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  3. Managing Pain and COVID-19

Daily Update

Coronavirus (COVID-19) updates

  • Therapeutic Goods Administration has updated advice for health professionals on the shortage of tocilizumab (Actemra) to advise the urgent conservation of intravenous forms for treatment of hospitalised COVID-19 patients. A new substitution instrument has been put into place to enable timely dispensing of the medication when in stock. Read more here: Tocilizumab (Actemra) Serious Scarcity Substitution Instrument | Therapeutic Goods Administration (TGA)

  • Due to the Covid-19 Pandemic the TGA has alerted health professionals that there is a shortage of tocilizumab (Actemra). If you are a health professional you can read the following guidelines to manage the shortages. https://buff.ly/3lFFG8w These shortages may affect patients with:

- rheumatoid arthritis
- polyarticular juvenile idiopathic arthritis
- systemic juvenile idiopathic arthritis
- giant cell arteritis
- cytokine release syndrome

  • WHO’s Dr Kate O’Brien busts some vaccine myths related to infertility, DNA and composition of vaccines in this week’s Science in 5. https://www.youtube.com/watch?v=B-aaVh0BQSw&feature=youtu.be

  • Why are there so many vaccines in development and what are the different types? https://www.who.int/news-room/feature-stories/detail/the-race-for-a-covid-19-vaccine-explained

  • As we learn about the long-term effects of COVID-19, doctors have found a crossover with fibromyalgia and other chronic pain conditions https://buff.ly/3mnnii4

  • Find out what the different tests are, when they should be used and how to interpret the results in this new Australian Prescriber article on testing for #COVID19 https://buff.ly/3jZr2pb

  • If our finding that the new coronavirus is attacking cells through a protein associated with pain and disabling the protein can be confirmed in humans, it may provide a new pathway for drug development to treat COVID-19." @ConversationEDU https://buff.ly/2FI2D8J

  • Painaustralia CEO @CarolJBennett Dr Jennifer Abbey AM & Philip Daffas CEO @painchek highlight the perfect storm of #COVID19 and aged care and the urgent need to fast track technology advances in pain assessment for vulnerable populations and their families https://buff.ly/3frpMIe

  • The treatment needs of COVID-19 survivors are not yet fully appreciated. Although initially assumed to be a respiratory disease, it is now clear that it affects a variety of systems.’  Chronic pain after COVID-19: implications for rehabilitation https://buff.ly/3beiB5C

  • National COVID-19 Clinical Evidence Taskforce has concluded that evidence indicates that hydroxychloroquine is potentially harmful and should not be used as a treatment for anyone with COVID19  https://covid19evidence.net.au/wp-content/uploads/MR_Taskforce_hydroxychlororoquine.pdf…

  • Pain fellows are facing unique challenges and difficulties during the #COVID19 pandemic. In a letter to the editor, @harvardmed pain fellows ask that healthcare leaders consider tangible actions to address their concerns @PainMedJournal https://buff.ly/3aQF0Wm

  • Management of autoimmune disease during the COVID-19 pandemic @AustPrescriber https://buff.ly/3iQQJHi

  • COVID19 symptoms are most likely to appear in a specific order, research from @USC published in @FrontiersIn finds https://buff.ly/2Edlnf2

  • Since the pandemic struck, many pain-management strategies are no longer an option. “These are some of the most disadvantaged people in society, and they have very little support at best of times,” says Painaustralia’s CEO CarolJBennett https://buff.ly/3arv99h

  • JobKeeper Payment extension extended for six months until 28 March 2021. Proposed changes to eligibility requirements and payment rates will apply from 28 September 2020. 

  •  Ancillary funds guidelines amended due to COVID-19 - Find out how to apply the amendments to the guidelines for public and private ancillary funds.

  •  Further mental health support for Victorians during COVID-19.

  • The SPHERE (Sydney Partnership for Health, Education, Research and Enterprise) partnered with the NSW Multicultural Health Communications Service and NSW Health have developed easy to understand resources that has a local focus about chronic disease management and COVID-19.

  • “We now have a lot more information about hydroxychloroquine, and it doesn’t work.” https://www.sciencenews.org/article/covid-19-coronavirus-hydroxychloroquine-no-evidence-treatment

  • Considering the potential for an increase in #ChronicPain after the #COVID19 #pandemic" https://bit.ly/31khvAM

  • Pain that lingers: A subset of #COVID19 patients experience ongoing symptoms and complications such as organ damage. Researchers are now proposing reasons for some of them https://buff.ly/3fg7sBJ

  • New COVID-19 test for on the spot results: Australian company AnteoTech Limited developed a high sensitivity COVID-19 test which could detect SARS-CoV-2 significantly faster than current swab testing. The test aims to deliver on the spot results which could have an impact on community transmission.

