ASCIA COVID-19 information

The ASCIA COVID-19 webpage has been developed in response to the COVID-19 infectious respiratory disease outbreak caused by the most recently discovered coronavirus. The situation regarding COVID-19 is rapidly changing so the content of this webpage is reviewed on a daily basis and updated as required.

This webpage includes links to the following information:

ASCIA COVID-19 informationCOVID-19 FAQ Links to other organisations, government, news and publications | COVID-19 and Telehealth | Medical product supply updates | IUIS  COVID-19 Primary Immunodeficiency Survey | COVID–19 Global Rheumatology Alliance Registry | COVID-19 Symptom Checker

The latest updates to the ASCIA COVID-19 webpage include:

ASCIA COVID-19 information 

ASCIA Checklist - Actions to reduce the spread of COVID-19 - Updated 30th March 2020

pdfASCIA PCC Checklist: COVID-19 Actions 2020126.44 KB30/03/2020, 13:50 

ASCIA COVID-19 and Immunodeficiency patient information - Updated 30th March 2020

www.allergy.org.au/patients/immunodeficiencies

ASCIA Position Paper - Pharmacological Treatments for COVID-19 - New 30th March 2020

www.allergy.org.au/hp/papers#p4

ASCIA 2020 Conference postponed to 2021

https://www.allergy.org.au/conferences/ascia-annual-conference

ASCIA COVID-19 FAQ - Updated 31st March 2020 - see below
 

ASCIA COVID-19 Frequently Asked Questions (FAQ)

This information has been developed in response to the COVID-19 infectious respiratory disease outbreak caused by the most recently discovered coronavirus. The situation is rapidly changing so the content of this FAQ is regularly reviewed and updated.

What is COVID-19 and how does it spread? 

Coronaviruses are a large family of viruses that cause respiratory infections, including the common cold and more severe diseases such as Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS). The most recently discovered coronavirus (formerly the Novel 2019-nCOV coronavirus), causes coronavirus disease (COVID-19). This virus and disease were unknown before the outbreak began in December 2019.

The World Health Organisation (WHO) is assessing ongoing research on how COVID-19 is spread. Studies to date suggest that the coronavirus that causes COVID-19 is mainly spread through contact with respiratory droplets containing the virus. COVID-19 can spread when someone:

  • Inhales droplets containing the virus when a person with COVID-19 coughs or sneezes.
  • Touches a person or surface that is contaminated with droplets containing the virus, then touches their eyes, nose or mouth. From there, the virus can enter the body and cause illness.
What precautions should people with immunodeficiencies take?

Most people with primary and secondary immunodeficiencies are immunocompromised and are therefore at greater risk of any respiratory infections. The precautions they take to prevent infections are consistent with the actions listed below, and they should follow the usual advice from their physician. Further information is available at www.allergy.org.au/patients/immunodeficiencies

What precautions should people with respiratory allergy and other allergies take?

Most people with allergic rhinitis (hay fever), eczema, food, insect or medication allergy are not immunocompromised and are therefore not considered to be at greater risk of any respiratory infections. People with asthma are also not considered to be immunocompromised, however, asthma may sometimes be triggered by infections. People with asthma should already be aware of the need to avoid infections and what to do if they become unwell or come in contact with any infectious disease. They are advised to follow the usual advice from their physician. It is important that asthma is well controlled and that inhalers are used as directed by the treating doctor to reduce the impact of COVID-19 (and other infections) as much as possible.

Some allergic rhinitis and asthma symptoms may be similar to those caused by infections, so it is important to treat allergic rhinitis and asthma to prevent symptoms that could be mistaken for infections from viruses, such as such as colds, influenza and COVID-19.

Even if you are not immunocompromised it is vital that everyone follows the most recent government advice and restrictions, to reduce the spread of COVID-19.

