Coronavirus (COVID-19) Health workforce response
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COVID-19 pandemic plan for the Victorian health sector
Victoria’s health system is prepared for an emerging coronavirus (COVID-19) pandemic with a new plan to manage more cases and the growing risk of an outbreak in Victoria.
The COVID-19 Pandemic Plan for the Victorian Health Sector sets out a four-stage response to COVID-19. The plan is flexible and proportionate to the current risk and will be updated as we learn more about the virus.
Chief Health Officer alerts and updates
- Chief Health Officer alert - 2019 Coronavirus disease (COVID-19) - 05 Apr 2020 - (Update to Alert issued 01 April 2020)
- Chief Health Officer Update
Stay up to date
- Check this page regularly
- Up-to-date epidemiological data
- Subscribe to CHO alerts: health.vic.gov.au/newsletters
- Subscribe to our Coronavirus update newsletter
- Follow the Chief Health Officer on Twitter: twitter.com/VictorianCHO
The World Health Organisation (WHO) has declared the new coronavirus outbreak a Public Health Emergency of International Concern.
This site will be updated as new information becomes available.
The Coronavirus disease 2019 (COVID-19) General practice quick reference guide - Version 17 - 05 April 2020 (Word) for general practitioners and health professionals provides advice for the management of suspected cases.
The Coronavirus disease 2019 (COVID-19) Guidelines for health services and general practitioners - Version 17 - 05 April 2020 (Word) provides more detailed clinical information and advice about coronavirus (COVID-19).
The Coronavirus disease 2019 (COVID-19) Healthcare worker PPE guidance - 3 April 2020 (Word) provides regularly updated personal protective equipment guidance as new evidence becomes available.
The Coronavirus disease 2019 (COVID-19) Use of n95 respirators in clinical settings (Word) describes the different types of respirators and indications for their use.
People without symptoms should not be tested.
Patients who meet at least one clinical AND at least one epidemiological criterion should be tested:
Fever (≥38°C) or history of fever (for example night sweats, chills)
Acute respiratory infection (for example, shortness of breath, cough, sore throat).
Close contacts of confirmed COVID-19 cases with onset of symptoms within 14 days of last contact
Travelers from overseas with onset of symptoms within 14 days of return
Cruise ship passengers or crew with onset of symptoms within 14 days of disembarkation
Paid or unpaid workers in healthcare, residential care, and disability care settings
People who have worked in public facing roles in the following settings within the last 14 days:
- Homelessness support
- Child protection
- The police force
- Firefighters who undertake emergency medical response
- Childcare and early childhood education
- Primary or secondary schools
Any person aged 65 years or older
Aboriginal or Torres Strait Islander peoples
Patients admitted to hospital where no other cause is identified
Any person in other high-risk settings, including:
- Aged care, disability and other residential care facilities
- Military operational settings
- Boarding schools
- Correctional facilities
- Detention centres
- Settings where COVID-19 outbreaks have occurred, in consultation with the department.
All patients being tested for COVID-19 should be isolated (at home or in hospital) until test results are available. All patients should attend an emergency department if clinical deterioration occurs.
Notify the department of confirmed cases as soon as practicable by calling 1300 651 160, 24 hours a day.
Only confirmed cases should be notified to the department.
- Assessment and testing for COVID-19
- COVID-19 infection, immunity and recovery
- Vaccination and medications
- Practice environment and workforce
- Vulnerable groups
- Where can I find out more information?
What should I do when assessing a patient with respiratory symptoms in a community setting?
- Separate from other patients.
- Place single-use surgical mask on the patient.
- Use droplet and contact precautions (gown, gloves, eye protection and single-use face mask) when assessing the patient
- Conduct a medical assessment, and focus on:
- History of contact with sick people or confirmed COVID-19 cases.
- Travel history, occupation and/or residence in high risk settings
- The date of onset of illness and especially whether there are symptoms or signs of pneumonia.
- If the patient has symptoms and signs suggestive of pneumonia, viral load might be higher. These patients should be tested and treated in hospital. If clinically required, ambulance transport should be used - advise 000 operator of suspected COVID-19.
