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07/May/2020

In the last couple of weeks pop-up and drive through testing centres for COVID-19 have been appearing in places like shopping centre carparks, town halls and community centres.

Testing in Australia has now been expanded to include anyone with COVID-19 symptoms. At the beginning of the pandemic we were focused on mainly testing people who’d been overseas, on cruise ships or had been in direct contact with someone diagnosed with the virus.

Now focus has moved to community transmission. This is when someone develops COVID-19 for no obvious reasons. They’ve not been overseas or in contact with someone with the virus…that they know about.

Symptoms

As we know some people may have the virus without having obvious or severe symptoms. If they’re out and about they may unwittingly spread this highly infectious virus to others.
That’s why testing is being broadened to anyone who has symptoms such as:

  • fever, chills or sweats
  • cough
  • sore throat
  • shortness of breath
  • runny nose
  • loss of sense of smell.

For more information about symptoms and to see if you or someone you care for may have the virus, use the healthdirect Coronavirus (COVID-19) Symptom Checker. Answer a few simple questions to find out if you need to seek medical help or be tested. Or call the National Coronavirus Helpline on 1800 020 080, 24 hours a day, seven days a week.

It’s important to be aware that there are currently some slight differences in the testing criteria for states and territories.

For example Victoria has started a two week testing blitz. As well as people with symptoms, some people can be tested even if they don’t have symptoms. This includes people with chronic conditions, Aboriginal and Torres Strait Islanders and people who can’t work from home (including healthcare workers, police, construction workers).

Visit your state/territory health website for information about testing criteria relevant to where you live or call the National Coronavirus Helpline on 1800 020 080.

So what are the tests and how do they work?

First, it’s important to note that all tests for COVID-19 are performed by health professionals. You may have seen information about home tests on social media. In Australia it’s illegal for anyone to sell a home testing kit and claim that you can test yourself for COVID-19. Supply of these kits is also prohibited under the Therapeutic Goods (Excluded Purposes) Specification 2010. Testing for COVID-19 is complicated and requires the specialised knowledge and training of health professionals. As well as the actual testing and interpretation of results, they’re also able to give you expert information and support. So if you see these home tests advertised, ignore them.

The main test currently used for COVID-19 is a swab test.

A swab (similar to a long cotton bud) is inserted into your nose or back of your throat to collect fluid and cells. Once the sample has been collected it’s sent to a lab for testing.

At the lab, technicians will look for genetic material from the virus. They will then send the result to the health professional who took the sample. This usually takes between 1-3 days. You’ll be contacted with the results – whether you have the virus or not.

The swab test can only tell you if you have an ongoing infection, it can’t tell if you’ve had COVID-19 in the past.

While this test is considered to be very accurate, especially in a laboratory setting, there can be errors. People may be told they aren’t infected when they are. This is called a false negative. It can happen if a sample hasn’t been taken correctly or if the virus hasn’t replicated in your body to a level that can be detected. There’s also the possibility of a false positive, when a person has been told they have the virus, but they don’t. This can happen if the sample becomes contaminated in the lab. However these are not common occurances.

Another test that may be used in some situations looks for antibodies in your blood. If you have the virus, your body will create antibodies to fight it. The blood test will look for this. However it takes time for your body to create antibodies, so you may have already recovered from the virus before antibodies appear. So this test can’t tell you if you still have the virus, or when you may have had it – only that you have had it.

Testing as we go forward

As well as testing for COVID-19 in people who have symptoms or suspect they may have the virus, testing may begin to be carried out on the community at random.

Called sentinel testing or sentinel surveillance this mode of testing will look for cases of COVID-19 in people that aren’t displaying symptoms.

It’s likely that sentinel testing will be happening in the near future as we begin to relax restrictions. We just have to wait to hear from the Federal Government as to how and when it’ll happen.

For more info, read What is sentinel surveillance and how might it help in the fight against coronavirus? 

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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28/Apr/2020

Australia’s new contact tracing app

The Federal Government has launched COVIDSafe, an app designed to help health authorities track people who’ve been in contact with others infected with COVID-19. Within a few hours of its launch over a million Australians had downloaded it.

So what is COVIDSafe and how will it work?

COVIDSafe is a contact tracing app. It aims to enhance the tracing we do manually – which requires people to remember exactly where they’ve been and who they’ve been in contact with. This obviously has some limitations when it comes to accuracy and how quickly it can track down people.

COVIDSafe is an app you have on your phone, something most of us are never without 😊. It’s a voluntary system so you choose whether or not to use it.