What actions can reduce the spread of COVID-19 and other respiratory infections?
  • Hand hygiene is the top priority. Regular and thorough hand washing with soap and water throughout the day, particularly after using the bathroom and before eating is vital for preventing infections. Alcohol-based hand-gel can be used to sanitise hands when soap and water isn’t available. Avoid touching your eyes, nose and mouth. Also avoid shaking hands or any other greeting that involves contact. 
  • Respiratory hygiene is also a priority. This involves covering the mouth and nose with a bent elbow or tissue when coughing or sneezing, then disposing of the used tissue immediately. It is also important to maintain at least 1.5 metre distance away from anyone, especially if they cough or sneeze.
  • Stay home if you are unwell or if you have recently travelled. If anyone has a fever, cough or breathing difficulty, they should stay home, seek medical attention (call in advance), and follow the local health authority instructions. Self-isolation is required if contact has been made with someone with COVID-19 symptoms, or symptoms develop following contact with someone who has COVID-19 (see details below). Quarantine of 14 days is required for people who have travelled, even if they do not feel unwell.
  • Follow government advice and restrictions. It is important that everyone complies with government restrictions, which include the actions listed above, in addition to not travelling (except for essential workers), and physical/social distancing measures. Examples include working from home where possible, avoiding any gatherings and partial or full closures of most hospitality businesses. 
When is self-isolation required?

Self-isolation is required if contact has been made with someone with COVID-19 symptoms, or symptoms develop following contact with someone who has COVID-19. Information on how to self-isolate is on the following websites:

www.health.gov.au/resources/publications/coronavirus-covid-19-isolation-guidance    

www.health.govt.nz/our-work/diseases-and-conditions/covid-19-novel-coronavirus/covid-19-novel-coronavirus-health-advice-general-public/covid-19-novel-coronavirus-self-isolation

Can the immune system be “boosted” against infections such as COVID-19?

Despite various claims, there are currently NO recommended supplements or other agents which have been proven in conventional medical studies to boost immunity against infections such as COVID-19.

Getting enough sleep, healthy eating, managing stress and regular exercise (whilst complying with government restrictions regarding social distancing) will optimise immune system function.  By combining these measures with the actions listed above, this may help reduce spread of infections, including COVID-19.

© ASCIA 2020

ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.

ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice. The content of ASCIA resources is not influenced by any commercial organisations.

For more information go to www.allergy.org.au

To donate to allergy and immunology research go to www.allergyimmunology.org.au


Links to information from governments and other organisations, news and publications

The situation regarding COVID-19 is rapidly changing, so ASCIA continuously monitors publications and information from the World Health Organisation (WHO), other organisations, Australian government and New Zealand government . The ASCIA COVID-19 webpage is reviewed on a daily basis and updated as required.

WORLD HEALTH ORGANISATION (WHO)

Clinical management of severe acute respiratory infection when novel coronavirus (nCoV) infection is suspected  
pdf2020 WHO Clinical management suspected COVID-19855.57 KB23/03/2020, 04:17

News - www.who.int/news-room/q-a-detail/q-a-coronaviruses 

INTERNATIONAL IMMUNOLOGY/ALLERGY ORGANISATIONS

https://education.aaaai.org/resources-for-a-i-clinicians/covid-19

COVID19 Joint IPOPI ESID INGID APSID LASID ASID ARAPAID SEAPID Statement Update_1_v2.0_20200310 (PDF)

https://www.ukpin.org.uk

https://cgdsociety.org/home/latest-news/coronavirus-covid-19/

https://primaryimmune.org/coronavirus

AUSTRALASIAN SOCIETY FOR INFECTIOUS DISEASES (ASID)

ASID Interim guidelines for clinical management of COVID-19 in adults https://www.asid.net.au/documents/item/1873

ASID Letter to CMO regarding hydroxychloroquine https://www.asid.net.au/documents/item/1875

AUSTRALIAN AND NEW ZEALAND INTENSIVE CARE SOCIETY (ANZICS)

https://www.anzics.com.au/coronavirus-guidelines/

AUSTRALASIAN COLLEGE FOR EMERGENCY MEDICINE (ACEM)

https://acem.org.au/COVID-19

AUSTRALIAN GOVERNMENT

www.health.gov.au/health-topics/novel-coronavirus-2019-ncov 

www.health.gov.au/resources/videos/coronavirus-video-good-hygiene-starts-here  

Call the Coronavirus Health Information Line 1800 020 080 (24 hours a day, 7 days a week) or call Healthdirect Hotline 1800 022 222 (24 hours a day, 7 days a week) to speak to a registered nurse about your health concerns. 

