nsw health covid-19 · 8/27/2020 · 6. data – children 0-2 years. from january 2020 to 24...
TRANSCRIPT
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NSW Health COVID-19
Maternity, Neonatal, Special Care Nurseries and Child and Family Health Community of Practice
27 August 2020
Respiratory Pandemic Preparedness
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Today’s Agenda
►Welcome and update from Dr Nigel Lyons
►Associate Professor Joshua Vogel, Principal Research Fellow, Burnet Institute
►Feedback from issues arising in last week►Prof Michael Nicholl (Maternity)
►Dr Srini Bolisetty (NICU & SCN)
►A/Prof Elisabeth Murphy (Child and Family Health)
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Clinical Communities of Practice (CoPs)Update from Dr Nigel Lyons, Deputy Secretary
► Clinical Communities of Practice
► What’s new this week► PPE, surveillance and medication updates
► The Clinical Council
► Clinical guidance and resources► New, revised and under development
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What’s new this week?4
New infection prevention and control resources
In the past week, the Clinical Excellence Commission (CEC) has released a range of new and updated resources to support health workers and others responding to the COVID-19 pandemic.
These include an update to the COVID-19 Infection Prevention and Control: Response and Escalation Framework – FAQs and new guidance around infection prevention and control with aerosol generating procedures.
Visit the NSW Health website to learn more.
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DATA - Pregnant women
From January 2020 – 24 August 2020
► Twenty-six pregnant women have been diagnosed with COVID-19. This represents a small proportion of all COVID-19 cases (0.68%). None of these women identify as Aboriginal.
► 8 women were in their first trimester, 9 were in their second trimester and 9 were in their third trimester at the time of notification.
► Of the 26 cases, 8 most likely acquired their infection overseas and the remaining 18 acquired their infection locally in NSW. Of those who acquired their infection in NSW, 11 were linked to a known case or cluster, 3 were household contacts of a confirmed case and 4 were unlinked to any known cases or clusters.
► Of the 26 cases, 25 reported having symptoms. Most symptoms that pregnant women reported were mild. There have been no deaths in pregnant women
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DATA – Children 0-2 years
From January 2020 to 24 August 2020
► Thirty-six children aged 0-2 years have been diagnosed with COVID-19. This represents a small proportion of all COVID-19 cases (0.95%). Most (64%) of cases are male (noting small case numbers), and one child identifies as Aboriginal.
► Of the 36 cases, 16 most likely acquired their infection locally in NSW, 19 acquired theirs overseas and 1 acquired their infection interstate (in Victoria). Of those who acquired their infection in NSW, 6 were epi-linked to a known case or cluster, 7 were household contacts of a confirmed case and 3 were unlinked to any known cases or clusters.
► Of the 36 cases, 23 had symptoms. Most symptoms that children reported were mild. There have been no deaths in children aged 0-2 years.
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Guidance available
► Guidance for infant feeding (coming soon)
► Guidance for neonatal services (updated 1/5/2020)► https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-
practice/Pages/guide-neonatal-services.aspx
► Guidance for maternity and newborn services (updated 15/7/20)► https://www.health.nsw.gov.au/Infectious/covid-19/Pages/guidance-for-maternity-
services.aspx
► Guidance for pregnant women and new parents (updated 14/7/20)► https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-
practice/Pages/guide-pregnant-women-and-new-parents.aspx
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Relevant information for all areas
►ACI – Indirect impact of COVID-19► https://aci.crowdicity.com.au/ or register via NSWH-
► Tara Dimopoulos-Bick (Evidence Generation and Dissemination team, ACI) on [email protected]
►Health Consumers NSW https://www.hcnsw.org.au/visiting-guide/
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Associate Professor Joshua VogelPrincipal Research FellowNational Clinical Evidence Taskforce Burnet Institute
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Specific issues and information week ending 21 August 2020
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MaternityIssue What we know
Recent RANZCOG statement on ‘COVID-19: Protection of midwives and doctors in the birth unit’ has made recommendations including:
- In settings of increased community transmission, suspend the use of water immersion for labour and birth for all women
Within NSW, the number of maternity patients with locally acquired suspected, probable or confirmed COVID-19 is very low. The NSW guidance reflects this context.
The Guidance developed for NSW for maternity and newborn services remains unchanged at this time, which advises:
- Women who are not probable, suspected or confirmed to have COVID-19 may continue usual practice
- For those women who are probable, suspected or confirmed to have COVID-19 water immersion is not recommended.
The RANZCOG statement also advises that:
- Labour and birth are potentially aerosol-generating behaviours
- N95 masks are required for healthcare workers caring for women with suspected or probable COVID-19 in labour, birth and caesaran section
The CDNA National Guidelines for Public Health Units released their most recent guidance on 24 August 2020 with no changes to aerosol generating procedures. Considering the low numbers of COVID-19 in NSW, the CEC has not changed its existing guidance on PPE recommendations.