- For guidance and service delivery models for providing immunisation services, please see our Victorian immunisation services factsheet (Word)
Who should I test for COVID-19?
Test all cases meeting the current criteria for COVID-19 testing, which are listed in the General Practice Quick Reference Guide and Guidelines for health services and general practitioners. Please ensure you refer to the latest version of these documents as the criteria may change.
If you have a patient who meets the criteria for COVID-19 testing (and who does not have symptoms or signs of pneumonia):
- Place a surgical mask on the patient and isolate them in a single room with door closed.
- Use droplet and contact precautions (single-use surgical face mask, eye protection, gown and gloves).
- Collect specimens for COVID-19 testing:
- Take a single nasopharyngeal swab for COVID-19 PCR. To conserve swabs the same swab that has been used to sample the oropharynx should be utilised for nasopharynx sampling (i.e. one swab per patient only).
- Take blood in a serum tube for storage at VIDRL.
- Consider alternative causes, in particular consider testing for other respiratory viruses using a multiplex PCR if available.
If appropriate personal protective equipment is unavailable, direct the patient to the nearest coronavirus assessment centre.
Patients with symptoms and signs suggestive of pneumonia should be tested and treated in hospital.
All patients who meet the criteria for COVID-19 testing should be advised to self-isolate until the results of the test are known; further advice should be provided based on test results.
Who should not be tested for COVID-19?
Patients without symptoms should not be tested.
Patients with fever or respiratory symptoms who do not meet the criteria for COVID-19 testing should not be tested. These patients should still be advised to self-isolate. Those well enough to be cared for in the community should remain home, and not attend work, school or any public places until symptoms have completely resolved. If they have had fevers they should remain at home until they have been afebrile for 72 hours.
When do I need to notify a case to the department?
Notification to the department is only required for confirmed cases – phone 1300 651 160, 24 hours a day.
Where can I find more information about COVID-19?
Detailed information for medical practitioners can be found in the Guidelines for health services and general practitioners.
What is the incubation period?
The incubation period is the duration between exposure to the virus and the onset of symptoms. The World Health Organization (WHO) currently estimates that the incubation period ranges from 1 to 14 days, with a median incubation period of 5 to 6 days. These estimates will be refined as more data becomes available.
When is someone considered infectious?
Evidence on the duration of infectivity for COVID-19 infection is evolving. Epidemiological data suggests that the majority of transmission occurs from symptomatic cases. The role of asymptomatic and pre-symptomatic transmission is still unknown. Cases are currently considered infectious from 24 hours prior to the onset of symptoms until they meet criteria for release from isolation.
Can reinfection occur?
Apparent re-infection has been reported in a small number of cases. However, most of these reports describe patients having tested positive within 7-14 days after apparent recovery. Immunological studies indicate that patients recovering from COVID-19 mount a strong antibody response. It is likely that positive tests soon after recovery represent persisting excretion of viral RNA, and it should be noted that PCR tests cannot distinguish between “live” virus and noninfective RNA.
What are the recommendations for influenza vaccination?
With COVID-19 spreading across Australia, this year it is more important than ever to ensure that patients receive the seasonal influenza vaccination. Influenza vaccination should be given as soon as possible. The regular influenza season may coincide with the peak of the current COVID-19 pandemic, potentially placing additional burden on the Australian health system.
- Influenza vaccine distribution to immunisation providers has commenced. Adjuvanted influenza vaccines are available for people aged 65 years and over.
- From the 1st of May, the flu vaccine will be mandatory for people wanting to visit an aged care facility (including aged care workers).
- Claims that influenza vaccination may increase the risk of coronavirus infection have been circulating on social media. There is no convincing evidence to support these claims.
Are ibuprofen and other non-steroidal anti-inflammatories safe to use in patients infected with COVID-19?
- There have been some concerns internationally that use of ibuprofen, or other non-steroidal anti-inflammatories (NSAIDs) during COVID-19 infection may lead to an increased risk of complications or death.
- There is currently no published peer-reviewed scientific evidence to support a direct link between use of ibuprofen and more severe infection with COVID-19.
