With influenza circulating in the community alongside COVID-19 it is important to protect our most vulnerable, including residents of residential aged care facilities (RACF).

The Commonwealth Department of Health has distributed oseltamivir and molnupiravir to RACF for use in residents. To assist with this, NSW Health has enacted legislation to permit RACF to hold and store both these medications.

Molnupiravir and nirmatrelvir/ritonavir are now also available on the Pharmaceutical Benefits Scheme (PBS) for residents of RACF through community pharmacies.

Administration of antiviral treatment

• Oseltamivir (Tamiflu®) can be used in residents with confirmed influenza or for prophylactic use in exposed residents during influenza outbreaks in RACFs. Use of this medicine may shorten the duration and severity of the illness.
• Molnupiravir (Lagevrio®) and Nirmatrelvir/ritonavir (Paxlovid™) can be used in people with confirmed COVID-19 in the community (including in RACF) with mild to moderate symptoms who are immunosuppressed or who are aged over 50 and at risk of severe disease OR people who are aged 70 and over whether they have symptoms or not. The drug should be commenced as early as possible but no later than day 5 after symptom onset.
  

The administration of antiviral treatment soon after symptom onset for people with COVID-19 or influenza can reduce disease severity. Additionally, the administration of influenza antivirals to residents of RACF after exposure improves clinical outcomes and assists in controlling the outbreak.

NSW Health is working with general practitioners (GPs) and providers of RACF to make sure residents are aware of these medications and are able to receive them as soon as they need them.

Resources

This information has been developed to assist GPs, residents and their families to make informed decisions regarding the use of antiviral medicines:

• Flu and COVID-19 antiviral treatment: Advice for Residential Aged Care Facility (RACF) residents
  A fact sheet for residents of RACFs and their families to help guide decisions about using antivirals for influenza (flu) and COVID-19 treatment and prevention.
• Antiviral pre-assessment form
  To be completed by a GP and includes a section for the resident (or their guardian) to indicate their preference for antiviral medication. 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.
• Advice for antiviral treatments and prophylaxis in Residential Aged Care Facilities (RACF) 2022
  A fact sheet for clinicians to provide guidance on the use of oseltamivir, molnupiravir and nirmatrelvir/ritonavir.

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