Guidance for health services to respond to changing COVID-19 transmission risks in the community.
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The Victorian Health Service Guidance and Response to COVID-19 Risks (VHSGR) has been developed to inform health service processes and interventions in response to changing risks of COVID-19 transmission in the community.

The role of the VHSGR is to bring together and collate in a central repository, guidance and advice which will support health services mitigate the risks of COVID-19 transmission, whilst at the same time providing appropriate care and safety for patients, staff and visitors.

It includes guidance on topics such as:

  • Personal protective equipment (PPE) use
  • Health care worker surveillance testing
  • Patient pre-operative testing and screening
  • Elective surgery
  • Visitor information
  • Outpatient consultations
  • Emergency Department policy
  • Healthcare worker mobility.

If it is decided that a risk rating should be changed, the Department of Health will enact and communicate the decision to health services. This website will also be updated immediately to reflect the new change to risk ratings.

Current risk rating

Current Victorian Health Service Guidance and Response to COVID-19 Risks ratings in place in Victoria.

The map below shows the risk ratings across Victoria.

Risk rating Location Date the risk rating was applied
COVID Ready (green)

N/A

Not applicable
COVID Alert (amber) Regional Victoria 3 June 2021
COVID Active (red) Metropolitan Melbourne 3 June 2021
COVID Peak (black) N/A Not applicable

Risk ratings

Risk ratings can be applied to the state of Victoria, or to specific geographical regions and/or individual health service.

There are four risk levels, with each rating reflecting the risk of COVID-19 transmission in the community, and how a health service should respond and prepare to reduce that risk:

  1. COVID Ready (green) – low risk
    Victorian Health Service Guidance and Response to COVID-19 Risks - COVID Ready (Word)
  2. COVID Alert (amber) – moderate risk
    Victorian Health Service Guidance and Response to COVID-19 Risks - COVID Alert (Word)
  3. COVID Active (red) – high risk
    Victorian Health Service Guidance and Response to COVID-19 Risks - COVID Active (Word)
  4. COVID Peak (black) – very high risk
    Victorian Health Service Guidance and Response to COVID-19 Risks - COVID Peak (Word)

All decisions to change risk ratings will be made by the Victorian Department of Health.

COVID-19 risk levels: green is covid ready, orange is covid alert, red is covid active and black is covid peak
Victorian health service guidance and response to COVID-19 risks levels

Procedures at different risk ratings

See advice on appropriate health service procedures and activities at different risk ratings.

COVID Ready

Advice on appropriate health service procedures and activities at COVID Ready risk rating.

Topic Recommended procedure
PPE Tier 1

Routine care of COVID negative. 

Face masks are mandatory for all healthcare workers.

More information on Personal Protective Equipment (PPE).

PPE Tier 2

Routine care of low-risk SCOVID for staff in community COVID testing locations.

More information on Personal Protective Equipment (PPE).

PPE Tier 3

AGPs and risk of AGBs in low-risk SCOVID.

Exposure/care/contact with high-risk SCOVID and confirmed COVID patients.

For staff undertaking COVID testing at port of entry testing locations.

More information on Personal Protective Equipment (PPE).

Patient/resident testing and screening

Testing patients/residents with compatible clinical and/or epidemiological risk factors.

You can read more in the Coronavirus (COVID-19) pre-operative testing of elective and emergency surgery patients – FAQs for healthcare workers (Word).

Health care worker surveillance testing Routine testing of asymptomatic staff who are exposed and/or provide care to high risk SCOVID and confirmed COVID-19 patients.
Workforce attestations and screening

Daily attestations at a minimum.

You can read more in the Daily Attestations: frequently asked questions (Word).

Elective surgery  All categories undertaken.
Visitors

Restrictions on visitors as per Public Health Directions.

Pre-attendance screening based on clinical and epidemiological factors, at a minimum.

More information on visiting hospitals is available on the coronavirus website.

Specialist outpatient consulting Face to face or telehealth appointments to occur as per normal arrangements.
Emergency department 

As per normal emergency department triage and risk assessment protocols.

You can read more in the Physical distancing in emergency departments and urgent care centres (Word).

Vulnerable workers (high-risk employees) Appropriate for high risk employees to attend work as per normal working arrangements.
Workforce mobility

Care facility workers and HCWs who meet high risk hospital work premises worker definition limited to working at one facility (where practical). All other HCWs permitted to work at multiple sites.

