News in brief: Revised VITT advice from health dept; Mandatory vaccination needed for all hospital staff; Call for consistent OS benefit reporting on oncology drugs;

Revised VITT advice for primary care

The Department of Health has released guidance for GPs on the management of thrombosis with thrombocytopenia syndrome after COVID-19 AstraZeneca vaccine.

The recommendations differ slightly from the multidisciplinary guidance issued by the Thrombosis and Haemostasis Society of Australia and New Zealand vaccine-induced immune thrombotic thrombocytopenia (VITT) syndrome Communications Committee in May.

According to the DoH guidance, the initial investigations in primary care should a full blood count and D-dimer which can reviewed within six hours and repeated within 24-48 hours for patients with normal results and persistent symptoms,.

In contrast, the THANZ multidisciplinary guidelines recommend obtaining urgent FBC, APTT, PT, fibrinogen and D-dimer within four hours.

The guidance for GPs includes criteria for when results should prompt referral to ED for for further investigation and urgent haematology advice

Mandatory vaccination needed for all hospital staff

The Morrison government is being urged to make vaccinations compulsory for all hospital staff across Australia and have a roll out plan to provide vaccine every hospital worker.

The peak body representing Catholic not-for-profit hospitals, Catholic Health Australia (CHA), says the Federal government already has a mandatory vaccination scheme for aged care and should put in place a similar scheme for all hospital staff across Australia, public and private.

CHA says its hospitals are already redeploying unvaccinated staff to clinical areas where there is a lower risk of contact with COVID patients and vaccinating staff as and when Commonwealth supplies become available.

“Every year health care staff are required to get vaccinated against the flu and yet there’s no such directive for COVID,” said CHA’s Health Policy Director James Kemp.

National Cabinet should bring in a uniform rule for mandatory COVID vaccination for hospital staff – regardless of whether they work in ED, ICU or any other clinical or support position, he added.

“The high transmissibility of the Delta variant of COVID is putting workers and the people they care for at greater risk as well as putting extra strain on staff,” he said

Mr Kemp said: “Every worker should have a date in their diary to get vaccinated. Every dose that comes into the country should have a hospital worker’s name next to it.”

Call for consistent OS benefit reporting on oncology drugs

Overall survival (OS) results should be clearly and consistently listed on cancer drug labels, health researchers argue.

A review of FDA-approved cancer drugs found “substantial variation” in OS reporting, which could hinder prescribers’ identification of clinically significant or undetermined survival benefits.

OS “is arguably the most definitive patient-relevant outcome when evaluating cancer drugs in clinical trials,” the researchers said in a letter to JAMA.

“Consistently communicating the association of cancer drugs with OS in US FDA-approved labelling can help inform treatment decisions.”

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