Healthdirect Australia has developed a COVID-19 Symptom Checker, an online self-guided tool to help people find out if they need to seek medical help.

NEW ZEALAND GOVERNMENT

www.govt.nz/covid-19-novel-coronavirus/  

Call the Government Helpline on 0800 779 997 (9am to 5pm, 7 days a week) if you are not sure what support is available, don’t know who to contact for help or would like more information.

NATIONAL ASTHMA COUNCIL AND ASTHMA AUSTRALIA: COVID-19 AND ASTHMA 

https://www.nationalasthma.org.au/news/2020/covid-19-and-your-asthma-patients 

COVID-19 NEWS AND PUBLICATIONS
COVID-19 Global Cases. Center for Systems Science and Engineering, Johns Hopkins University. 2020
An interactive web-based dashboard to track COVID-19 in real time  
https://www.arcgis.com/apps/opsdashboard/index.html#/bda7594740fd40299423467b48e9ecf6
Q&A: What you need to know about COVID-19. Australia Doctor/ Medical Observer. March 2020
 
Coronavirus puts drug repurposing on the fast track. Nature Biotechnology. February 2020
 
The Lancet COVID-19 Resource Centre https://www.thelancet.com/coronavirus 
 
Dong et al. An interactive web-based dashboard to track COVID-19 in real time. The Lancet February 2020 

van Doremalen et al. Aerosol and Surface Stability of SARS-CoV-2 as Compared with SARS-CoV-1. NEJM March 2020 https://www.nejm.org/doi/full/10.1056/NEJMc2004973 

Fang et al. Are patients with hypertension and diabetes mellitus at increased risk for COVID-19 infection?  The Lancet March 2020 https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30116-8/fulltext 

Kalil A. Treating COVID-19—Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics. JAMA March 2020 https://jamanetwork.com/journals/jama/fullarticle/2763802

Portnay et al. Telemedicine in the Era of COVID-19. JACI March 2020.  https://www.jaci-inpractice.org/article/S2213-2198(20)30249-X/fulltext

Shaker, Greenhawt et al. COVID-19: Pandemic Contingency Planning for the Allergy and Immunology Clinic. JACI March 2020. https://www.jaci-inpractice.org/article/S2213-2198(20)30253-1/abstract

Wu et al. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. Summary of a Report of 72 314 Cases From the Chinese Center for Disease Control and Prevention.

JAMA February 2020 https://jamanetwork.com/journals/jama/fullarticle/2762130

Zhang et al. Clinical characteristics of 140 patients infected with SARS‐CoV‐2 in Wuhan, China. Allergy February 2020 https://onlinelibrary.wiley.com/doi/10.1111/all.14238


COVID-19 and Telehealth

Significant expansion of telehealth items announced

Following advocacy by health peak bodies, the Commonwealth government has announced whole of population telehealth for patients, general practice, primary care and other medical services to support the response to COVID-19 and provide safe access to health services for patients and doctors alike.

Please note that additional specialist items are expected to become available. In the meantime, telehealth consultations for the selected services below provided by specialist and consultant physicians and paediatricians will no longer be restricted to patients with COVID-19 or vulnerable patients and doctors.

The following items will from 8am on 30th March, have telehealth (videoconferencing) and telephone consultation equivalents with no restriction on location, although they are still subject to a bulk billing restriction.

  • 110 (Consultant physician. Initial attendance)
  • 116 (Consultant physician. Subsequent attendance)
  • 119 (Consultant physician. Minor attendance)

This is a rapidly moving area, and we expect further updates over the next week as we continue to work with the Government on further expansion of telehealth services for physicians. 

Please continue to regularly check the MBS online webpage for more details. You will find both specialist factsheets and provider FAQs.