  • New study finds a common rheumatoid arthritis and lupus management drug, hydroxychloroquine, ineffective in treating #COVID19 https://buff.ly/2ZVtg14

  • New research outlines impacts of #Covid19 that has stressed health care systems worldwide so that many pain services are no longer open for business. Chronic pain patient populations remain isolated with consequent social and psychological impact. https://buff.ly/32N8nqW

  • Graded exercise therapy may not be appropriate for treating post-viral fatigue in patients recovering from covid-19, @NICEComms has advised doctors https://www.bmj.com/content/370/bmj.m2912

  • Considering the potential for an increase in chronic pain after the COVID-19 pandemic. New research published in @PAINthejournal consider the possible downstream consequences of #COVID19 https://ncbi.nlm.nih.gov/pmc/articles/PMC7302093/

  • WHO says 'evidence emerging' of coronavirus spreading through the air https://t.co/UjNmdJRvhn?amp=1

  • Global Patient Advocacy in the COVID Era: What Is the Future of Patient Advocacy Around the World? A panel discussion on so many issues important to patients globally, like digital capabilities, access, health equity, clinical trials, ethical principles, and stronger collaborations.

  • Australia College of Rural and Remote Medicine (ACRRM): A new guide for general practices explains how to make the most of the nurse role during COVID-19. It also shows how nurses attract revenue streams that will sustain practices today and into the future. It has been endorsed by ACRRM, the Australian Association of Practice Management, the RACGP, and the Australian Primary Health Care Nurses Association.

  • Creaky Joints has produced some educational and support resources- Living with Arthritis During COVID-19

  • An old anti-inflammatory drug, dexamethasone, which has been described as cheap, old and boring, has now emerged as a potential #COVID19  treatment https://buff.ly/3hCNxz9

  • Are you or someone you care for, finding it difficult to access your pain management team due to #COVID19? There are many new consulting and prescribing changes to help support your care through the pandemic, and to support your pain management.  https://buff.ly/2B8goLg

  • Hydroxychloroquine: US revokes emergency approval of malaria drug for #COVID19. The @US_FDA says drug is unlikely to work against coronavirus and notes heart risks https://buff.ly/2UNYaFD

Coronavirus (COVID-19) recent updates

  • In response to this growing need for accessible and safe options to manage pain during #COVID19 @PainBC is offering free Gentle Movement @ Home live-streaming sessions that for people living with pain from the comfort of their homes https://buff.ly/2AVB4G3

  • The short answer is yes. You can also freely access precautionary measures to help minimise the risks, learn more at https://buff.ly/2BUVy2p

  • #Covid19: Lancet retracts paper that halted hydroxychloroquine trials https://buff.ly/3gSXnwH

  • The downstream consequences of disrupting treatments for chronic pain have yet to be modelled but are likely to be substantial." COVID-19 will have consequences for people with chronic pain, a large population with the greatest global burden of disease. https://buff.ly/36AkU0y

  • The Department of Health has released a 30-minute online training module covering the fundamentals of infection prevention and control for COVID-19 and is intended for health care workers in all settings. It also includes COVID-19 - What is it?, signs and symptoms, keeping safe - protecting yourself and others and mythbusting.

  • The healthgovau has released a COVID-19 video featuring Alison McMillan, Australia’s Chief Nursing and Midwifery Officer, who demonstrates how to wear personal protective equipment (PPE) for allied health professionals. https://buff.ly/2TCWgXU

  • The RACGP, NACCHOAustralia, ANUmedia and LowitjaInstitut have put together recommendations for healthcare workers operating in Aboriginal community controlled health services and other primary care settings during COVID-19

  • The RACGP is urging people to avoid new telehealth "pop up" businesses and instead consult with their usual GP. COVID-19 has seen a surge in telehealth services that rely on quick patient turnover. Continuity of care with your usual GP is more important now more than ever.

  • Links are emerging between COVID-19 and patients with chronic pain, and immune conditions such as IBD, MS, and psoriasis. Preliminary clinical treatment recommendations for both stable and infected patients are reviewed in this article from PracticalPain https://buff.ly/2yDHDwo

  • Safeworkaustralia.gov.au have provided a set of National COVID-19 safe workplace principles. https://www.safeworkaustralia.gov.au/covid-19-information-workplaces/other-resources/national-covid-19-safe-workplace-principles

  • CONSUMER INFO: If you or someone you're caring for is taking blood pressure-lowering medication, here's what you need  to know -https://bit.ly/bpcovid19             -https://nps.org.au/covid-19-and-medicines-faqs#i-take-blood-pressure-lowering-medication.-what-does-covid-19-mean-for-me…?

