The National COVID-19 Clinical Evidence Taskforce is a coalition of 32 peak health organisations who came together in March 2020 to provide Australian clinicians with evidence-based clinical recommendations for the care of people with COVID-19.
The Taskforce’s living recommendations are developed using rigorous methods by 250 of Australia’s leading clinical experts and approved with 100% consensus by the 32 member organisations. The Taskforce undertakes daily global evidence surveillance and updates recommendations as new and reliable evidence emerges.
This is a world-first living guideline for the treatment of COVID-19, providing a single, accessible source of consistent, evidence-based guidance at a time of great uncertainty.
We’ve prepared this explainer to help consumers better understand treatment options for the different stages of the disease—mild, moderate and severe.
If you test positive, you must self-isolate at home. Your local public health service will contact you with advice and information about how long you’ll need to do so.
If you are like most people with COVID-19, you won’t need to go to a clinic or hospital, and can safely self-manage the illness at home. Even so, it’s important to connect with an appropriate health-care service (either by contacting a dedicated COVID-19 service or by calling your GP) for an initial assessment and continuing contact throughout your illness.
Initially, you may experience flu-like symptoms such as cough, sore throat, fever, aches, pains and headache. You might temporarily lose your sense of smell and taste; less common symptoms include nausea, vomiting and diarrhoea. Whatever your symptoms, you’ll need plenty of rest, fluids and paracetamol for aches, pains or fever.
Take particular note of how you’re feeling from day five onwards, as this is the time some people begin to deteriorate significantly. Around 20% of people fall into this category, with older people and those with particular pre-existing health conditions more likely to require hospitalisation. Watch out for intense fatigue, difficulty breathing or an overall deterioration in how you’re feeling.
If your symptoms worsen, you’ll need to contact your care provider, or if your symptoms are very serious (such as difficulty breathing), call 000 and ask for an ambulance, and don’t forget to tell them you have COVID-19.
If you are taken to hospital, doctors will measure your oxygen levels and perform a chest X-ray and blood tests to determine whether you have pneumonia (infection in the lungs, which is a sign of moderate or severe COVID-19). If pneumonia, low oxygen levels or other signs of severe infection are detected, you’ll need to stay in hospital and will probably be given oxygen.
If this is the case, you’ll also be given a strong anti-inflammatory medicine called dexamethasone. This is a widely used, low-cost drug that was recently found to reduce the risk of dying from COVID-19 (by 15% for people on oxygen and by about a third for people on a ventilator). However, for people who are not on oxygen, dexamethasone may increase the risk of death — probably because inflammation is not such a big factor at that stage of disease — and the side-effects of dexamethasone would outweigh any potential benefit to those patients.
Because inflammation increases in patients who are unwell, three medicines – tocilizumab, sarilumab and bariticinib – have been shown to dampen the immune response and decrease the risk of dying in people with more severe disease. In addition, a newer antiviral medicine called remdesivir, which was originally developed to treat Ebola, has been shown to reduce the time to recover from more severe forms of COVID-19 — but not to reduce the risk of dying from the disease.
If you become even more unwell, these treatments will continue but you may need more support for breathing, such as high-flow oxygen or a ventilator, and will likely be cared for in an intensive care unit.
The Taskforce has developed specific recommendations on disease-modifying treatments and respiratory support for the care of children and adolescents, and pregnant, breastfeeding and postpartum women.
We are continually working on updating all recommendations to reflect special populations.
Currently, treatment is the same regardless of the variant.
Vaccination substantially reduces the likelihood of infection, and particularly of developing severe illness. However, while the chance is much lower, it is still possible for a vaccinated person to become infected and develop symptoms requiring treatment in hospital.
Your recovery depends on many factors, including your previous health and fitness, and how sick you became with COVID-19.
Most people recover fully, however some people have ongoing symptoms. Post-acute COVID-19 or ‘long COVID’, describes the variety of symptoms that may arise in the weeks or months following acute COVID-19. A range of longer lasting symptoms have been reported in both adults and children, and it is not yet clear what determines who will develop these ongoing symptoms.
Our understanding of risk of the illness and effective management approaches is still emerging. However, many of the symptoms reported in post-acute COVID-19 have common features with symptoms that are regularly managed in primary care.
Our Care of Post-Acute COVID-19 flowchart lists the symptoms and signs that have been described post acute COVID-19 infection as well as recommendations for assessment and management.
There are many research studies underway, and it’s likely that some of these will help identify effective treatments in the coming months. We will update the guidelines as new and reliable evidence becomes available.
Access the Taskforce clinical guidelines and flowcharts: www.clinicalevidence.net.au