grandma, but very important that we are protecting the older people in our lives from the risk of COVID-19. So if you're going to see Mum or Grandma or Great-Grandma on Sunday, it might be a good idea for everyone in the family to do a rapid antigen test first up. Certainly, anyone who has symptoms which may indicate COVID-19 should stay home and not put Mum or Grandma or Great-Grandma at risk of becoming unwell with COVID-19. Please make sure that your vaccines are up to date. And, of course, now we're not only looking at keeping up to date with our COVID-19 vaccines, but also getting your influenza vaccines. Influenza vaccines now available for everybody aged six months and above in Australia. And we are seeing a rise in the number of influenza cases in Australia each week, and we expect to have significant numbers of people with influenza over the coming weeks. We want to protect Mum and Grandma and Great-Grandma from influenza, just like we're protecting them from COVID-19 because older people are more at risk of becoming seriously unwell and even losing their lives when we have outbreaks of influenza. Now, if your mum or your grandma or your great grandma is in a residential aged care facility it may be that the facility has restrictions in place at the moment, especially if they've got an outbreak of COVID-19. Everyone in a residential aged care facility is allowed to have at least one visitor a week under the government's guidelines. But there may not be the opportunity for large family gatherings in a facility which currently has an outbreak of COVID-19. So you may need to look at other ways of connecting with your mum, your grandma, your great grandma. And of course, many of us have been using iPads and video calls to connect all the family from around the country and around the world with Mum or Grandma or Great-Grandma. And so that may be an option if there's a lockdown in their facility on this weekend. And of course, you can always use the telephone, those phone calls which our mums and our grandmas and our great-grandmas love receiving every day to hear from us and to make sure that we're all doing OK and so that we can keep in touch and make sure our loved ones are OK as well. And of course, it's also a day for cards and letters and flowers and little gifts to your mum, your grandma, your great-grandma to know them...let them know how special they are in your life. So I wish everyone a 'Happy Mother's Day' on Sunday, a really important day for families to be coming together either physically or virtually with the women in your family who you love and adore. Make them feel spoiled and special this Sunday.

And that's our top three for this week. Thanks, everybody.

Top 3 questions

  1. You may have heard about a new treatment that is now available for COVID-19. What is it? Who will it benefit most? And how do you get it?
  2. Over the past few weeks, the close contact rules have been relaxed in several jurisdictions. What does this mean for cases and why is it different in depending on the state or territory? 
  3. With Mother’s Day this weekend, many families are hoping to catch up with older relatives in residential aged care. What can we do to stay connected with loved ones but still help keep them safe from COVID?

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