Are ACE inhibitors and ARBs safe to use in patients with COVID-19?
- There have been some concerns internationally about a possible link between ACE inhibitor medications (angiotensin converting enzyme inhibitors) and ARBs (angiotensin II receptor blockers) and increased risk of infection with COVID-19 and worsened outcomes.
- At this stage, peak international and Australian cardiology bodies strongly recommend that patients stay on their current anti-hypertensive therapy.
- See the Heart Foundation website for further information.
Can hydroxychloroquine be used for prophylaxis?
- There is no clinical evidence that hydroxychloroquine is effective as prophylaxis against COVID-19.
- Hydroxychloroquine is in short supply and should be prioritised for use in recognised indications including autoimmune conditions and Q-fever endocarditis.
- The Pharmaceutical Society of Australia (PSA) have advised pharmacists to refuse the dispensing of hydroxychloroquine unless it is for a recognised indication.
Should anti-viral or adjunctive drugs be prescribed for patients with confirmed COVID-19 infection?
- Interim clinical guidelines for the management of patients with COVID-19 have been released by the following peak professional bodies:
- These guidelines clearly state that there are no proven pharmaceutical treatments for COVID-19 (other than supportive care). No antiviral or immunomodulatory agent has thus far been proven effective in clinical trials, and they may even be harmful and/or in short supply.
- At this stage, treatment of COVID-19 with antivirals is considered ‘experimental’ and should only occur within the context of controlled intervention trials.
- Two controlled interventional trials of antiviral therapies for COVID-19 are recruiting hospitalised patients in Australia and New Zealand: REMAP-CAP (endorsed by ANZICS), and ASCOT (endorsed by ASID).
How can we best implement social distancing in the consultation setting, including practices with small consultation rooms?
Physical distancing is to be practiced within clinics and wards, between staff and patients, and between staff and staff. This includes:
- waiting room chairs separated by at least 1.5 metres
- direct interactions between staff conducted at a distance
- staff and patients to remain at least 1.5 metres apart with the exception of clinical examinations and procedures.
- Use droplet and contact precautions (gown, gloves, eye protection and single-use face mask) when assessing a patient with respiratory symptoms in a community setting, see Advice for clinicians within the Coronavirus disease 2019 (COVID-19) Guideline for health services and general practitioners.
If a GP at my clinic tests positive to COVID-19, should all other staff be required to self-isolate and should I close my clinic?
Like others, health and aged care workers need to isolate themselves for 14 days after:
- returning from overseas
- being in close contact with someone confirmed to have COVID-19.
You can still go to work if you have:
- had casual contact with COVID-19 cases and are well
- directly cared for confirmed cases while using PPE properly
- Monitor yourself for symptoms and self-isolate if you become unwell.
For aged care workers, these rules also apply:
- from 1 May, you must have your influenza vaccination to work in or visit an aged care facility
- if you’re a residential aged care worker, you must not go to work if you have a fever or symptoms of a respiratory illness
Further advice on COVID-19 when clinicians can and cannot work click on the tab Advice to healthcare workers on this page.
Are there instructions on cleaning my clinic after case identification?
For advice on recommended environmental cleaning and disinfection instruction of clinics and/or consultation room, go to Environmental cleaning and disinfection within the Coronavirus disease 2019 (COVID-19) Guideline for health services and general practitioners.
When can we use telehealth?
The Commonwealth emphasises the importance of using telehealth item numbers responsibly, appropriately and for the right reasons during this pandemic. A service may only be provided by telehealth where it is safe and clinically appropriate to do so.
From 30 March 2020, telehealth (video-call) and phone consultation items are available to all Medicare eligible Australians for a wide range of consultations. The new MBS temporary bulk billed telehealth item numbers for COVID-19 are general in nature and have no relation to diagnosing, treating or suspecting COVID-19.
The item numbers must be bulk billed. Providers do not need to be in their regular practice to provide telehealth services. Providers should use their provider number for their primary location, and must provide safe services in accordance with normal professional standards.
For the latest news on the temporary COVID-19 bulk billed MBS telehealth items please consult www.mbsonline.gov.au, including a link to the temporary item numbers, COVID-19 fact sheets and latest news.