Medical Product Supply Updates

In response to the COVID-19 outbreak many suppliers of medical products are working to ensure the continuity of supply to patients in Australia and New Zealand, whilst also protecting the health of their employees. ASCIA is monitoring the situation and will post notices from the TGA (Australia) and suppliers on this page.

TGA amendment to restrict hydroxychloroquine prescribing https://www.tga.gov.au/scheduling-decision-final/notice-amendment-current-poisons-standard-under-paragraph-52d2a-therapeutic-goods-act-1989

ASID letter to CMO regarding hydroxychloroquine (Plaquenil) https://www.asid.net.au/documents/item/1875

ARRC letter to patients regarding hydroxychloroquine (Plaquenil) https://www.autoimmune.org.au/2020/03/25/hydroxychloroquine-plaquenil-update/ 

TGA critical medicine shortages in Australia https://apps.tga.gov.au/prod/MSI/search

Adrenaline (epinephrine) autoinjector supply www.allergy.org.au/members/adrenaline-autoinjector-availability

Venom allergen supply www.allergy.org.au/members/insect-allergy

Other Medical Product Updates are available from suppliers here (AMSL, Bayer, Gamma Allergy, Mylan, Nutricia, Sanofi, Stallergenes Greer) 

International Union of Immunological Societies (IUIS) Primary Immunodeficiency and COVID-19 Survey

There is an urgent need to understand the impact of COVID-19 on immunodeficient and immunosuppressed patients. Whilst co-morbidities such as diabetes, cancer, arterial hypertension and heart disease have been documented in people infected with SARS-CoV-2, there is currently no information on the consequences and outcomes for people with primary immunodeficiencies (PID).

ASCIA members are invited to complete the following survey, that has been sent to ASCIA and other clinical immunology organisations by Professor Stuart Tangye, on behalf of the International Union of Immunological Societies (IUIS) Expert Committee of Inborn Errors of Immunity. The survey link is https://www.surveymonkey.com/r/67RBPNZ

The IUIS has prepared this electronic survey for completion by clinicians globally, to capture initial information to get an idea of the numbers of PID patients affected/infected with SARS-CoV-2, and the effect of infection on the patients.

This survey focusses on obtaining this top level of information and has been prepared by Professors Isabelle Meyts, Nizar Mahlaoui and Kate Sullivan, in conjunction with the European Society for Immunodeficiencies (ESID), the French national reference center for PID (CEREDIH - Centre de Référence Déficits Immunitaires Héréditaires) and the International Patient Organisation for PID (IPOPI). The survey has been approved for global distribution.

Once the IUIS has an idea of the number of affected PID patients and the impact of SARS CoV2, the plan is to follow up with another IUIS survey that will require a greater level of information, to go to clinicians with affected/infected PID patients. The IUIS is conscious of the demands on time and resources due to COVID-19 on top of regular busy schedules and is grateful to all participating societies and organizations, which will all be acknowledged for their help and input into this initiative.


COVID–19 Global Rheumatology Alliance Registry

ASCIA is part of the COVID–19 Global Rheumatology Alliance. The mission of this alliance is to create a secure, de-identified, international case reporting registry and curate and disseminate the outputs from that registry. The COVID–19 Global Rheumatology Alliance physician-entered data registry is now available at https://rheum-covid.org 

This registry will facilitate the Alliance's primary goals, which are to:

  • Understand the outcomes of patients with rheumatologic conditions who develop COVID–19 infection and the influence of their comorbidities and medications on their outcomes.
  • Understand the influence of rheumatologic medications, such as hydroxychloroquine, on the outcomes of patients who develop COVID–19 infection.

The COVID–19 Global Rheumatology Alliance is interested in all cases, from asymptomatic to severely affected.

The Alliance aims to provide information back to doctors, patients, and researchers about how rheumatic disease patients and those treated with rheumatology drugs fare when they get infected. Data collected will potentially provide valuable information going forward to help make decisions about how to direct further studies and treat our patients.


COVID-19 Symptom Checker 

Healthdirect Australia has developed a COVID-19 Symptom Checker, an online self-guided tool to help people find out if they need to seek medical help.

COVID-19 Symptom Checker

Content updated 31st March 2020

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