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Communique

Weekly Communique #31

12 November, 2020

WEEK IN REVIEW

IPC Panel EOI for paediatric and clinical engineering expertise

The Taskforce is calling for Expressions of Interest from suitably qualified individuals with paediatric or clinical engineering expertise to join the newly established Infection Prevention and Control (IPC) Panel, a collaboration between the Taskforce and the Infection Control Expert Group (ICEG).

Please note, applications for other sub-specialty positions have closed.

Please click here to view the Expression of Interest, which outlines the role of IPC Panel members, key selection criteria and the application process.

Expressions of interest close Thursday 19 November 2020.

Congratulations to Taskforce contributor Joshua Vogel

Deputy Chair of the Taskforce Guidelines Leadership Group and Methods Chair of the Pregnancy and Postpartum Care Panel, A/Prof Joshua Vogel was this week awarded the 2020 Nature Research Award for Driving Global Impact (DGI) for his outstanding body of work in maternal and child health, including research focused on the prevention of newborn deaths due to premature births in low and middle-income countries. Read more here.

Joshua also led the recent publication of a Taskforce paper on the Clinical care of pregnant and postpartum women with COVID-19: Living recommendations from the National COVID‐19 Clinical Evidence Taskforce in the Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG). Read here.

HAVE YOU USED OUR GUIDANCE?

The Taskforce is interested in understanding how our guidance is being used. Dr Tari Turner has been conducting interviews with clinicians across all disciplines and is now seeking particular feedback from infectious diseases physicians and critical care and/or emergency practitioners.

If you have recommendations of good examples of the use of our guidance, or people we should talk to about how our guidance is being used, please email [email protected]

 


QUICK STATISTICS

COVID-19 research pipeline

  • 29,110 studies published or registered in Cochrane COVID-19 Study Register, 957 added this week
  • 2,051 randomised controlled trials registered (data from Covid-nma site), 72 added this week
  • 2,524 systematic reviews registered in PROSPERO, 49 added this week
  • 115 randomised controlled trials published (data from Covid-nma site), 3 added this week

 


LIVING GUIDELINES

Australian guidelines for the clinical care of people with COVID-19: Version 28.1

NEW RECOMMENDATIONS

  • No new recommendations this week

UPDATES TO EXISTING GUIDANCE

  • Remdesivir for adults hospitalised with COVID-19 who require ventilation

Updated wording to reflect that the strong recommendation against remdesivir for adults hospitalised with COVID-19 who require ventilation relates to the commencement of treatment in this patient group:

Do not start remdesivir in adults hospitalised with COVID-19 who require ventilation.

Remdesivir should be continued with the appropriate dose and duration, if it was started prior to requiring ventilation. Within this population, ventilation includes invasive or non-invasive mechanical ventilation and extracorporeal membrane oxygenation (ECMO).Use of remdesivir may still be considered in the context of randomised trials with appropriate ethical approval, such as combination therapies that include remdesivir.

  • New section text information

Text has been added to each section in our online guideline platform MAGICApp to indicate which panel is the primary panel for the development of the recommendations within that section.

The Taskforce is continually monitoring research to update recommendations weekly as new evidence accumulates.

 


CLINICAL FLOWCHARTS

10 clinical flowcharts have been developed by the Taskforce to cover:

  • Assessment for suspected COVID-19
  • Management of adults with mild COVID-19 UPDATED
  • Management of adults with moderate to severe COVID-19 UPDATED
  • Management of adults with severe to critical COVID-19 UPDATED
  • Respiratory support for adults with severe to critical COVID-19
  • Management of people with COVID-19 who are older and living with frailty and/or cognitive impairment
  • Management of people with COVID-19 who are receiving palliative care
  • Preparedness for CPR during the COVID-19 pandemic
  • CPR for adults with COVID-19 in healthcare settings
  • Basic life support for adults in the community during the pandemic

Changes to the flowcharts this week include:

  • Management of adults with mild COVID-19:
    • evaluation of the home care setting to include the capacity for strict infection prevention and control
    • in people with suspected or confirmed COVID-19, the use of other treatments such as insulin, other diabetes medications, or statins should continue as usual.
  • Updated text changes to remdesivir recommendation

EVIDENCE UNDER REVIEW

We are currently reviewing evidence to develop recommendations and flowcharts to guide practice in areas including:

  • Immunoglobulin vs standard care NEW
  • Hydroxychloroquine vs standard care UPDATE
  • Remdesivir for children and adolescents
  • Care of people recovering from COVID-19/Post-viral syndrome
  • Oestrogen-containing therapies

 


NEWS & EVENTS

Cochrane

Cochrane has published a new review this week: Interventions to support the resilience and mental health of frontline health and social care professionals during and after a disease outbreak, epidemic or pandemic: a mixed methods systematic review. Read here.

The full list of Cochrane Reviews and related content from the Cochrane Library can be found here.

ANZ Guideline Network

The ANZ Guidelines International Network are hosting a webinar to discuss the collaboration to support healthcare for First Nations people during the COVID-19 pandemic.
Topic:First nations-led guideline development – supporting prevention and management COVID-19 in primary healthcare
Date:Friday, 27 November 2020
Time: 11am-12pm AEDT
Speakers: A/Prof Catherine Chamberlain, NHMRC Career fellow, Editor of NHMRC’s Guidelines for Guidelines module: Engaging Aboriginal and Torres Strait Islander people in guideline development; Dr Jason Agostino, Medical advisor to NACCHO; Professor Peter O’Mara, Chair, RACGP Aboriginal and Torres Strait Islander Health.

 


NEW TOPICS AND QUESTIONS

It is a core mission of the Taskforce to engage with frontline clinicians to rapidly identify and address priority clinical questions.

Each week we collect suggestions for new clinical questions or topics for consideration by the Taskforce. A document that lists all of the suggested questions, topics and new patient groups that we have received to date is available here.

Please encourage your clinical colleagues to provide their insights via the website.

Topics