You can read more in the Movement of workers during the coronavirus (COVID-19) pandemic (Word).

Student clinical placements

Student clinical placements permitted in all settings but restricted from providing care/being exposed to high-risk SCOVID and confirmed COVID patients.

You can read more in the Student clinical placements - Coronavirus (COVID-19) guidance (Word).

COVID Alert

Advice on appropriate health service procedures and activities at COVID Alert risk rating.

Topic Recommended procedure
PPE Tier 1

Routine care of COVID negative. 

Face masks are mandatory for all healthcare workers.

More information on Personal Protective Equipment (PPE).

PPE Tier 2

Routine care of low-risk SCOVID for staff in community COVID testing locations.

More information on Personal Protective Equipment (PPE).

PPE Tier 3

AGPs and risk of AGBs in low-risk SCOVID.

Exposure/care/contact with high-risk SCOVID and confirmed COVID patients.

For staff undertaking COVID testing at port of entry testing locations.

More information on Personal Protective Equipment (PPE).

Patient/resident testing and screening

Testing patients/residents with compatible clinical and/or epidemiological risk factors.

You can read more in the Coronavirus (COVID-19) pre-operative testing of elective and emergency surgery patients – FAQs for healthcare workers (Word).

Health care worker surveillance testing Increased testing of asymptomatic staff who are exposed and/or provide care to high-risk SCOVID and confirmed COVID-19 patients.
Workforce attestations and screening

Daily attestations at a minimum.

You can read more in the Daily Attestations: frequently asked questions (Word).

Elective surgery  All categories undertaken.
Visitors

Restrictions on visitors as per Public Health Directions.

Pre-attendance screening based on clinical and epidemiological factors, at a minimum.

More information on visiting hospitals is available on the coronavirus website.

Specialist outpatient consulting

Telehealth encouraged.

Risk assessment for face-to-face appointments.

Emergency department 

Consider COVID service plans.

You can read more in the Physical distancing in emergency departments and urgent care centres (Word).

Vulnerable workers (high-risk employees) Where possible, high-risk employees should be considered for re-deployment.
Workforce mobility

Care facility workers and HCWs who meet high risk hospital work premises worker definition limited to working at one facility (where practical). All other HCWs permitted to work at multiple sites.

You can read more in the Movement of workers during the coronavirus (COVID-19) pandemic (Word).

Student clinical placements

Student clinical placements permitted in all settings but restricted from providing care/being exposed to high-risk SCOVID and confirmed COVID patients.

Students restricted to one campus/site only.

You can read more in the Student clinical placements - Coronavirus (COVID-19) guidance (Word).

COVID Active

Advice on appropriate health service procedures and activities at COVID Active risk rating.

Topic Recommended procedure
PPE Tier 1

Addition of eye protection when treating COVID negative patient/residents.

Face masks are mandatory for all healthcare workers.

More information on Personal Protective Equipment (PPE).

PPE Tier 2

As per standard precautions for COVID negative patients/residents.

More information on Personal Protective Equipment (PPE).

PPE Tier 3

All exposure/care/contact with low-risk/high-risk SCOVID and confirmed COVID patients.

For staff COVID testing at port of entry and community testing locations.

For treatment of anyone who has worked in or volunteered at a hotel quarantine site and/or other port of entry in the last 14 days.

More information on Personal Protective Equipment (PPE).

Patient/resident testing and screening

Testing patients/residents with compatible clinical and/or epidemiological risk factors.

Asymptomatic testing based on risk assessment.

You can read more in the Coronavirus (COVID-19) pre-operative testing of elective and emergency surgery patients – FAQs for healthcare workers (Word).

Health care worker surveillance testing Health services with an outbreak to follow outbreak-based testing program as per directions/advice from Public Health, Department of Health.
Workforce attestations and screening

Daily attestations and enhanced screening based on clinical and epidemiological risk factors.

You can read more in the Daily Attestations: frequently asked questions (Word).

Elective surgery 

Category 1, 2A only.

All other elective surgery is subject to a system assessment by the Department of Health.

Visitors

Restrictions on visitors as per Public Health Directions.

Pre-attendance screening, based on clinical and epidemiological risk factors.

More information on visiting hospitals is available on the coronavirus website.

Specialist outpatient consulting

Telehealth recommended wherever possible.

Risk assessment for face-to-face appointments.

Emergency department 

Implement COVID service plans.

You can read more in the Physical distancing in emergency departments and urgent care centres (Word).