What chronic conditions are included in the new provisions for telehealth? Are mental health care plans included too?
From 30 March 2020, telehealth (video-call) and phone consultation items are available to all Medicare eligible Australians for a wide range of consultations. The new MBS temporary bulk billed telehealth item numbers for COVID-19 are general in nature and have no relation to diagnosing, treating or suspecting COVID-19. Mental Health plans are included.
For the latest news on the new MBS temporary bulk billed telehealth item numbers for COVID- please consult www.mbsonline.gov.au, including links to the temporary item numbers COVID-19 fact sheets and latest news. Fact sheets are available for Allied Health providers, Consumers, GPs and OMPS, Mental Health practitioners, Nurse Practitioners, Obstetric Attendances, participating Midwives and Specialists. Please find further at COVID-19 Temporary MBS Telehealth Services fact sheets .
What platforms are best use for telehealth/video calls?
MBS telehealth services are videoconference services, and this is the preferred approach for substituting a face-to-face consultation. However, in response to the COVID-19 pandemic, providers will also be able to offer audio-only services via telephone if video is not available. There are separate items available for the audio-only services.
No specific equipment is required to provide Medicare-compliant telehealth services. Services can be provided through widely available video calling apps and software such as Zoom, Skype, FaceTime, Duo, GoToMeeting and others.
Free versions of these applications (i.e. non-commercial versions) may not meet applicable laws for security and privacy. Practitioners must ensure that their chosen telecommunications solution meets their clinical requirements and satisfies privacy laws.
For further updates, refer to commonwealth government overarching COVID-19 Temporary MBS Telehealth Services fact sheets.
If I cannot physically examine my patient, how can I effectively provide the correct diagnosis and medical advice?
Many important questions and challenges have been raised, and the Commonwealth will continue to work through these. The Commonwealth will continue to communicate changes on the Government website www.health.gov.au, with regular webinar updates listed online, and through peak bodies.
How can doctors provide scripts, medical certificates and referrals via telehealth consultation?
Prescriptions can be mailed or emailed to the patient or the patient’s pharmacist – refer to the Provider Frequent Asked Questions at COVID-19 Temporary MBS Telehealth Services fact sheets for temporary telehealth bulk-billed items.
The Home Medicines Service is a temporary program, which aims to support and protect the most vulnerable members of our community from potential exposure to novel coronavirus (COVID-19) by providing a fee per delivery payable to Australian pharmacies for the home delivery of Pharmaceutical Benefits Scheme (PBS) and Repatriation Pharmaceutical Benefits Scheme (RPBS) medications thereby removing the need for a patient to visit a Pharmacy.
Vulnerable people, and those in home isolation, will be able to order their PBS and RPBS prescriptions remotely and have these items delivered to their homes to reduce their potential exposure to COVID-19. Further advise can be found at COVID-19 Home Medicine Service.
The Australian Government is currently working to fast track the implementation of electronic prescribing (ePrescribing) to help protect people most at-risk in our community from exposure to COVID-19. Updates on this can be viewed on the Government website.
Many important questions and challenges have been raised, and the Commonwealth continue to work through these. We will continue to communicate changes on the Government website www.health.gov.au, with regular webinar updates listed online, and through peak bodies.
Work Safe telehealth item numbers specifically state “video”, do they accept phone consultations (MBS does)?
Although the WorkSafe document does not explicitly outline phone consultations, we have confirmed with WorkSafe that phone consultations are accepted for WorkSafe clients.
Please refer to the MBS Online under the heading `General Practitioner Attendances’ for items numbers for phone consultations (there are separate item numbers for video consultations and phone consultations).
Information about WorkSafe - item codes for telehealth are now available.
DHHS acknowledges the diversity of issues that may present in vulnerable groups of our population. This is a challenge that is not being overlooked, be assured we are planning as best we can and will respond as quickly as we can as issues arise.
Can I continue to provide clinical care in aged care/residential care/supported homes?
You can still go to work if you have:
- had casual contact with COVID-19 cases and are well
- directly cared for confirmed cases while using PPE properly
Monitor yourself for symptoms and self-isolate if you become unwell.
