COVID-19

The NSW Nurses and Midwives’ Association is providing support and advice to any members seeking information regarding the novel coronavirus (COVID-19).

Join the NSWNMA to ensure you’re covered at work.

If members are concerned their employer is not following these guidelines, the NSWNMA can provide assistance to ensure appropriate measures are in place. Contact us.

Click here for the latest Workforce Advice for NSW Health staff Click here for the latest WHS Advice for NSW Health staff

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Mandatory vaccination requirements – 30 Sep

The Minister of Health signed off on the Public Health (COVID-19 Vaccination of Health Care Workers) Order 2021 on 26 August 2021.

The Ministry of Health has released these comprehensive FAQs regarding the Public Health Order (PHO) requiring vaccination for COVID-19.

The terms of the PHO now include all those working in what we would know as the NSW Health Service (including the Ambulance Service). It also includes all private health facilities as defined in the Private Health Facilities Act 2007 (i.e. private health facility means premises at which any person is admitted, provided with medical, surgical or other prescribed treatment and then discharged, or premises at which a person is provided with prescribed services or treatments).

It also can include into the future any other person or type of health care work that the NSW Chief Health Officer may identify.

The PHO defines work as including: students on a student placement; volunteers; work done under a contract of service, including VMOs.

Those currently working in the above services will need to be able to demonstrate that they have had at least one COVID-19 vaccination by 30 September 2021 and have received their second dose by 30 November 2021. Evidence of vaccination compliance or a medical exemption must be provided to your employer. If not, workers will not be permitted to enter and work at the facility.

The Association has and continues to make representations to the NSW Ministry of Health and NSW Government in relation to issues with access to vaccines and concerns regarding vaccine hesitancy. We have also raised concerns regarding the potential loss of a vital component of the workforce.

Exemption

An exemption is possible on medical grounds, using this form approved by the NSW Chief Health Officer.

The PHO also requires employers to take all reasonable steps to ensure compliance by their workers.

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Mandatory vaccination requirements for workers in LGAs of concern – 19 Sep

There are requirements for authorised workers in Local Government Areas (LGA) of concern to receive their first vaccination prior to the 30 September.

If you live in an LGA of concern but work in another LGA, you will be required to have had your first COVID-19 vaccine by 19 September in order to attend work.

As of Saturday, 28 August, workers are also required to apply for a permit to travel to/from work.

Exemptions

An exemption will be granted if the worker is unable, due to a medical contraindication, to receive a COVID-19 vaccine and presents a medical contraindication certificate.

The Minister may, in writing and subject to conditions the Minister considers appropriate, exempt a person or class of persons from the operation of this Order if the Minister is satisfied it is necessary to protect the health and well-being of persons.

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Permits for health workers living or working in affected LGAs

Essential workers who live in affected LGAs or travel to work in an affected LGA will now require a permit from Service NSW​​​​​​:

• From Saturday, 28 August, authorised workers from the LGAs of concern are required to carry a permit from Service NSW declaring that they are an authorised worker and cannot work from home
• From Saturday, 28 August, anyone entering an LGA of concern for the purposes of work must carry a worker permit issued by Service NSW.

End to surveillance testing

Members living in Canterbury-Bankstown, Cumberland and Fairfield LGA are no longer required to undergo COVID-19 routine testing if working outside your LGA.

• From 12.01am Monday, 23 August, workers from the Canterbury-Bankstown, Cumberland and Fairfield LGAs no longer have to be tested for COVID-19 in the previous 72 hours to work outside their LGA.

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Priority Pfizer access

Authorised workers between the age of 16 – 39 who live within one of the 12 local government areas (LGA) of concern, can access priority Pfizer vaccination appointments.

These areas include: Blacktown, Campbelltown, Canterbury-Bankstown, Cumberland, Fairfield, Georges River, Liverpool, Paramatta, Bayside, Burwood, Strathfield local government areas (click this link for a full list of suburbs) or the Penrith suburbs of Caddens, Claremont Meadows, Colyton, Erskine Park, Kemps Creek, Kingswood, Mount Vernon, North St Marys, Orchard Hills, Oxley Park, St Clair and St Marys.
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What you need to do:

Go to the NSW Government website: www.nsw.gov.au/covid-19/health-and-wellbeing/covid-19-vaccination-nsw/authorised-worker-priority-appointments and follow the instructions provided.