Vulnerable workers (high-risk employees) Health services should re-deploy high-risk employees based on risk assessment. Where not possible, consider whether appropriate to attend work.
Workforce mobility

Where practical, consider restricting all care facility workers and HCWs mobility to one campus/facility.

You can read more in the Movement of workers during the coronavirus (COVID-19) pandemic (Word).

Student clinical placements

Student clinical placements permitted in all settings but restricted from providing care/being exposed to high-risk SCOVID and confirmed COVID patients.

Students restricted to one campus/site only.

You can read more in the Student clinical placements - Coronavirus (COVID-19) guidance (Word).

COVID Peak

Advice on appropriate health service procedures and activities at COVID Peak risk rating.

Topic Recommended procedure
PPE Tier 1

Addition of eye protection when treating COVID negative patient/residents.

Face masks are mandatory for all healthcare workers. 

More information on Personal Protective Equipment (PPE).

PPE Tier 2

As per standard precautions for COVID negative patients/residents.

More information on Personal Protective Equipment (PPE).

PPE Tier 3

All exposure/care/contact with low-risk/high-risk SCOVID and confirmed COVID patients.

For staff COVID testing at port of entry and community testing locations.

More information on Personal Protective Equipment (PPE).

Patient/resident testing and screening

Testing patients/residents with compatible clinical and/or epidemiological risk factors.

Routine pre-elective surgery and pre-elective caesarean testing.

Additional patient testing as per risk assessment.

You can read more in the Coronavirus (COVID-19) pre-operative testing of elective and emergency surgery patients – FAQs for healthcare workers (Word).

Health care worker surveillance testing Health services with an outbreak to follow outbreak-based testing program as per directions/advice from Public Health, Department of Health.
Workforce attestations and screening

Daily attestations and enhanced screening based on clinical and epidemiological risk factors.

You can read more in the Daily Attestations: frequently asked questions (Word).

Elective surgery  Category 1 only.
Visitors

Restrictions on visitors as per Public Health Directions.

More information on visiting hospitals is available on the coronavirus website.

Specialist outpatient consulting

Face-to-face outpatient appointments by exception.

Risk assessment for face-to-face appointments.

Emergency department 

Escalated COVID service plans.

You can read more in the Physical distancing in emergency departments and urgent care centres (Word).

Vulnerable workers (high-risk employees)

High-risk employees are to be redeployed or if not possible, furloughed 

Workforce mobility

Where practical, all care facility workers and HCW mobility restricted to one campus/facility.

You can read more in the Movement of workers during the coronavirus (COVID-19) pandemic (Word).

Student clinical placements

Student clinical placements restricted from providing care/being exposed to high-risk SCOVID/confirmed COVID patients.

Student clinical placements restricted from high-risk hospital work premises including ED, ICU, COVID/SCOVID wards and aged care.

You can read more in the Student clinical placements - Coronavirus (COVID-19) guidance (Word).

Terminology explained

Definitions of frequently used terminology

Read the definitions of frequently used terminology.

Confirmed COVID case

A person who tests positive to a validated SARS-CoV-2 test.

Low risk SCOVID case

Includes persons awaiting the results of a test, where there may be symptoms that could be consistent with coronavirus (COVID-19) but no epidemiological risk factors. Where a patient/resident’s history cannot be obtained, they should be considered as a low-risk suspected case until further screening information can be obtained, at which point a revised diagnosis of the patient/resident’s condition can be made and appropriate changes to PPE implemented.

High risk SCOVID case

A person in quarantine for any reason (including: being a close contact of a confirmed case or coronavirus (COVID-19) or a returned traveller from overseas, or a relevant interstate area with outbreaks as defined by public health, in the last 14 days) with or without a compatible clinical illness. This group of people is also referred to as 'at-risk'.

A person who has a compatible clinical illness and meets one or more of the following epidemiological risk factors (within 14 days prior to illness onset):

  • Contact with a confirmed case or an exposure site as defined by public health
  • Was employed in an area where there is an increased risk of coronavirus (COVID-19) transmission for example:
    • aged care workers/ healthcare workers working in a location where there are active outbreaks
    • other high-risk industries (such as abattoirs) where there are known cases /or high levels of community transmission
  • Lived in or visited a geographically localised area at high risk as determined by public health.
  • Has been released from a quarantine facility.

COVID negative

  • A person who tests negative to a validated SARS-CoV-2 nucleic acid test.
  • A person who is a cleared case.
  • A person who screens negative and/or has no clinical or epidemiological risk factors for COVID-19.

