Practical Advice for Fellows
The impact of COVID-19 on Fellows’ private practices has been swift and significant. College is of the view that Fellows are best placed to make individual decisions regarding how and where they choose to practice in these current circumstances. We strongly encourage Fellows to communicate with each other and share solutions, both locally and nationally via College.
The pressure on Fellows in both the private and public setting is appreciated. We are working with our College COVID-19 Taskforce to ensure that sensible and appropriate advice is delivered to Fellows and patients in a timely fashion. Fellows are urged to keep abreast of government advice and apply this practically. The below information has been stepped out in four key areas:
- COVID-19 Vaccine Rollout
- Triaging of Clinical Care and Patient Categorisation
- Your Practice
- Your Patients
- COVID-19 Dermatology Registries
COVID-19 Vaccine Rollout
On 25 January 2021, the TGA announced its provisional approval of the Pfizer/BioNTechn COVID-19 vaccine for use in Australia. A staged rollout is expected to commence in February 2021. The Department of Health’s vaccine rollout roadmap has determined the phases of vaccination for priority groups.
The Department of Health’s recent information sheets for health professionals are below with further details and to help answer patient questions:
Triaging of Clinical Care and Patient Categorisation
On 15 May 2020, the Prime Minister announced the reintroduction of hospital elective surgery in three stages, to be reviewed monthly. It is a decision of each jurisdiction to determine the stage, timeline and the level of normal surgical activity.
Guidance has been developed to assist Fellows with decisions around clinical urgency
For guidance on the safe use of laser and energy-based devices, see:
- The Australasian Society of Cosmetic Dermatologists revised statement (26 April 2020): Guidance on the safe use of Laser & Energy Based Devices taking into consideration COVID-19/SARS-CoV-2
- Article published in the AJD (Aug 2020) Guidance on infection control and plume management with Laser and Energy-Based Devices taking into consideration COVID-19 (Sullivan JR et al).
Dermatological manifestations of COVID-19
A factsheet on Dermatological Manifestations of COVID-19 and a visual guide to skin signs associated with COVID-19 including a one page summary have been developed. These aim to inform Fellows of current evidence and prepare for patients presenting with cutaneous eruptions which are secondary to COVID-19 infection.
College has developed guidance on the COVID-19-related management of pernio / chilblains.
Business Operations and Considerations
During these challenging times, College remains cognisant of the financial impact on many practices COVID-19 has presented. To provide assistance, we have sought third party advice from our current auditor, William Buck. The information has been provided without charge and is high level and general in nature. It provides guidance for Fellows on government subsidies and other financial matters.
College strongly recommends Fellows seek specific guidance from their own accountants, advisers and indemnity groups who can tailor advice to their particular practice, financial position and business model.
William Buck COVID-19 Resource Centre
William Buck invites members to explore and utilise their website resources, specifically curated with business owners and operators in mind.
The resources cover a number of important topic areas including:
- Accessing government subsidies
- Preparing business continuity plans
- Reviewing your tax obligations
- Access to regularly update FAQ page specific for COVID-19
To view these resources, visit: https://www.williambuck.com/covid-19-and-your-business/
LiquidHR Webinar for Employers and Business Owners
College’s HR consultant, LiquidHR, have produced a webinar for members called “Practical advice for employers navigating downturns and government orders to close”.
Click here to view (members only): Practical advice for employers navigating downturns and government orders to close
The following information has been developed to assist in your decision making about your practice set-up and operations. Topics include:
- Signage in and around your practice
- Reception desk organisation
- Hand sanitiser
- Waiting room set-up
- Inside doctor’s rooms
- Personal protective equipment (PPE)
- Cleaning your practice
- Staff reminders
Prolonged use of masks and goggles can cause adverse skin reactions such as acne, contact dermatitis and pressure effects as well as exacerbating any underlying skin conditions. Here are some tips for you and your patients to avoid skin problems:
This resource covers off a number of areas to think about relating to management of staff and practice management. Topics include:
- Managing staff illness and a COVID-19 safe working environment
- Staff contact with a potential or confirmed COVID-19 case
- Close contact but while using PPE, and PPE reuse
- COVID-19 case definition
- Staff entitlements in event of self, staff forced, government or practice mandated isolation
- Staffing levels and reducing hours
- Staff working from home/remotely
- Australian Government Support for businesses and employees
Clinical Service Provision
The following information has been developed to assist in your decision making about providing care to patients. Topics include:
- Continuity of care
- Letters and referrals
- Immunosuppressive and biologic medications
- Your role as an advocate
The US Centers for Disease Control and Prevention has released interim guidance which aims to advice US clinicians on when it is safe to discontinue transmission-based precautions for patients with confirmed COVID-19, as determined by either a test-based, symptom-based or time-based strategy. Please note that this guidance is subject to frequent review of evidence.
Patients taking immunosuppressive agents or biologics
- For guidance on the management of patients on immunomodulators for cutaneous disease, including biologic agents and new small molecular inhibitors, view the Australian and New Zealand consensus statement published on 9 April 2020 in the Australasian Journal of Dermatology.
- College has released two factsheets:
- The American Academy of Dermatology has released Guidance on the use of biologic agents during COVID-19 outbreak.
- Refer to the Department of Health’s definition of people at risk for serious illness from COVID-19, which includes biologics and most disease-modifying anti-rheumatic drugs (DMARDs).
COVID-19 Dermatology Registries
International Collaboration and Rapid Harmonization across Dermatologic COVID-19 Registries | Journal of the American Academy of Dermatology | Published 17 June 2020
Federal Government Links
Department of Health | COVID-19 Health Alert – daily update
Department of Health | Definition of people at risk for serious illness from COVID-19
MBS Online | COVID-19 Teleheath
Therapeutic Goods Administration | COVID-19: Information on medicines and medical devices
Pharmaceutical Benefits Scheme | Restriction requirement exemptions for some medicines during COVID 19