The following clinics are participating:

• NSW Health Vaccination Centre, Sydney Olympic Park
• Qudos Bank Arena NSW Health Vaccination Centre
• South Western Sydney Vaccination Centre
• Prairiewood Vaccination clinic
• Nepean Vaccination clinic
• St George Vaccination clinic

The vaccine is free and you do not need a Medicare card to make an appointment. This invitation is only for you and cannot be forwarded on to anyone else.

You will need to make your second appointment when booking. The booking system will set it at the appropriate interval.

On the day of your vaccination you will need to bring photo ID as well as proof of your place of work. If you do not bring both of these, you may not be able to proceed for your vaccination.

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Mandatory vaccination by 17 September – MPSs/State Operated Nursing Homes 

In late June, National Cabinet agreed to a requirement for all aged care workers to receive at least one dose of the COVID-19 vaccine by 17 September, 2021.

The Commonwealth Department of Health has now provided more information on the mandatory vaccination process, including who is affected and possible exemptions. Exemptions are limited to those with a medical contraindication (certified by a medical practitioner) or a temporary inability to access a vaccination due to limited supply or access issues. Please refer to the Department’s document Mandatory Vaccination of Aged Care Workers.

Nurses and midwives working in a public health service with federally funded aged care beds will be required to receive at least one dose of the COVID-19 vaccine by 17 September, 2021.

At the multi-purpose service (MPS), this will apply to all employees including:

• All Clinical Staff
• All Agency Staff
• All Support and Services staff, including HealthShare staff
• All Maintenance and administration staff
• All Managers
• All employees visiting from other sites and services will also be required to provide proof of at least the 1st vaccination upon arrival.

The NSWNMA has been advised that staff who have not yet been vaccinated will receive priority to ensure they receive their first dose by 17 September 2021.

For more information, please refer to the FAQ document provided by the Ministry of Health.

NSW Health will seek redeployment opportunities for unvaccinated employees in non-aged care facilities, before 17 September 2021, pursuant to NSW Health Policy Directive ‘Occupational Assessment, Screening and Vaccination Against Specified Infectious Diseases’ (PD2020_017).

Redeployment opportunities may be limited due to the isolated geographic location of some services, differences in profile and skill set between Aged Care Services and the opportunities available in other services in NSW Health. Due to the requirement for vaccination, any redeployment to another facility is likely to be permanent in nature.

We are awaiting the public health order from the NSW Government to be issued which will give effect to the above requirements and make them legally enforceable.

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COVID-19 testing during paid work hours

Wherever possible, NSW Health agencies will facilitate the opportunity for affected NSW Health staff ​​​​​to undertake the required COVID-19 testing during normal working hours.

• Where the COVID-19 test is available at the site where the staff member usually works, NSW Health agencies will facilitate the opportunity for employed staff to undertake the required testing during a rostered shift or normal working day wherever possible.
• Where the COVID-19 test is only available at a site that is not the staff member’s usual work location, NSW Health agencies will facilitate wherever possible the release of staff for part of their rostered shift or working day to undertake the required COVID-19 testing at a site where it is available.
• Where the NSW Health agency determines that neither option listed above is possible, employed staff who attend for the required testing outside of normal working hours will need to be paid for such attendance.

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Free parking

Thanks to persistent pressure from unions, on 23 July the government announced free parking for health workers affected by the lockdown.

From the next NSW Health pay cycle, NSW Health staff will be provided free parking in Greater Sydney public hospital car parks. NSW Health will also seek the assistance of relevant local councils to waive parking fines around hospital and vaccination facilities for healthcare workers.

This is a temporary measure while the current restrictions are in place.

In addition, LHDs have been encouraged to be flexible with staff having difficulties attending work due to public transport reductions.

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Paid leave to attend vaccination

The Department of Premier and Cabinet has released an updated Circular (C2021-14 Employment Arrangements during COVID-19) reconfirming the existing 20 days of paid special COVID-19 leave (in the specified situations) as well as some additional vaccination support for all government sector workers. See extract below:

Support for COVID-19 Vaccinations (effective from 16 July 2021) To support employees receiving a Therapeutic Goods Administration approved vaccination for COVID-19, agencies may provide: flexible working arrangements to facilitate attendance at vaccination appointments, and/or access to special leave of up to two hours, or an equivalent payment at base rate of pay.

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Personal Protective Equipment (PPE)

For detailed advice on PPE, visit this page.

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Redeployment of public health staff based on vaccination status

In light of the current COVID-19 outbreak in Sydney, NSW Health has confirmed an intention to relocate unvaccinated public health staff.

