• COVID symptoms and testing
• Staying at home and going out
• COVID and your support workers
• Infection control for wheelchair users
• Infection control with children
• Disinfecting your home

COVID symptoms and testing

What are the symptoms of COVID-19?

The Australian Government have devised an online tool called the Coronavirus (COVID-19) Symptom Checker. This is a short questionnaire which helps you decide whether you need to self-isolate and be tested. You can also ask your family, friends and carers to complete the questionnaire any time they have symptoms. Healthdirect also has an app which you can download to your phone so you can complete this questionnaire easily and as often as you’d like.

If you require testing:

• Stay in contact with your GP regarding your situation both before and after testing. They will have an awareness of your condition, your medications and can communicate with your specialists urgently if required.
• If you are feeling extremely unwell and feel that you require hospitalization, please call 000 and ensure that the officers are aware of why you are calling so that they can take steps to ensure they are wearing adequate PPE before they enter your home.
• Each state and territory has dedicated COVID clinics set up in hospitals and medical centres and may have drive-through clinics. You may need to make a booking for testing or provide a referral, but this differs from clinic to clinic. To reduce your wait time and to ensure that this is as quick and convenient as possible, it’s best to call ahead and make sure you know what to expect before you leave home. If you intend to get tested at a drive-through clinic and require staff to gain access to you inside a wheelchair accessible van, call ahead to ensure that this is possible. Some states and territories may provide testing at home so check with your local health service to find out if this is available to you. Please ensure that you wear a mask to the testing appointment.
• Healthdirect allows you to search COVID-19 testing clinics in your area which are wheelchair accessible and have accessible parking. You can search for health services and tick boxes to indicate preferences for accessible parking/toilet and wheelchair access. However, if you would like to plan your outing with more certainty, the phone number of each clinic is listed on your search results so you can call ahead and check.
• Once you have identified yourself as having symptoms which may indicate COVID-19, you must self-isolate until you receive a negative result. Self-isolation means different things to different people with a neuromuscular condition. For some, it will mean changing how you manage your personal care and daily activities so that you can do this with minimal assistance. For others, it might mean having a dedicated family member or members who isolate with you to do all essential tasks for a few days. For those who have support workers coming into the house, they must be notified immediately. Many support workers move between residences of people with a disability so the agency or individuals must be notified that you’re in the process of being tested. Support workers may decide or be directed to work differently and limit their movements while you await your test results. If your care becomes unmanageable or unsafe while you isolate then call your Support Coordinator (if you have one), alternatively call the Disability Information Helpline on 1800 643 787 and the NDIS Contact Centre 1800 800 110 immediately.
• Once you get your test results back, you will be notified by a health professional of how to proceed. Let your GP know of your result and ensure that you are getting adequate care and monitoring for your illness, even if you test negative to COVID-19.

Staying at home and going out with a neuromuscular condition

There is so much information about COVID-19 and it can be confusing. The Department of Social Services has created an excellent summary of all the things we need to be doing to keep ourselves and those around us safe. It’s a good idea to look over it regularly to make sure you’re putting in place all the necessary measures.

Depending on where you live in Australia there will be different restrictions in place regarding going out in public. Regardless of restrictions, some people with neuromuscular conditions have chosen to stay home apart from essential trips out. Even if the restrictions have been eased in your area it’s still your right to continue with higher-level infection control measures if you wish.

There are some ways that you can limit your exposure to the virus:

• Where possible have telehealth appointments with health professionals and therapists. Many people with neuromuscular conditions chose to have home visits for therapy appointments well before COVID became an issue and this is certainly a good way to reduce the number of people that you come into contact with while still getting therapy.
• Have prescription medications delivered to your home through the National Health Home Medicines Service (available to those with chronic conditions and those who are immunocompromised).
• Have groceries and other items delivered to your home with contactless delivery. The NDIA has worked with supermarkets to provide a priority service for those with a disability. These Supermarkets include Woolworths, Coles, IGA and Foodland IGA, Foodworks and Harris Farm. To find out more, see these supermarkets’ websites.
• If you do go out plan your trip. Phone ahead and see if the clinic or business that you are visiting has COVID safe measures in place and ask what they are. You may like to explain your condition and ask how you can reduce your risk of exposure; i.e. at a Doctor’s visit, could you wait in an isolated room rather than waiting room? If you have carers accompany you on a public outing have a conversation with them about your expectations of how you’d like risk managed so they can help you maintain those boundaries and practices and act as your advocate in situations where it might be difficult for you to do so for yourself.
• If you are a wheelchair user there are some extra precautions that you can take to reduce your risk of transmission both while you are at home and out and about.

