The following is a special Covid-19 update from the Optometrists and Dispensing Opticians Board (ODOB) 19 November 2021:
Firstly, we would like to thank all practitioners for following the protocols to ensure safe practice, particularly as we move through significant change regarding Covid-19. Ahead of more Government announcements in the next couple of weeks, we want to provide you with some updates we have received so far.
THE REQUIRED TESTING AND VACCINATIONS AMENDMENT ORDER, AND EXEMPTIONS
Please note the Covid-19 update from our communique dated 27 October 2021. Since this update, the Vaccine Mandate has been amended.
The Covid-19 Public Health Response (Required Testing and Vaccinations) Amendment Order 2021 was issued on November 8. It tightened up the process for those seeking medical exemptions, and exemptions will only be granted for a maximum period of six months. On expiry, workers will need to reapply and prove that the reason for the exemption still exists. The requirement for all healthcare practitioners – whether they are seeing patients face-to-face or virtually – has also been amended. The Required Testing and Vaccinations Amendment Order no longer requires those who do 100% virtual consultations to be vaccinated. However, we do understand that this will be rare within our professions.
We also take this opportunity to remind all practitioners, and their staff covered by this order, that they are required to have had their first vaccine doses administered by 15 November 2021. Second vaccine doses are due 1 January 2022.
BOOSTERS FOR COVID-19
On Monday 8 November, Medsafe approved a booster dose of the Pfizer Comirnaty vaccine for people aged 18 and older, at least six months after completion of the primary course (two doses). Today the Ministry updated its website to reflect their rollout plan for boosters for COVID-19. The first booster doses will be administered from 29 November 2021 onwards, and bookings will open on 26 November. You can make a booking using Book My Vaccine.
The Optometrists and Dispensing Opticians Board (the Board) supports the need of booster vaccinations for Covid-19 and encourages you to get it when you are due.
Please click here to view the Covid-19 Public Health Response (Required Testing and Vaccinations) Amendment Order 2021.
MINISTRY OF HEALTH POSITION STATEMENT ON PRE-CONSULTATION TESTING OF UNVACCINATED INDIVIDUALS IN HEALTHCARE SETTINGS
On 19 November 2021, the Ministry of Health released a position statement on the management of unvaccinated individuals in healthcare settings. It includes a discussion of the risks of transmission occurring from unvaccinated individuals seeking healthcare and actions which can be taken and the rationale for these actions to mitigate those risks. This statement is in particular directed at the issue of pre-consultation testing of unvaccinated patients.
In summary, it states:
- Individuals cannot be refused access to health care.
- Restrictions to access to health care must be informed by a risk assessment, and the onus is upon the provider to justify that the risks are sufficiently high to support those restrictions.
- Total vaccination coverage and the prevalence of Covid-19 in the community are important factors in the efficacy of any mitigations aimed to prevent transmission.
- Vaccination status is one of many risk factors for infection and transmission. There is currently no evidence that the application of an alternative pathway based solely on vaccination status, or the routine incorporation of unvaccinated asymptomatic individuals into a high-risk pathway is justified.
- Routine testing of asymptomatic individuals prior to consultation would identify some infectious individuals and decrease the risk of transmission. However, the feasibility, cost and effectiveness of this strategy has not been determined and must be assessed prior to diversion of scare testing resources from urgent work.
- Pathways exist for decreasing the risk of transmission from any asymptomatic individual. These pathways must be utilised effectively prior to the introduction of additional interventions.
- The management of unvaccinated individuals through an alternative pathway is highly likely to negatively impact access to care which must be balanced by a demonstrable benefit.
- Children form a large group of individuals who are unable to vaccinated and as such are likely to form a majority the group managed through an alternative pathway. Specific consideration must be given to how this would impact on children’s clinical care.
Please click here to read the this position statement on the Ministry of Health’s page on “Covid-19: Advice for all health professionals.”
We note that this may be a difficult time for employers, as guidance from the Ministry is still unclear. We wish to reiterate previous guidance – whether you are in private practice or in the public health system – all health practitioners have a responsibility to ensure there is continuity of care. In doing so, please:
- Ensure you have a documented risk assessment plan. Worksafe have released interim guidance to support employers, which may be useful.
- Where practitioners deem it a high risk to see patients (particularly in areas where there are low vaccination coverage and high numbers of community transmission), we would advise you plan for alternative pathways of care for your patients. This may require you to phone and see which practitioners are willing to see those patients.
- Alternatively, you could schedule special clinics/timeslots where there are additional screening processes in place, adequate personal protective equipment (PPE) are used, and infection prevention controls (IPCs) are in place to limit risks.
COVID-19 PROTECTION FRAMEWORK
As you are all aware, Aotearoa New Zealand is just weeks away from entering its next phase of battling Covid-19; when the Covid-19 Protection Framework (or the so-called “traffic light system”) will be introduced. While the detail is still vague, the Board and other healthcare responsible authorities (RAs) are working with the Ministry of Health to better understand how this will impact our professions. We will advise you on this once we have more clarity. However, from the initial review of the guidance received from the Ministry of Health to date, it seems like this would not affect optometrists and dispensing opticians much. Overall, it appears that the following measures will remain key:
- appropriate and relevant screening processes
- the safe use of personal protective equipment (PPE), and
- adequate infection prevention controls (IPCs).
Click here for more information on the Covid-19 Protection Framework. We hope to get further advice from the Ministry of Health in the next two weeks. If you have any questions, please feel free to contact us.
Nā māua noa, nā
Jayesh Chouhan, Board Chair and Elmarie Stander, Registrar