All NSW public health organisations have been asked, where possible, to redeploy unvaccinated health staff away from areas that see and treat undifferentiated patients – where doing so doesn’t compromise clinical services. These areas include:

• Emergency Departments (in particular ‘hot’ or ‘red’ zones for the treatment of probable, suspected or confirmed COVID-19 cases);
• Intensive Care Units;
• COVID-19 Wards; and
• Respiratory Wards.

After robust NSWNMA representations to the Ministry, the following considerations have been outlined and health staff are to be assured any redeployment is a temporary arrangement, with a commitment to return to original work locations as soon as possible.

What Health agencies will consider when deploying staff based on vaccination status:

• Staff willing to volunteer to be deployed will be considered first for deployment wherever possible and ahead of others that would prefer to stay where they are;
• Consideration will be given to family/carer/other responsibilities outside the workplace that limit the capacity of an employee to redeploy;
• Maintaining existing shift configurations (e.g. if currently working 8 hour shifts, then to be deployed on 8 hour shifts) wherever practical to do so;
• Ensuring staff have the required skills and credentialing for the relevant setting; and
• Ensuring adequate and appropriate induction, orientation and supervision in the new deployment location.

​​​​​Health agencies are required to review and address any issues of significant financial detriment should these be raised by health staff.

If you are redeployed, it is important to request you are fit tested and receive training if you have not already done so. For further information, please check these updated CEC guidelines, and if you’re unsure, NSWNMA members can contact the Association.

A brief reminder, if you are yet to receive your COVID-19 vaccinations:

• Health staff will be scheduled for vaccination appointments during rostered hours. If this is not possible, paid time will be offered.
• If you require to be off work due to side effects of being vaccinated, it will be considered sick leave. If a health worker has no sick leave balance then additional paid sick leave will be made available.
• If your employer tasks you to undertake vaccinations, training is expected to occur in work time/paid time. Where it is undertaken outside or additional to normal working hours, employees will be paid for the time taken to complete the course.

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Administration of COVID-19 vaccine

To access FAQs on administering COVID-19 vaccines, click here.

Vaccine preparation and procedure

A number of resources have been developed to support clinicians in the process of preparing vaccines, including labelling requirements. These have been developed separately for both of the vaccines:

• Management of COVID-19 Pfizer (Comirnaty) vaccine from refrigerator to administration
• Management of COVID-19 Vaccine AstraZeneca (ChAdOx1-S) from refrigerator to administration

Vaccination plan

The NSW Ministry of Health has issued advice to healthcare workers on the rollout of the national COVID-19 vaccination plan.

Vaccines are voluntary, free and offered in a phased approach (Phases 1a, 1b, 2a, 2b and 3 as set out by the Australian Government).

Vaccination in work time

Ministry advice is that vaccination for health workers should occur in work time, although it is recognised that when scheduling the second dose it may not align with rosters issued for that day or if scheduled for three months time when the roster is unknown. The Ministry preference for the second dose to occur in work time (rostered shift) but in any event is to be treated as paid time if this is not possible.

Expanding the vaccination workforce

In advice issued 28 June 2021, the NSW Chief Health Officer has expanded the classification of registered health professionals who can now assist in administering COVID-19 vaccinations at designated hubs, under appropriate supervision, and provided they have completed identified training. Such professionals will be engaged and remunerated at their relevant classification rate.

This decision makes it possible for certain health professional students to be engaged as ‘Vaccination Workers’ and hired as casuals under the Public Health System Nurses’ and Midwives’ (State) Award. Rates of pay for these staff will be determind by the Ministry.

The Statewide Protocol for the Supply or Administration of COVID-19 Vaccine sets out the framework and protocol for the supply and administration of vaccines that encompasses this additional workforce.

​As stated by the Ministry of Health, healthcare workers considered for prioritisation in Phase 1a of the vaccination program include:

• Ambulance and patient transport staff
• Emergency department staff
• Critical care ward staff (ICUs and HDUs, ECMO and medical retrieval teams)
• COVID clinic and COVID testing staff (public and private)
• COVID ward staff
• COVID immunisation clinic staff
• COVID pathology lab staff (public and private)
• Workers at the Special Health Accommodation facility

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Vaccination position statements and supportive evidence

As professional leaders in this area, nurses and midwives can find the NMBA’s position statement on vaccination here.

Ahpra’s position statement on Registered health practitioners and students and COVID-19 vaccination is available to view here.

