23 March 2021

Dear colleagues,

There has been coverage recently about the increasing cases of positive COVID-19 tests for people in hotel quarantine.  As you would be aware, the Australian Government is committed to supporting the repatriation of Australian residents who have been living overseas.  Many of these people are either coming from or transiting through places with a high incidence of COVID.

For the past four to five months, we have been caring for around 6 – 16 COVID positive patients at any time, but this number has recently grown to closer to 30 patients at once and is expected to increase further in the coming weeks.

In order to ensure that Queensland is fully prepared to play our part in safely welcoming these Australians home, in addition to our airport and hotel quarantine roles, Metro North Health is one of two Hospital and Health Services in South East Queensland establishing low-density COVID wards at our facilities to safely and effectively care for people who test positive while in hotel quarantine.

To create capacity to do this, we are standing up 30 non-COVID subacute beds at STARS.  This will ensure that we retain capacity to care for Queenslanders as well as caring for returning Australians.

Thank you to all the teams involved in this effort, which allows us to continue supporting the directions of the Chief Health Officer.

Vaccination update – access

Thank you to everyone who has received the COVID vaccine to date. As at close of business yesterday, we had administered 7953 vaccines across clinics at STARS, RBWH, TPCH, Redcliffe Hospital, Caboolture Hospital and COH (Brighton Health Campus).

We are continuing to provide a significant number of vaccinations each day for external priority frontline workers, including hotel quarantine and airport staff, Australian Border Force, Queensland Police Service, and Queensland Ambulance Service.

Whilst staff members (including volunteers, students, mental health NGOs etc.) that have direct patient contact can currently book/present for vaccination, please note that priority will be given to Phase 1a staff who present.

Earlier this week, the Therapeutic Goods Administration (TGA) approved the Australian manufacture of the AstraZeneca COVID vaccine and today approved the release of the first four batches – that is over 800 000 doses!!!.  Now that production is up and running, we anticipate a good steady supply in the coming months.  This means we expect to be offering vaccines to non-patient facing staff by the end of March, with a wholesome staff access program from around 6 April.

As we complete vaccinating our staff, we will move to commence administering vaccines for known patients in our chronic disease services and to opportunistic inpatient vaccination.

Vaccination update – reporting and feedback

For those staff who have already received your first vaccine dose, there are a range of opportunities to provide reporting and/or feedback relating to side effects.

Reporting can be undertaken by any one of the below ways.

1. You can report adverse events to your QH vaccination clinic health professional and ask them to report on their behalf.  Under the Public Health Act 2005 and the COVID-19 Vaccination Code, vaccine service providers are required to report any adverse events following immunisation directly to Queensland Health.  Reporting by vaccination clinic health professionals is via the COVID-19 AEFI Portal. You must be a health professional working in one of our vaccination clinics to make a report.
2. You can report adverse events to your Non-QH health provider and ask them to report on your behalf.  These health providers provide a report using the COVID-19 AEFI PDF form.
3. You can submit a report directly to the TGA. See tga.gov.au/reporting-problems for more details.  This can be either directly to the TGA (via online form or email)

Separately, there is also an opportunity to provide feedback regarding your vaccination experience, including milder side effects via the Queensland Health supported “vaxtracker’ survey. I did speak about this today in the Vidcast.  At this time, the only opportunity to participate in this survey is to register at the time of your vaccination (as the QR code for your vaccine changes daily in each clinic and depends upon the ‘batch number’ of the vaccine you received.  We display this QR code in the surveillance area of each of our vaccination clinics to enable you to participate.

In the short–term, we will enable the function to automatically invite you to participate in this survey (with your consent gained at the time of vaccination) so that you do not have to scan the QR code.  You can ‘opt out’ at any time from the survey.

Vaccination update – adverse reactions

On today’s Vidcast there were several questions about adverse reactions.  The evidence shows that this is a small portion of the total number of people worldwide (about 17 million) who have received a COVID vaccine to date.  This is good news, but it’s essential that you wait in the observation area after your vaccine to be monitored, and you remain vigilant over the days following your vaccination.

As with many other vaccines, it is common to experience mild to moderate side effects such as headache, fatigue, muscle aches and chills/fevers.  Staff are encouraged to treat these symptoms with simple analgesia and rest as required.  Most side effects will resolve within one or two days.  It is not necessary to have a COVID-19 swab for these mild transient symptoms experienced in the first 48 hrs after a vaccination – however, if symptoms persist, then you should present for testing.  Any severe or persistent side effects should be reported to your vaccine provider.

Around 300 staff have self-identified so far as having a history of allergy, anaphylaxis or other relevant condition that requires further assessment before vaccination.  This group will be contacted in the coming weeks to triage to one of our supervised clinics, or referral to the specialist adult vaccination service.  I thank you all for being patient whilst we are establishing and maturing this screening and referral service.  If you haven’t been contacted before Easter, please escalate through your supervisor to your EOC and we will escalate your case for management.

There are lots of questions about possible links with blood clots.  I would like to draw your attention to ongoing work by the TGA, the European Medicines Agency (EMA) and the UK Medicines and Healthcare products Regulatory Agency.  Recent preliminary reviews of risk of blood clots in people vaccinated with the AstraZeneca COVID-19 vaccine have found that the vaccine is not associated with an increase in the overall risk of blood clots. Read more. The TGA advises that people in Australia should continue to get the AstraZeneca vaccine when eligible.

Thank you all for your patience and eagerness to participate in the vaccination program.

Regards,

Dr Liz Rushbrook
Metro North Incident Controller

Metro North HHS – overview of cases*

HHS	Patients being managed by HHS						FEVER Clinics
	Total In-patients			Virtual Ward / HITH / or similar	Deaths **	Total cases managed by HHS (including recovered) ***	# of clinics	Presentations
		ICU Pts
		ICU-NOT Ventilated	ICU-Ventilated					Last 24 hrs	TOTAL^
MN TOTAL	29	0	0	0	3	491	5	251	151,079

* As at 23/03/2021  1200
** Metro North Health has three recorded deaths (one person a return traveller into NSW, who passed away in NSW)
*** These numbers reflect the cases being managed by Metro North.