  • Painaustralia welcomes the creation of deputy CMO for mental health @healthgovau and the appointment of Ruth Vine to this important role. Big mandate ahead and its great to see that the mental health aspects of COVID-19 will be seriously considered https://buff.ly/2Lpwl1i

  • The genie is out of the bottle': telehealth points way for Australia post pandemic  https://buff.ly/35Sj4HY

  • This pandemic highlights the importance of innovation and trying to provide services in new and more accessible ways  to ensure people can still access mental health supports and services how and when they need them during these difficult times." https://buff.ly/3cZVXh9

  • Doing What Matters in Times of Stress: An Illustrated Guide - World Health Organisation

  • Dramatic falls in the uptake of health care services have fuelled concerns that patients are delaying tests and treatments for fear of COVID-19 infection or facing an overwhelmed health system MJAInsight https://buff.ly/35ybdzl

  • “The long term harms, including increased social and health inequality, may well dwarf the death toll of covid-19 itself.”  Trust is crucial in lockdown—and beyond  bmj_latest https://buff.ly/2Wi2pJB

  • 'I just spent my entire stimulus payment on a ketamine treatment at a private hospital for chronic pain because the public hospital I get it done at cancelled all elective admissions': life gets harder for vulnerable Australians during coronavirus crisis https://buff.ly/2zpzXO2

  • You may have seen information on hydroxychloroquine in the media over the last few days.  Our position hasn't changed. Currently, there is no evidence to support the use of hydroxychloroquine as a treatment for COVID-19. https://bit.ly/npshydrox 

  • As we continue to navigate the coronavirus pandemic, many hospitals and health services are actually less busy than usual: Managing chronic conditions in the time of coronavirus insightSBS https://buff.ly/2VL8rTV

  • The TGA will permit conditional substitution of certain medications to ease serious shortages as a result of unprecedented demand due to COVID-19 https://buff.ly/3bMn6nF

  • 5 highlights from NPSMedicineWise’s new comprehensive update for health professionals on the use hydroxychloroquine for COVID-19 https://ajp.com.au/news/there-are-very-limited-data-to-support-its-use/…  

  • Coronavirus has created a crisis for primary care doctors and their patients: How the COVID-19 is making health care access problems even worse. Important lessons for everyone as we all come to terms with the full scale of the fallout from the pandemic https://buff.ly/3eRy3Gt

  • As case numbers of COVID-19 continue to rise around the world, an increasing number of reports of neurological symptoms are emerging. Some studies report that over a third of patients show neurological symptoms. https://buff.ly/2KCAZZw

  • NPSMedicineWise has released new information for health professionals on hydroxychloroquine in the latest addition to their COVID-19 information hub. https://buff.ly/3cQPgxM

  • The Aged Care Royal Commission is calling for submissions from the general public and organisations relating to the impact of COVID-19 on the aged care sector. If your pain management needs in aged care have been impacted by the pandemic please contact us. https://buff.ly/2yOIQAu

  • Clinical Challenge: Chronic Pain and COVID-19 — Pain patients may be hit harder than others https://buff.ly/2Vv1GVa

  • Immunosuppressants and Coronavirus: Here is What You Should Know Even during the COVID-19 pandemic, physicians are advising patients to stay on their immunosuppressant medications. Here’s why. https://buff.ly/2VOnR8Z

  • Chronic Pain and Social Despair–Doctors Need to Listen. "similar to our lack of system readiness for COVID19 our complicated and costly healthcare system is not only unprepared to deal with the epidemic of stress in society, it contributes to the problem." https://buff.ly/2ziI52X

  • Should a doctor prescribe hydroxychloroquine for family and friends to treat COVID-19? According to an editorial published today by NPSMedicineWise the answer should be 'no', from medical, ethical and possibly even legal perspectives. https://buff.ly/3eI1KcU

  • Principles of ethical prescribing for self and others: hydroxychloroquine in the COVID‑19 pandemic published in the Australian Prescriber by NPS Medicinewise https://www.nps.org.au/australian-prescriber/articles/principles-of-ethical-prescribing-for-self-and-others-hydroxychloroquine-in-the-covid-19-pandemic

  • Dr Jill Newby, Associate Professor of Psychology at the  UNSW, shares practical ways for workplaces to cope with COVID-19  related anxiety. https://blackdoginstitute.org.au/education-training/community-and-schools/covid-19-webinars

  • IVF and low-risk elective surgery to begin again as National Cabinet ditches coronavirus ban https://www.abc.net.au/news/2020-04-21/coroanvirus-national-cabinet-elective-surgery-ivf-to-resume/12168770?fbclid=IwAR3o4tKWUszptLXxXxgD1mCPxfLlEHniRjfnJNI1lDef15-I3COzZYrNl00

  • Australia's elderly will be better supported to avoid medicine-related harm following important changes to Home Medicine Review (HMRs) and Residential Medication Management Review (RMMR) programs announced by the Government https://www.psa.org.au/remunerated-medicine-review-follow-ups-now-allowed/