If you decide to opt-in, you’ll need to download it from Google Play or the App Store and agree to the terms. You’re then asked to enter:

  • your name (or fake name if you prefer) – so the relevant health officials can confirm they’re speaking to the right person if they need to contact you
  • your age range – so health officials can prioritise cases for contact tracing if needed
  • postcode – to make sure health officials from the right State or Territory who work in your area can contact you, and to prioritise cases for contact tracing, e.g. hotspots
  • phone number – so that you can be contacted if needed for contact tracing.

Once it’s installed on your phone the app will look for other phones nearby that also have the app installed. If you’re within 1.5 metres of someone (who also has the app) for 15 minutes or more, the app will give the other phone a ‘digital handshake’, taking note of the date and time, distance and duration of the contact.

COVIDSafe will then store this data in an encrypted format on your phone. It’ll stay there for 21 days – to allow for the longest incubation period of the virus (14 days) plus the time needed to confirm a positive test result. After 21 days the data will automatically be deleted.

If you test positive to COVID-19, you’ll be contacted by your state or territory health officials. They’ll ask you to upload the app data to the central server. If you agree, you hit the upload button on the app and the encrypted data will be uploaded. The info will then be used to track people you’ve been in contact with so they can be tested. The contacts uploaded to the database are only those encrypted in the app on your phone – not your personal contacts – unless they’ve been in close contact with you (e.g. people you live with).

Why does the government want us to opt-in?

We’re flattening the curve – yay for us! While this is great news we need to remember that most of us haven’t been in contact with the virus and are still susceptible to it, especially those of us who have chronic conditions, are older or have suppressed immune systems.

Our physical distancing measures have allowed our healthcare system to become better prepared for COVID-19 and (hopefully) not become overwhelmed by a lot of very sick people at once – as we’ve seen in other parts of the world. But it means that most of us are still vulnerable to this very infectious virus.

Knowing if you’ve been in contact with someone with the virus means you can be proactive and get tested, look after your family, isolate and prevent further spread. That’s the aim of this app.

But what about my privacy?

Understandably people are worried about their privacy and the security of their data.

So before downloading the app, it’s worth considering how much of our privacy we are willing to trade-off in order to achieve a potential public benefit.

Peoples level of comfort with this will differ with some people willing to download the app on its release while others will want more assurances and information before they utilise the app.

What you should know

First – it’s important to know that if you do opt-in you can uninstall COVIDSafe from your phone at any time. This will automatically delete all the information stored on your device and stop other users from collecting your contact data.

The design specifications and the functionality of COVIDSafe have not been independently analysed. Although the government has announced it will release the source code within two weeks for people to test.

Laws are being drafted to protect the use of your data on the COVIDSafe app. The government has stated that our information will only be used for the reasons of contact tracing and that strict laws will be introduced to govern the use of the information that COVIDSafe collects. But the Law Council of Australia expressed some concerns that the laws underpinning the legality of the app makes no provision for oversight and reporting on the use of this data ¹. The legislation concerning COVIDSafe will be introduced in May when Parliament resumes so we’ll have to wait and see what’s proposed.

The data collected by the COVIDSafe app will be stored by Amazon Web Services, a US company. This means that the Australian data they collect may be bound by US law enforcement (under a 2018 law) that allows them to obtain information held by US-registered data companies no matter where the data is held ².

What happens after the pandemic

When this is all over (can’t wait for all that happy dancing and partying!) everyone who has the app will be prompted to delete it. This will also delete all the app info from your phone. The information contained in the central server will also be destroyed at the end of the pandemic. However it’s unclear to predict when this will happen given the uncertainties surrounding the spread of the virus.

It’s not a magic bullet

As much as we’d like a quick fix, COVIDSafe isn’t a magic bullet. It’s just another tool to help us manage our way through this pandemic. It will work alongside the physical distancing, good hygiene, testing and the manual tracing we’re already doing.

COVIDSafe may help us end restrictions earlier and be proactive when it comes to testing and isolating if it lets you know if/when you’ve been in contact with the virus.

However at the end of the day, it’s important that we all ask questions, review the information provided by the government about the app and our privacy (even all the nitty gritty) and make our own decisions about whether we download the app.

We will get through this pandemic, it will just take some time – so stay safe, stay informed and be kind.

Contact our free national Help Line

Our nurses are available weekdays between 9am-5pm to take your calls (1800 263 265), emails (helpline@msk.org.au) or messages via Messenger. So if you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain or accessing services – contact them today.

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16/Apr/2020

Exercise is vital to our health, even while we’re in iso. It helps us manage our pain, our musculoskeletal conditions, our weight (especially with all the cooking we’re suddenly doing 😆) and our mental wellbeing.