Current guidance on the Application of PPE in COVID-19 developed by the CEC:
- Does not define labour and birth as potentially aerosol-generating behaviours- Does not recommend the use of P2/N95 masks in delivery/birthing suites with suspected, probable or
confirmed cases unless respiratory aerosol generating procedures are undertaken
The CEC will refer the RANZCOG recommendations to the National Expert Advisory Group (ICEG) for further advice, particularly regarding the new definition of ‘aerosol-generating behaviours’.
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Maternity – Communication via social media and videos
Neonatal
Issue What we know What we are doing Next steps
Routine care of unwell neonates during the COVID-19 Pandemic in NSW
Community prevalence of COVID-19 in NSW remains low.
When a baby becomes unwell the most likely cause will be the more common causes of newborn complications.
COVID-19 testing should occur concurrently with other investigations.
A negative COVID-19 test should not prevent the start of usual care
Local health districts must have clear local guidance to ensure rapid referral and assessment of an unwell baby.
https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/guide-neonatal-services.aspx
Providing clear direction in NSW Health guidance for the COVID environment (see links above)
Notify the CoP if this changes
The latest Guidance for maternity and neonatal services can be found here: • Neonatal Services https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/nicu-and-special-care-nursery.aspx
• Maternity and Newborn https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/maternity-and-newborn-care.aspx
• Management of COVID-19 in Healthcare Settings Version v3.2 http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0019/582112/Management-of-COVID_19-in-Healthcare-Settings.pdf
Neonatal
Issue What we know What we are doing Next steps
From the mailbox –‘Should babies of women with confirmed COVID-19 be removed from the birthing room for resuscitation?’
The baby does not have to be moved to another room for resuscitation.
A risk assessment will identify the most effective location for neonatal resuscitation at birth - usually in the birth room for both speed and neonatal temperature control.
At birth the baby is a close contact not a case of COVID-19.
The PPE required for the baby should mirror the PPE worn by the maternity team for the mother.
https://www.health.nsw.gov.au/Infectious/covid-19/communities-of-practice/Pages/guide-neonatal-services.aspx
Providing clear direction in NSW Health guidance for the COVID environment (see links above)
Notify the CoP if this changes
Neonatal
Issue What we know What we are doing Next steps
Updated guidance soon to be published
Version 3 of the Neonatal Guidance will be published next week with additional information about the care of babies of women who are considered ‘close contacts’, in recognition of the increased number of identified close contacts in NSW.
New infant feeding guidance in the COVID-19 context. The guidance
• prepared in response to questions from clinicians
• applies to feeding infants of any age when the mother is suspected probable or confirmed COVID-19 in the acute healthcare setting or at home
• Includes specific infection prevention and control measures to be used by health workers
Providing clear direction in NSW Health guidance for the COVID environment (see links above)
Notify the CoP if this changes
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Source: https://www.acel.org.au/ACEL/ACELWEB/Publications/AEL/2020/SE2/Article_7.aspx
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Child and Family HealthNew and emerging issues
Issue What we know What we are doing Next steps
Guidance on Child and Family Health Services
Version 5 is available Ensuring that Districts to continue to offer CFH services with use of a mix of modalities.
Advice on groups Advice is required on conducting groups in a COVID safe manner.
Guidance has been developed by the CEC and will be available shortly.
Districts to be able to offer group services to families.
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Child and Family HealthPPE in Child and Family Health Services
Issue What we know Specific CEC Advice
PPE- Use of masks Healthcare workers are required to wear a mask if caring/working within 1.5m of any patient.
Seeking specific advice on how this applies to Child and Family Health service delivery.
PPE- Reuse of masks A CFH Nurse may have separate consults seeing individual clients where they don’t touch their mask and it does not become soiled or moist.
If a surgical mask can be worn without pulling it down or removing it to speak, it can be worn for up to four (4) hours. If it is pulled down or removed to speak, it must be discarded immediately and hand hygiene performed. If it is touched, hand hygiene should be performed immediately. It should be removed if it becomes damp or loose.
PPE- Use of aprons Child and Family Health nurses are seeking advice on the use of aprons in the 1-4 week check.
An apron is not required unless the CFH Nurse thinks that she may come into contact with a body fluid.
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Child and Family HealthResources for Parents and Carers
• COVID-19: physical distancing and family wellbeing, Raising Children’s Network
• Face masks and coronavirus: supporting children 0-12 years, Raising Children Network
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Child and Family HealthResources for Clinicians
• Families stepping up to help us cope with COVID-19, Australian Institute of Family Studies
• Families in Australia Survey, Life during COVID-19, Report 3: Help and support, Australian Institute of Family Studies
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Save the Children, Resource Centrehttps://resourcecentre.savethechildren.net/library/kids-talk-coronavirus
► https://www.youtube.com/watch?time_continue=13&v=sQsAMtcPi-M&feature=emb_logo
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Thank youAsk questions via:[email protected]
Find COVID-19 NSW Health Information: www.health.nsw.gov.au/Infectious/diseases/Pages/coronavirus.aspx
Next meeting: 9am 24 September 20