For aged care workers, these rules apply:
- from 1 May 2020, you must have your influenza vaccination to work in or visit an aged care facility.
- if you’re a residential aged care worker, you must not go to work if you have a fever or symptoms of a respiratory illness
For further information about providing clinical care in these settings, seeCoronavirus (COVID-19) advice for the health and aged care sector.
Is there advice about contact with elderly? Should we be recommending people reduce contact with elderly relatives?
Interventions to support ‘transmission reduction, or ‘physical distancing’ measures are particularly important in reducing the spike of infections and protecting our elderly and those with chronic diseases or pre-existing medical conditions. Find out more at Physical distancing and other transmission reduction measures - coronavirus (COVID-19)
Are there resources (including in common community languages) and pictorial information for vulnerable groups including CALD, homeless?
COVID-19 translated information for people from culturally and linguistically diverse backgrounds, health professionals and industry in over 40 languages is available on the department’s website. A GP poster is currently available in simplified Chinese.
Are pregnant women considered an 'at risk' group for COVID-19?
At this time, pregnant women do not appear to be more likely to develop severe COVID-19 than the general population. It is expected that most pregnant women who develop COVID-19 will experience mild or moderate illness from which they will make a full recovery. However, there is currently limited information available regarding the impact of COVID-19 on pregnant women and their babies. Therefore, it would be prudent for pregnant women to practice social distancing and ensure good hygiene practices to reduce the risk of infection.
Can vertical transmission of COVID-19 occur?
Currently, there is no evidence for vertical transmission of COVID-19 and no evidence that maternal COVID-19 infection affects foetal development.
Assisted Reproductive Treatments (ART)
For guidance for assisted reproductive treatments, including in-vitro fertilisation, please see our guidance for assisted reproductive treatments factsheet (Word).
Call the Department of Health and Human Services on to discuss any questions you have. If you need a translator first call 131 450, then request the hotline on 1300 651 160.
For Victorian updates to the current incident, go to:
Department of Health and Human Services, Victoria - Coronavirus disease (COVID-19)
For national updates:
Department of Health (Australian Government) Coronavirus Alert
Royal Australian College of General Practice (RACGP): https://www.racgp.org.au/coronavirus
Australian Health Practitioner Regulation Agency (AHPRA): https://www.ahpra.gov.au/News/COVID-19.aspx
For international updates:
WHO Western Pacific Coronavirus disease (COVID-19) outbreak
WHO Coronavirus resources https://www.who.int/health-topics/coronavirus
Coronavirus Disease 2019 (COVID-19) CDNA National Guidelines for Public Health Units (COVID-19 SoNG): https://www1.health.gov.au/internet/main/publishing.nsf/Content/cdna-song-novel-coronavirus.htm
Anyone who works in health, aged or residential care who has taken the recommended infection control precautions, including the use of recommended PPE, while caring for a confirmed case of COVID-19, is not considered to be a close contact. However, they should also be advised to self-monitor and if they develop symptoms consistent with COVID-19 infection they should isolate themselves and notify the department on 1300 651 160 so they can be tested and managed as a suspected case of COVID-19.
From midnight 15 March 2020, any healthcare worker or residential aged care worker arriving or returning from any overseas destination must self-quarantine (self-isolate) for a period of fourteen (14) days.
Healthcare workers who have been overseas in the past 14 days and are unwell with a compatible illness should not attend work and seek appropriate medical care. All unwell healthcare workers should consider being tested for COVID-19.
Hospital workers must not enter or remain at a hospital in Victoria from midnight 23 March, if:
- the person has been diagnosed with COVID-19, and has not yet met the criteria for discharge from isolation
- if the person has travelled/arrived in Australia from any country in the past 14 days
- has had known contact with a person who is a confirmed COVID 19 case
- has a temperature higher than 37.5 degrees or symptoms of acute respiratory infection
There are now restrictions on who can visit - or work at - a Victorian hospital
This is to help reduce the spread of coronavirus into hospitals by people who may pose a risk and do not have an important reason to be there.
