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
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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 15 - 20 March 2020 (Word) for general practitioners and health professionals provides advice for the management of suspected cases.
The Coronavirus disease 2019 (COVID-19) Guideline for health services and general practitioners - Version 15 - 20 March 2020 (Word) provides more detailed clinical information and advice about novel coronavirus (COVID-19).
The Coronavirus disease 2019 (COVID-19) Healthcare worker PPE guidance - 30 March 2020 (Word) provides regularly updated personal protective equipment guidance as new evidence becomes available.
People without symptoms should not be tested.
Patients who meet at least one clinical AND at least one epidemiological criteria should be tested.
Acute respiratory infection (for example, shortness of breath, cough, sore throat)
Travelers from overseas with onset of symptoms within 14 days of return
Close contacts of confirmed COVID-19 cases with onset of symptoms within 14 days of last contact
Healthcare workers and residential aged care workers meeting clinical criteria
Aged and residential care residents meeting clinical criteria
Patients who are Aboriginal or Torres Strait Islander people meeting clinical criteria
* ≥ 38 degrees, without another immediately apparent cause such as urinary tract infection or cellulitis
The following patients should also be tested:
Patients admitted to hospital with acute respiratory tract infection AND fever *
* ≥ 38 degrees, without another immediately apparent cause such as urinary tract infection or cellulitis
Only confirmed cases should be notified to the department
A person who tests positive to a validated SARS-CoV-2 nucleic acid test or has the virus identified by electron microscopy or viral culture.
More detailed definitions of close contact are available in the guidelines for health services and general practitioners
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.
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.
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.
Vaccination and medication
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).
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.
Where can I find out more information?
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: https://www.dhhs.vic.gov.au/novelcoronavirus
For national updates: https://www.health.gov.au/news/latest-information-about-novel-coronavirus
For international updates: https://www.who.int/westernpacific/emergencies/novel-coronavirus
WHO resources https://www.who.int/health-topics/coronavirus
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)
- 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)