But when you’re not able to go to your usual exercise classes, gym, sporting club or fitness centre – online videos and exercise apps seem like the answer. And with most of us in some form of isolation or quarantine, there’s been a proliferation of them being shared on social media and across the internet in general.

But they’re not all created equal. Some are purely videos to watch and follow, others are apps that provide more interaction and features. Some are free, while others require payment.

So before you pull on your leotard, buy a new thingamajig or sign up to that app, here are some things to think about:

  • What are the qualifications of the leader? Are they a qualified exercise professional – e.g. physiotherapist, exercise physiologist, fitness instructor? With many fitness and wellness centres closed because of COVID-19 many qualified instructors have moved online. This is great news (for us) as there’s only so much walking we can do. But there are also lots of well-meaning people with time on their hands posting exercise videos, as well as other people looking to make a quick buck. So make sure that the instructor is qualified to teach or lead exercise classes.
  • Are they catering to the general public or people with musculoskeletal conditions? Many general exercise videos or apps will be useful for all of us – musculoskeletal condition or not – especially if they’re gentle. But there are some exercises that may actually be harmful to you. And some that you shouldn’t try without a proper assessment from a qualified instructor as well as guidance to ensure you’re actually doing the exercise properly. To misquote the tagline from Alien – “in your lounge room, no one can hear you scream”…except for the other people in your household, your pets and the neighbours (the walls are thinner than you think!). The point is it can be very easy to hurt yourself if you’re not shown how to do some exercises correctly and safely, particularly if you have a musculoskeletal condition or another health issue.
  • Which leads to our next point – can you ask questions or get more info from the instructor? If you can, it gives you the ability to ask if they’ve instructed other people with your condition, make sure the exercises are safe for you to do, and get advice if you’re not quite sure you’re doing things correctly. If you can’t interact with them in any way, maybe look for another online exercise class/video/app.
  • What’s the cost? Is it free, or is there a fee? Or can you access a free basic version, and another version with additional features which you need to pay for? Is there a free trial period so you can make sure you actually like it? And if you do have to sign-up for anything, make sure you read all the fine print so you know exactly what you’re agreeing to.
  • Does your equipment support the tech? If you’re downloading an app, can your desktop, tablet, phone, watch etc handle it? Do you need to download additional software to use it? Are you prepared and/or able to do that?
  • Are you set up for it? Is your computer in a location that allows you room to exercise? If you only have a smartphone or tablet, can you view the exercise videos clearly? Is your internet able to cope with any downloads or streaming? If the answer to any of these is no, maybe look at alternatives formats such as DVDs. And with DVDs ask yourself all of these questions as well. There are a lot of good exercise DVDs and a lot of variety as far as types of exercise, but there are also a lot of dodgy ones. So take time to evaluate them carefully.
  • Is the exercise something you enjoy doing? If you don’t enjoy doing it, you’re unlikely to continue to do it. So find something that you find fun, engaging, challenging and enjoyable.
  • Can you set goals for yourself? Exercise needs to challenge you so you continue to get the health benefits. If it’s too easy, or doesn’t progress over time, you won’t see any improvements. Setting yourself SMART goals – Specific, Measureable, Achievable, Realistic and Timed – can help with this. Find out how you can create SMART goals.

There are a lot of things you can do to remain active during this pandemic and stay safe. Check out our blog about exercising during the pandemic. It has a range of different things you can do to stay active while isolated.

For more information, visit our website or call our MSK Help line weekdays on 1800 263 265. Or email helpline@msk.org.au.

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01/Apr/2020

This blog was updated 17 July 2020 in response to changes to telehealth. 

“From July 20, telehealth GP providers will be required to have an existing and continuous relationship with a patient in order to provide telehealth services.

This will ensure patients continue to receive quality, ongoing care from a GP who knows their medical history and needs.

A relationship is defined as the patient having seen the same practitioner for a face-to-face service in the last 12 months, or having seen a doctor at the same practice for a face-to-face service during the same period.

In areas under stage three restrictions in Victoria, this requirement will not apply to those living under new restrictions in Victoria.” (1)

Read the full media release from Greg Hunt, Minister for Heath, for more information.

And read the rest of our blog for more info on telehealth – what it is, how it works and the costs (if any) involved.

“We’re not in Kansas anymore Toto. Welcome to our brave new world”.

OK, so I’ve mixed my classic Hollywood movie and a classic Huxley novel, but we really are in unchartered waters!

At the end of March 2020 the Federal Government announced that telehealth would be available for everyone. It’s one of the many measures the government is introducing, to enforce physical distancing and slow down the spread of the virus.