What restrictions will be placed on visits?
Across Victoria, patients in public, private and denominational hospitals, multi-purpose services and day procedure centres will only be allowed one visit per day, from a maximum of two visitors at one time for two hours a day.
Who is prohibited from visiting a Victorian hospital?
To keep patients and staff safe you will not be able to visit a hospital if you:
- have been diagnosed with coronavirus and have not been discharged from isolation
- have arrived in Australia within 14 days of your planned visit
- have recently come into contact with a person who has a confirmed case of coronavirus
- have a temperature over 37.5 degrees or symptoms of acute respiratory infection.
Are there exemptions to these rules?
There are some categories where visitors can stay longer than two hours, but the maximum limit of two visitors at a time will still apply. These exemptions are:
- the parent, guardian or temporary carer of a patient who is under 18 years old
- the carer of a patient with a disability
- the partner or support person of a patient who is pregnant and attending hospital in relation to their pregnancy
- accompanying a patient to the hospital's emergency department
- accompanying the patient to an outpatient appointment
- providing end of life support to a patient of the hospital.
All visitors can expect to be screened on entry
Before you can enter any hospital to visit a patient in one of the above categories, you will be screened to ensure you do not have a temperature. Further advice on implementation will be provided shortly.
Who can work at a Victorian hospital?
The only people who may enter hospitals for work purposes are:
- a person who is an employee or contractor of the hospital
- a student under the supervision of an employee or contractor of the hospital
- a person providing health, medical or pharmaceutical goods or services to a patient of the hospital (whether paid or voluntary)
- a person providing goods or services necessary for the effective operation of the hospital (whether paid or voluntary)
- union and employer representatives
- a person involved in emergency management or law enforcement
- a person who enters an area of the hospital exempted from the restriction.
What about people providing a care and support visit?
A person providing a care and support visit to a patient may visit for a maximum of two hours per day, provided this is the only care and support visit made to the patient on that day.
All other types of permitted visitors may stay longer than two hours if they wish.
Are there any other restrictions on visits?
Yes. There is a maximum limit of 2 visitors at one time, not including hospital workers. Visitors can be in any combination of the permitted visitor categories.
Are there any time limits on visits?
A person who is attending solely to provide care and support for a patient can only remain with a patient for a maximum of two hours per day. The two-hour time limit applies only to care and support visitors, not to any other type of visit.
Can hospitals vary these limits at their own discretion?
Hospitals cannot allow more visitors than these directions permit. Hospitals can, however, issue even more strict limits on visitors should they need to.
What if I do not comply?
A person who ignores the ban will be liable for fines of up to approximately $20,000, or up to approximately $100,000 in the case of companies and other bodies corporate.
How will these directions be implemented?
Safer Care Victoria is currently preparing advice to support health services in the appropriate implementation of these directions.
- COVID-19 Hospital Preparedness Assessment Tool (Word) - this checklist has been developed to support Victorian hospitals (metropolitan, rural and private) to plan their response to COVID-19 and is based on and should be read in conjunction with your business continuity plans and pandemic plans.
- COVID-19 Hospital Preparedness Scenario Testing Tool (Word) - this document is designed to be used to test Victorian health services pandemic preparedness plans for the management of COVID-19 through presenting two realistic and challenging scenarios for health services to work through.
- COVID-19 assessment and streaming matrix - decision matrix for assessing and streaming COVID-19 patients arriving at emergency departments, urgent care centres and hospital-based screening clinics. This tool was developed to assist busy clinicians to be able to make informed COVID-19 patient assessment decisions in a timely manner.
- GP Poster (PDF)
- GP Poster - Simplified Chinese (PDF)
- Guidance for chronic disease management (Word)
- How to put on and fit check a P2 respirator (PDF)
- How to put on your PPE (PDF)
- How to take off your PPE (PDF)
- Rational use of personal protective equipment for coronavirus disease 2019 (COVID-19) - World Health Organization (PDF)
- Rational use of personal protective equipment and laboratory testing factsheet (COVID-19) (Word)
- Caring for people with COVID-19 - National COVID-19 Clinical Evidence Taskforce