  • National Cabinet has released the Management and Operational Plan for COVID-19 for People with Disability which forms part of the national response developed by the Govt for COVID-19 https://buff.ly/3ckrcDg
  • New research, published by International Association for the Study of Pain provides guidance for those attempting to rapidly transition to remote care with technology, and discusses the lessons for the future of the pain treatment https://buff.ly/2VygzWA
  • Hydroxychloroquine: The drug that many pain patients need and why it’s so important that access continues https://buff.ly/34wtUCO

  • Elective surgery cancellations take toll on patients but nurse says ‘it’s not in vain’ https://thenewdaily.com.au/news/national/2020/04/15/elective-surgery-cancellations-coronavirus/?utm_source=Adestra&utm_medium=email&utm_campaign=Morning%20News%20-%2020200415

  • "There is an urgent need for research to address how mental health consequences for vulnerable groups can be mitigated under pandemic conditions, and on the impact of repeated media consumption and health messaging around COVID-19" The Lancet https://buff.ly/3cneDHq

  • “This initial assessment shows that the risks, in particular cardiovascular, associated with these treatments are very present and potentially increased in COVID-19 patients. Almost all of the declarations come from health establishments,” https://buff.ly/2y7x5oi. 

  • Dr Nick Coatsworth and Prof Michael Kidd, Deputy Chief Medical Officers provide a COVID-19 response update for Allied Health Practitioners https://buff.ly/2JQPmsR

  • American Society of Regional Anaesthesia and Pain Medicine has joined multiple American Societies in Endorsing COVID-19 Chronic Pain Best Practice Guidelines https://buff.ly/39SZFaj

  • “The chronic use of high dose of opioids is associated with side effects which may increase disease severity of COVID-19. This link is purely speculative, as we were unable to find any published data looking specifically at associations” Dr Andrew Huang provides a rapid response in the BMJ to the risk factors for Opioid use and disease severity of COVID-19 https://buff.ly/3dYCAGB

  • Interim arrangements for prescriptions for supply of medicines: Helping you get your medicine if you are confined to your home https://buff.ly/2xUeIU2

  • Australian Government Department of Health - COVID-19 infection control training
    This 30-minute online training module is for health care workers in all settings. It covers the fundamentals of infection prevention and control for COVID-19.

  • The RACGP has welcomed moves to allow GPs to send electronic prescriptions. Under the arrangements, patients can get a prescription from their GP directly sent to their pharmacy of choice via email or phone and their medication can be delivered to their door https://www.medianet.com.au/releases/186099/

  • NDIS participants to receive priority home delivery from leading supermarkets Stuart Robert MP https://ministers.dss.gov.au/media-releases/5711

  • BMJ covers Non-steroidal anti-inflammatory drugs and COVID-19 https://buff.ly/349hK2B

  • It's Estimated 1 in 4 Coronavirus Carriers Could Be Asymptomatic. Here's What We Know https://www.sciencealert.com/here-s-what-we-know-so-far-about-those-who-can-pass-corona-without-symptoms?fbclid=IwAR0ToAo5VPhEVrfp7b2G6W46W_6Qe4f7ze_nN88mgIl6v24vFKrZsvJ4tbw

  • 'I feel like a sitting duck': how the threat of coronavirus affects our most vulnerable https://www.theguardian.com/world/2020/apr/01/i-feel-like-a-sitting-duck-how-the-threat-of-coronavirus-affects-our-most-vulnerable?CMP=soc_567&fbclid=IwAR1TAfLIRjN64Kvbr6o1V3akBZ169O-dRv-0_L1nKiaL86FdH0_u8vS_-NA

  • The Centre for Mental Health at Swinburne University is conducting a survey on the impact of COVID-19 on the mental health of Australians. Click on the link below to participate. 
    https://swinuw.au1.qualtrics.com/jfe/form/SV_bvhCPY1OweJQbdz
  • Sleep supports our immune function and helps us deal with stress. During this uncertain time, making sleep a priority is more than self-care – it's essential. https://theconversation.com/sleep-wont-cure-the-coronavirus-but-it-can-help-our-bodies-fight-it-134674?fbclid=IwAR3TkIBL9ECRfXKQXeLW3DFwq2fBSTJaag-dYVEmQqtrBIPBQnkPUILvQgE
  • The TGA warns consumers to be cautious when seeking to purchase products claiming to be home self-tests for COVID-19, either online or through other means. COVID-19 tests are designed to be used under the direction of a health professional. https://www.tga.gov.au/…/warning-consumers-and-advertisers-…
  • Can coronavirus spread through food? Can anti-inflammatories like ibuprofen make it worse? Coronavirus claims checked by experts https://buff.ly/2yarnSH

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