COVID and your support workers

For some people with a neuromuscular condition, having external support workers involved in their everyday care can be a source of anxiety when it comes to COVID.

• If you engage support workers through an agency, they have obligations to train their staff in infection control. The Australian Government has provided online training for all NDIS providers. If you employ or contract support workers privately, you can ask them to do this training if they haven’t done so already.
• Some people who engage support workers work with them to find ways to reduce the number of homes they work in to reduce the chance of exposure. That might mean reducing the number of support workers you have but employing fewer workers for more hours. Some people have moved to having family only doing their care or family helping with a reduced number of support workers. However you choose to manage it is up to you.

It might be difficult to have a conversation with a support worker if you suspect they are showing symptoms of a respiratory illness yet show up to work in your house. However, remember that you are protecting yourself as well as those around you. If staff are aware that you have a monitoring process in place, they are less likely to turn up to work unwell. Here are a couple of resources which might help manage this:

• Healthdirect COVID symptom checker You can ask support workers to complete this questionnaire prior to each shift. If they answer yes to any of the questions that might mean they meet the criteria for COVID testing.
• The Victoria Government have produced a Daily Staff Attestation document which requires staff working in disability and aged care settings to sign a declaration that they do not have symptoms and have not been in contact with a COVID high-risk person. This might be a document that you’d like to print out and have staff sign prior to each shift.

It might be helpful for you to write down your expectations of infection control that you would like your support workers to follow, print it out and keep it somewhere that it can be referred to. You may like to keep hand sanitiser near your front door with a reminder to use this prior to starting the shift. Some people might choose to have handwashing instructions by the tap while others may prefer to keep their living environment free of signs. Keep open and ongoing communication with your support workers and other visitors about what your expectations are.

The following are some resources which might help with communicating your infection control needs to your carers.

• How to Hand Rub poster
• How to Hand Wash poster
• Wearing PPE for Disability Support Workers video

Infection control for wheelchair users

Wheelchairs present unique challenges to maintain infection control against viruses which can be carried on a surface as well as be transmitted by droplet infection (coughs and sneezes).

Manual Wheelchair

Self-propelling in a manual wheelchair means that your hands are constantly in contact with the hand rims. Washing your hands and using hand sanitiser is essential in combination with cleaning the rims of your wheelchair regularly. Applying a wet wipe to the rim of your chair while you propel forward a few metres is a good way to clean the rim on each side. Do this regularly throughout the day and often while you are out – every time you wash your hands to prevent the transfer of viruses and bacteria back and forth between your hands and the rims. If you wear gloves to protect your hands while propelling your chair, change these as frequently as you can, washing in between uses. Also, wipe the surfaces of your chair that you touch frequently. If your wheelchair has push handles ensure that these are wiped down regularly, especially between users. Make sure your wheelchair is wiped down all over each day.

Power Wheelchair

When using a power wheelchair, your joystick is the surface which can become a place where there is a transmission of bacteria and viruses. Using a wet wipe to clean this regularly throughout the day is important for infection control. It should be wiped over any time you wash your hands, both and home and while out. Several times per day wipe the surfaces of your chair that you touch frequently. Ensure that your wheelchair is wiped down all over each day.

Droplet transmission and social distancing

Because wheelchair users sit at a lower height than people standing and walking, the risk of droplet transmission is higher. Although there are no specific official recommendations for social distancing for wheelchair users it helps to be aware that you are more vulnerable to droplets carried in the air from other people’s coughs, sneezes and even normal speech. For this reason, a mask should be considered as an important item for being in public. Also consider increasing your distance from others in public where possible. If you have a companion with you while you are out, have them act as your advocate to help you maintain distance and lower your risk of exposure.

Infection control for children with a neuromuscular condition

Infection control for children can be difficult. Fortunately, several resources have been developed to help children understand the risk and how they can protect themselves and those around them. Children are often more willing to accept changes if they are involved in decision making and can have some input. Figure out which parts of infection management are flexible, and which are not negotiable.

Birdie and the Virus is a video which has been developed by Queensland Health to help children understand how viruses spread, infection control, swab testing, home isolation and recovery.

