7. Recommendations

7.1The Committee recommends that the Australian Government establishes and funds a single COVID-19 database to be administered by the soon-to-be developed Centre for Disease Control to capture data on:

• COVID-19 infections, complications, hospitalisations, and deaths as well as recurrent COVID infections

• This should incorporate COVID-19 infections in high-risk populations including: hospital-acquired infections (distinguishing this from community acquisition if possible), infections in aged care and other institutions, and infections in Aboriginal and Torres Strait Islander peoples and the immunosuppressed
• This should also include the collection of data regarding select comorbid conditions and ancestry to identify infections in Aboriginal and Torres Strait Islander peoples, culturally and linguistically diverse communities and the immunosuppressed

• Long COVID diagnoses including post COVID complications
• COVID-19 vaccination rates, vaccination side effects and post vaccination deaths
  2. The Committee additionally recommends that the Australian Government explore the use of innovative tools (e.g. artificial intelligence and self-managed care platforms) and data linkage within and between states and territories, to collect this data.

7.3The Committee recommends that at the present time the World Health Organization definition of long COVID be used clinically, but that the Australian Government Department of Health and Aged Care work with the states and territories to review this definition as more research and information becomes available.

7.4The Committee additionally recommends developing evidence-based living guidelines for diagnosis and treatment incorporating tiered care including referral pathways, co-designed with patients with lived experience.

7.5The Committee recommends that the Australian Government establish a nationally coordinated research program, led by the Department of Health and Aged Care (preferably the Centre for Disease Control), to coordinate and fund COVID-19 and longCOVID research.

7.6This funding should be longer term and be nationally coordinated. The funding should aim to better integrate research by fostering greater collaboration rather than fragmentation.

7.7The Committee also recommends that this research have adequate representation from Aboriginal and Torres Strait Islander peoples and the culturally and linguistically diverse population and be adequately funded to achieve these aims. Other vulnerable groups including the elderly, children, people with disability and the immunosuppressed should be represented.

7.8Research programs should span basic science, clinical trials, models of care, health promotion and implementation science.

7.9The Committee recommends that the Department of Health and Aged Care updates, focusses, and improves its COVID-19 vaccination communication strategy including by:

• Emphasising the benefit of COVID-19 vaccines in both reducing transmission and illness severity for acute COVID-19 infections and reducing the risk of developing long COVID
• Encouraging greater COVID-19 vaccination across the Australian population especially among children, young people and people of working age
• Encouraging immunisation in high-risk groups in particular as the virus becomes endemic
• Working with the states and territories to develop this health promotion program.

7.10The Committee recommends that the Pharmaceutical Benefits Advisory Committee regularly review the benefits of antiviral treatments for COVID-19 in accordance with emerging research with a view to expanding the list of groups eligible to access these treatments through the Pharmaceutical Benefits Scheme (PBS).

7.11The Committee also recommends that antiviral treatments for COVID-19 be approached as a pharmacist-initiated medication to participants eligible under the PBS.

7.12The Committee additionally recommends that the Australian Government review its framework for access to antiviral treatments for COVID-19 to include non-mortality and non-hospitalisation outcomes such as productivity gains, time to illness resolution, return to work and number of health encounters.

7.13The aim of the Committee is to ensure people get the support they need, most of which will occur via the primary care network. Accordingly, the Committee makes the following recommendations regarding management:

• Support and education should be provided to general practitioners (GPs) as well as other primary healthcare providers to diagnose long COVID and to help manage those suffering from it. Education for GPs should be coordinated and eligible for Continuing Professional Development (CPD). The Medicare Benefits Schedule (MBS) chronic disease management item number should be reviewed
• Clinical care should be linked to nationally coordinated research and data collection
• Funding be provided in partnership with state health departments for selected public hospitals to develop multidisciplinary long COVID clinics linked to nationally consistent referral guidelines for screening patients with challenging long COVID complications
• Mental health support for those with long COVID must be provided in an affordable, timely and equitable manner, and regular review of mental health issues should be part of GP management noting that the extent of related mental health impacts is still unknown
• Telehealth and digital health resources be leveraged to make self-management and access to primary care easier
• Funding be provided so that outreach long COVID clinics can be developed for rural and regional areas, accessible either face to face or via telehealth, as a GP resource.

7.14The Committee recommends the Australian Government establish and fund a multidisciplinary advisory body including ventilation experts, architects, aerosol scientists, industry, building code regulators and public health experts to:

• Oversee an assessment of the impact of poor indoor air quality and ventilation on the economy with particular consideration given to high-risk settings such as hospitals, aged care facilities, childcare and educational settings
• Lead the development of national indoor air quality standards for use in Australia.

7.15The Committee recommends funding be made available for Myalgic Encephalomyelitis/Chronic Fatigue Syndrome (ME/CFS) research and patient support and that this funding should be allocated in consultation with peak bodies for ME/CFS and with note of the recommendations of the ME/CFS Advisory Committee’s 2019 report to the National Health and Medical Research Council.

7.16The Committee recommends, given the multiple questions that have arisen during our Inquiry, that the Australian Government consider a comprehensive summit into the COVID-19 pandemic and Australia’s past and current response, including by governments at all levels, with particular consideration to the role of the future Centre for Disease Control.

Dr Mike Freelander MP

Chair

19 April 2023