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)

The state of Victoria*

*All health services in the state of Victoria, except for health services listed under COVID Alert, COVID Active and COVID Peak below
15 March 2021
COVID Alert (amber) None Not applicable
COVID Active (red) None Not applicable
COVID Peak (black) None 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

Guidance and advice

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. Masks should be worn by all staff in public/patient/resident facing areas, public shared areas and in non-clinical and non-public facing areas where physical distancing cannot be maintained.

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

No restrictions on patient visitors, unless in circumstances where health services determine their own requirements based on local risk assessment.

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. Masks should be worn by all staff in public/patient/resident facing areas, public shared areas and in non-clinical and non-public facing areas where physical distancing cannot be maintained.

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

No restrictions on patient visitors, unless in circumstances where health services determine their own requirements based on local risk assessment.

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. Masks should be worn by all staff in public/patient/resident facing areas, public shared areas and in non-clinical and non-public facing areas where physical distancing cannot be maintained.

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.

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.
Visitors

Patients/residents restricted to one visit, from one household, once per day.

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. Masks should be worn by all staff in public/patient/resident facing areas, public shared areas and in non-clinical and non-public facing areas where physical distancing cannot be maintained.

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

Visitors limited to selected circumstances only.

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.

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:

  • A parent/guardian/temporary carer of a patient under 18 years
  • To provide essential care and support necessary for a patient or aged care resident’s immediate physical, emotional or social wellbeing that optimises the care and support delivered by workers and can’t be provided by the person by electronic means
  • To provide interpreter or informal language support to enable delivery of care by workers
  • In the case of a pregnant patient of the hospital whose status as a patient relates to the pregnancy, the person is the patient’s partner or support person
  • in the case of a patient of the hospital who is in a maternity ward—the person is the patient's partner or support person
  • End of life support or immediate family member(s) of a patient or aged care resident whose medical condition is life threatening 
  • Patient or aged care resident who has a mental illness – the patient’s nominated person is present for matters related to their role as nominated person
  • Receiving education on how to support the patient or aged care resident care upon discharge.

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

a) any ward treating confirmed cases of coronavirus (COVID-19)

b) where the Chief Health Officer (or their delegate) notifies a hospital that there is community transmission in an area proximate to that hospital, that hospital’s:

  • ward(s) treating any high-risk suspected cases of coronavirus (COVID-19);
  • emergency department; and 
  • intensive care unit.

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.