Wearing a mask

Getting children to wear a mask can be difficult but there are some ways to help with the process:

• Start off with short amounts of time and make it positive and fun.
• Have your child put the mask on in front of a mirror so they can see how they look while you talk about how it protects them and those around them.
• Have everyone in the house practising wearing masks at the same time.
• Decorate masks. Have a craft session where you create amazing designs on paper masks. Stick on sequins and feathers and googly eyes.
• Buy some fabric masks with your child’s favourite characters on them.
• Put a mask on their favourite teddy or doll.
• Make sure their mask is appropriately sized so it’s not covering their eyes.

Handwashing

There are many resources available online to help children learn when to wash their hands and how. Here are just a few:

Young kids

• The Wiggles Handwashing Song
• The Wiggles Handwashing Song in Auslan
• Baby Shark Hand Wash Challenge
• Handwashing Heroes

Older kids and teens

• Proper handwashing experiment
• Tips and tricks for safely wearing masks in public
• How to make a handmade electric hand sanitizer machine (fun home project)

Social Distancing

Resources to help children understand how to maintain distancing and why:

• Baby Shark Social Distancing Song
• The Wiggles Social Distancing Song
• A video game to help children understand social distancing

Getting tested

If your child has symptoms which mean that COVID testing is necessary, there are some things you can do to help your child understand and prepare for the process.

• Discuss the need for testing with your child first. Read through the list of COVID symptoms on Healthdirect and have your child help identify which symptoms they have which indicates that they need to be tested. Involving your child in the process of decision making can sometimes help to overcome resistance and gain a deeper understanding of the process.
• Make sure you are clear about your need to isolate your child. Cancel appointments and all engagements until COVID testing results are made available to you. This means cancelling support workers who would usually come into your house to help care for your child.
• If you and your family are unable to manage care alone for this period, then contact the Disability Information Helpline on 1800 643 787 or the NDIS Contact Centre 1800 800 110 and discuss your situation with them. If your child has a Support Coordinator let them know so they can help coordinate emergency supports.
• Use some of the resources listed above to help your child understand why they need to be isolated until their results have been communicated to you.
• A Child’s Guide to Hospital: COVID-19 Test is a film for children about the process of being tested.

Disinfecting your home

Which products to use to clean the surfaces around the house?

The Therapeutic Goods Administration (TGA) regulates therapeutic goods in Australia. The TGA has recently received several enquiries seeking to know which disinfectants have been entered into the Australian Register of Therapeutic Goods (ARTG) for use against COVID-19.

Claims that a disinfectant has an effect against any virus must be expressly permitted by the TGA before being used in consumer advertising (including on the label). In response to the COVID-19 pandemic, the TGA has permitted SARS-CoV-2 and COVID-19 virus claims. The following list is comprised of disinfectant products that have been registered with the TGA as having a specific effect against SARS-Cov-2 (COVID 19) or COVID-19 on the product label.

This is a list of some suggested products which might be easy to find in the supermarket or online:

Product name: Clorox disinfecting wipes
Sponsor: Clorox Australia Pty Limited
Manufacturer: The Clorox Company
License name: Disinfectant, hospital grade
Therapeutic type: Listed disinfectant

Product name: Coles Ultra Hospital Grade Surface Spray Disinfectant
Sponsor: Aaron Laboratories Pty Ltd
Manufacturer: Aaron Laboratories Pty Ltd
License name: Aaron Laboratories Pty Ltd - Coles Ultra Hospital Grade Surface Spray Disinfectant - Disinfectant, hospital grade
Therapeutic type: Listed disinfectant

Product name: Glen 20 Surface Spray Disinfectant - Hospital Grade
Sponsor: RB (Hygiene Home) Australia Pty Ltd
Manufacturer: Reckitt Benckiser Pty Ltd
License name: NON/ STERILE DISINFECTANTS - WITH CLAIMS - Ethanol
Therapeutic type: Listed disinfectant

Product name: Oust 3 in 1
Sponsor: SC Johnson & Son Pty Ltd
Manufacturer: Pax Australia Pty Limited
License name: Hospital Grade Disinfectant, With Claims, Non-Sterile
Therapeutic type: Registered disinfectant

Product name: Strike Surface Spray Hospital Grade Disinfectant
Sponsor: Aaron Laboratories Pty Ltd
Manufacturer: Aaron Laboratories Pty Ltd
License name: Aaron Laboratories Pty Ltd - Hospital Grade Disinfectant, 'Ethanol', 'Ortho Phenylphenol', with Claims, Non-Sterile
Therapeutic type: Registered disinfectant

If you would like more information or see if the products you’re currently using have been found to be effective against COVID-19 there is a full list on the TGA website.