Routine healthcare worker testing

Testing of asymptomatic staff who are exposed and/or provide care to high risk SCOVID (offered 1 nasal throat swab every 7 days) and confirmed COVID-19 patients (4 saliva samples over 14 days, 1 nasal throat swab every 7 days).

Increased healthcare worker testing

Increased testing of asymptomatic staff who are exposed and/or provide care to high-risk SCOVID and confirmed COVID-19 patients (4 saliva samples over 14 days, 1 nasal throat swab every 7 days).

Clinical risk factors

Clinical compatible symptoms with COVID-19, such as fever, cough, shortness of breath, sore throat, loss of smell or taste.

Epidemiological risk factors

  • A person in quarantine for any reason (including; being a close contact of a confirmed case of coronavirus (COVID-19) and/or a returned traveller from overseas, and/or a relevant interstate area with outbreaks as defined by public health, in the last 14 days).
  • Contact with a confirmed case of COVID-19 and/or visited an exposure site as defined by public health.
  • Was employed/volunteered in an area where there is an increased risk of COVID-19 transmission (e.g. hotel quarantine workers, port of entry workers, aged care/health care workers where there are active outbreaks, other high risk industries (such as abattoirs) where there are known cases or high levels of community transmission).
  • Lived in or visited a geographically localised area at higher risk, as determined by public health.

AGP: Aerosol Generating Procedure

Procedures performed on patient/residents that are more likely to generate higher concentrations of infectious respiratory aerosols. Examples include bronchoscopy, tracheal intubation, non-invasive ventilation (e.g. BiPAP, CPAP), high flow nasal oxygen therapy, manual ventilation before intubation, intubation, cardiopulmonary resuscitation, suctioning, sputum induction, nebuliser use.

AGB: Aerosol Generating Behaviour

Behaviours that are more likely to generate higher concentrations of infectious respiratory aerosols. Examples include persistent and/or severe coughing, screaming and shouting, women in active labour who exhibit heavy breathing and panting.

Visitor restrictions

There may be occasions where COVID-19 transmission risks result in health services restricting visitors to their facility. The decision to restrict the number of visitors will be made based on ensuring the safety of staff, patients, residents and visitors themselves. However, there will be some exceptions to these restrictions even when risk levels are increased, including:

  • Providing essential care or support for the patient's immediate physical or emotional wellbeing, including support for people living with mental health conditions or dementia.
  • Is the parent, carer or guardian of a person under the age of 18.
  • As a nominated person (as defined in the Mental Health Act 2014), including for patients living with dementia.
  • As an interpreter or to provide language support.
  • To learn to support the patient or resident's care upon discharge.
  • As the partner or support person of a patient in maternity care, or pregnancy.
  • Accompanying a patient to an emergency department or outpatient patient appointment, if necessary.
  • Is immediate family (including kinship) of a patient with life-threatening condition.
  • End of life support or immediate family member(s) of a patient or aged care resident whose medical condition is life threatening

Higher risk employee categories

  • Aboriginal and Torres Strait Islander people 50 years and older with one or more chronic medical conditions
  • People 65 years and older with chronic medical conditions
  • People 70 years and older
  • People with compromised immune systems
  • Pregnant women > 28 weeks gestation

High risk hospital Work Premises

High-risk hospital Work Premises means any hospital ward treating a confirmed case or cases of SARS-CoV-2.

High-risk hospital Work Premises worker

Any worker involved in the direct care of patients in high-risk hospital Work Premises (see above) AND those workers who interact with a high-risk hospital Work Premises.

Enhanced screening

Additional screening over and above the Department of Health guidance, which could include local hospital-specific requirements such as temperature checks, previous exposure to COVID-19, determining whether a HCW works at other locations, etc.

System assessment

When the COVID-Active (red) risk rating applies:

  • All Category 1 and Category 2A surgery can be undertaken
  • All other elective surgery will be subject to an overall system assessment by the Department of Health. This will include assessment of:
    • Workforce demands
    • Bed capacity
    • ICU capacity
    • Community restrictions
    • Safety of patients, healthcare workers and the community
    • Other risks and demands on the system

The system assessment will be undertaken regularly, whilst the COVID Active (red) rating applies.

Health services will be advised when other categories of elective surgery (Category 2B and Category 3) are permitted under the COVID-Active (red) risk rating.