COVID-19 and influenza continue to co-circulate in the community. It is important to protect those at higher risk of severe disease, including residents of residential aged care facilities (RACFs).

NSW Health is working with general practitioners (GPs) and aged care providers to make sure residents have a plan in place for if they develop symptoms of COVID-19 or influenza; including a plan for testing and a discussion about antiviral medicines.

An Antiviral pre-assessment form for aged care facility residents is available to facilitate timely access of antiviral medicines for residents should they test positive to COVID-19 or test positive or be exposed to influenza.

Antiviral medicines for COVID-19 and influenza

The administration of antiviral medicine soon after symptom onset for people with COVID-19 or influenza can reduce disease severity.

• Nirmatrelvir/ritonavir (Paxlovid™) and Molnupiravir (Lagevrio®) can be used in people with confirmed COVID-19 in the community (including in RACFs) who meet the eligibility criteria. The drug should be commenced as early as possible but no later than day 5 after symptom onset.
• Oseltamivir (Tamiflu®) can be used in residents with confirmed influenza or for prophylactic use in exposed residents during influenza outbreaks in RACFs. Additionally, the administration of influenza antiviral medicines to residents of RACF after exposure to influenza can assist in controlling the outbreak.

Nirmatrelvir/ritonavir and molnupiravir are available on the Pharmaceutical Benefits Scheme (PBS) for residents of RACF through community pharmacies for treatment of COVID-19. Oseltamivir is available on private prescription, and through Public Health Units for RAFCs in outbreak.

Resources

These resources have been developed to guide discussions between residents and their families with their GP regarding the use of antiviral medicines:

• COVID-19 and flu antiviral medicines – Advice for people at high risk of severe illness
  A fact sheet for people at high risk of severe illness, including residents of RACFs, and their loved ones to help guide decisions about using antivirals for COVID-19 and influenza (flu) treatment and prevention.
• Antiviral pre-assessment form for aged care facility residents
  To be completed by a GP and supports the resident (or their guardian) to collaboratively form a plan with their doctor as to what antiviral medicines would be best for them. The pre-assessment form will not replace the requirement for a GP to prescribe the medication prior to administration but it will expedite access to the medication post exposure and for a confirmed case.
• Influenza and COVID-19 antiviral medicines
  A fact sheet for clinicians to provide guidance on the use of oseltamivir, molnupiravir and nirmatrelvir/ritonavir.

For additional information on holding antivirals at residential facilities, see the Requirements for residential care facilities (RCFs) under the NSW Poisons and Therapeutic Goods Legislation.