So what is telehealth and how does it work? 🤔

Simply put telehealth enables you to consult with your health professional over the phone or through a videoconferencing app (e.g. Zoom, FaceTime, WhatsApp).

Depending on the technology you have available, and how comfortable you are using it, you might have a conversation over your phone with your doctor (like any other phone call), or you may interact face-to-face through a videoconferencing app.

Don’t worry though – if you’re only comfortable talking on your phone, that’s fine. You don’t have to download apps and learn how to use them. But if you’re interested, they’re easy to use. They just take a little practice.

Will I have to pay more for telehealth?

It depends. The Health Department has recently made some changes around telehealth.

From 6 April 2020 telehealth services must be bulk billed for “Commonwealth concession card holders, children under 16 years old and patients who are more vulnerable to COVID-19”. (2)

The good news is that ‘vulnerable’ includes people being treated for a chronic condition and people who are immune-compromised. For all other patients, health professionals may set their own fees for the new temporary MBS telehealth items.

Confused? You’re not alone! Read this fact sheet (PDF) from the Department to find out more: COVID-19 Telehealth Services: Consumer Factsheet, Last updated: 8 May 2020

With any new system we need time to adjust

As many of us have discovered as we’ve started working, schooling and just trying to entertain ourselves at home, there may be some teething issues.

If you’re calling over the phone you’ll need to adjust to not seeing your doctor face to face; if you’re using an app you’ll need time to adjust to using new technology.

And if you’re using an app you may also experience slower internet speeds, which may affect your consultation. This is more likely to happen during busy times when everyone’s trying to get online (streaming their favourite shows, catching up with friends, watching cat videos).

As with any appointment, there can also be issues with time. Your health professional may be running late, they could be having tech issues, other patients needing more time, a medical emergency, or because they’re human and also need to adjust to working from home. You may be running late too. So it’s vital we all try to be patient, and give ourselves and others some leeway as we navigate this new ‘normal’.

But we can make it easier

We’ve identified these potential issues not to freak you out, but to prepare you. So here are our top tips to telehealth harmony.

Be patient – if your doctor is running late, if your internet is slow, if your appointment is rescheduled due to an emergency, be patient. This can be really hard to do when you’re unwell or in pain. You can feel vulnerable and worried, and being stuck at home can be frustrating. But becoming impatient won’t change the situation and will only make you feel worse – both physically and emotionally. Make a cuppa, read a book, do a crossword, talk with your partner/cat/dog/kids – distract yourself while you wait.

However if you have chest pain or difficult breathing, or have a medical emergency, call 000 immediately.

Don’t wait for your telehealth appointment.

Be prepared – before your appointment, make a list of the things you want to discuss with your doctor. Put them in order from the most important to the least. That way you won’t finish your consultation and then kick yourself for not asking X. Also – be aware that your appointment may end earlier than you anticipate if there’s a tech issue or an emergency. So lead with your most pressing questions or concerns, and if you have time, follow with the ones that are less important.

Be kind – our health professionals are doing the very best they can, often under very stressful, trying circumstances. They’re our frontline during this crisis, so please be kind to them. And be kind to yourself. You’re learning new technology or new ways to do things and just trying to stay sane during an insane time – recognise that you’re also doing the best you can. So hang in there.

Talk with someone who cares

Call the National MSK Help Line – our nurses are available weekdays from 9am to 5pm on 1800 263 265 or you can email helpline@msk.org.au. They can help you with info and support about musculoskeletal conditions, managing pain, treatments, accessing services, COVID-19 and much more.

Call the National Coronavirus Helpline – if you want information on coronavirus (COVID-19). It’s available 24 hours a day, seven days a week on 1800 020 080.

More to explore

Expert advice matters
Royal Australian College of General Practitioners
This new website from the RACGP provides information on the importance of continuing to see your GP – especially if you live with a chronic condition or you develop new symptoms or illnesses. It also provides lots of useful info about telehealth.

What is telehealth and is it right for you? 
NHMRC Partnership Centre for Health System Sustainability, March 2020
This guide explains the basics of telehealth and describes how to find telehealth services. 

Attending a video consultation 
NHMRC Partnership Centre for Health System Sustainability, March 2020
This guide explains how you should prepare so you can get the best out of your video consultation.

What can you use a telehealth consult for and when should you physically visit your GP?
The Conversation, 1 April 2020
Some info to help you work out when you should or shouldn’t use telehealth, with a handy infographic to clarify it even further.

References

(1) Continuous care with telehealth stage seven
Australian Government, Department of Health, 10 July 2020

(2) COVID-19 telehealth services: Consumer fact sheet
Australian Government, Department of Health, 8 May 2020




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