The National Boards and Ahpra have published a joint statement to help registered health practitioners and students understand what’s expected of them in giving, receiving and advising on and sharing information about COVID-19 vaccines. It can be viewed here.

The ANMF’s policy on vaccination is here.

ANMF Evidence on the COVID vaccine is here.

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Interstate Staff Travel for Recreational Purposes

Australian State and Territory borders are subject to rapid closures and changes to quarantine or self-isolation requirements without notice as a result of the COVID-19 pandemic. Staff are therefore asked to carefully consider interstate travel plans. Special Leave is not available for time spent quarantining or self-isolating as a consequence of recreational travel.

Interstate travel on compassionate grounds (due to death/ illness of relatives residing interstate) will be considered on a case by case basis by the employing Health Agency; in the event quarantine or self-isolation is required upon return to NSW.

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Response and Escalation Framework

The Framework contains: general principles to be applied; a risk matrix model; along with posters and FAQs in relation to each of the alert levels. Under the current Green alert, the COVID-19 precautions for health workers remain utilising standard precautions (including physical distancing in breaks), with transmission-based precautions utilised for suspected/probable/confirmed COVID-19 cases. Refer to the framework for more detailed information.

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Latest COVID-19 case locations in NSW

Have you been to a potential case location? Please check this list regularly and watch for COVID-19 symptoms.

Staff who may have visited potential case locations are advised to immediately:

• Attend a clinic for testing, even if they have no symptoms
• Watch for respiratory symptoms and get re-tested should any symptoms occur
• Self-isolate and remain in self-isolation until 14 days have passed since they attended a potential case location in the specified period, even if a negative test result is received.

Where a NSW Health staff member is self-isolating on Special Leave and becomes sick for any reason, they should transition onto Sick Leave.

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Special paid leave

Thanks to ongoing NSWNMA negotiations around leave entitlements, the Ministry has confirmed if you meet the current criteria for accessing paid special leave (refer to C2021-14 Employment Arrangements during COVID-19), you will be entitled to receive paid special leave, even if you have already used 20 days. We have been assured there is no finite amount of special COVID-19 leave available to nurses and midwives for the duration of the pandemic.

NSW Health employees have access to paid special leave (for COVID-19) prior to accessing their own accrued leave. This will be granted to employees who are unable to work because they are:

• Self-isolating due to travel or close contact COVID-19 exposure
• Caring for family members sick with COVID-19
• Caring for family members due to closure of school/daycare
• Unable to attend work due to transport disruptions or workplace closure
• A vulnerable health worker who, following completion of a risk assessment, is unable to be redeployed to a lower COVID-19 risk environment and is unable to work from home or self isolation

The special leave will be provided on a pro-rata basis for part time staff.

Where an employee is self-isolating on special leave and becomes sick for any reason; at that point the employee should transition onto sick leave. Where sick leave is exhausted, Health Agencies may grant additional sick leave on a case by case basis.

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Staff who have contact with a confirmed case of COVID-19

If close contact of a person confirmed to have COVID-19 has occurred

Until 14 days have lapsed from last contact, the staff member must:

• not attend work
• self-isolate other than for seeking individual medical care for 14 days from the last day of contact
• monitor symptoms for 14 days since last contact
• seek medical attention as soon as possible if fever or respiratory illness (even if mild) occur. Call the healthdirect helpline 1800 022 222 for advice or call ahead before seeing your GP or go directly to the local Emergency Department or COVID-19 clinic.

If casual contact of a person confirmed to have COVID-19 has occurred

The staff member must:

• continue to attend work if well
• self-isolate and seek assessment if they develop fever or respiratory illness.

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Temporary paid accommodation

Provisions for temporary paid accommodation for health workers providing frontline health services (including hospital and ambulance staff) were announced on 6 March 2020.

Due to the changing nature of the pandemic, Public Health Organisations (PHOs) will be required to use a risk-based approach when approving access to temporary accommodation. The immediate focus will be on:

Health workers providing frontline health services including permanent, temporary, casual (with booked shifts), hospital, ambulance and community staff. This includes Visiting Medical Officers (while working for NSW Health).

Temporary accommodation can be utilised in the following circumstances:

1. Staff who have contracted COVID-19;
2. Staff awaiting COVID-19 test results and/ or in self-isolation due to close contact with a positive COVID-19 case;
3. Frontline staff living with vulnerable high-risk family members; and
4. Frontline staff working extended hours, short shift changes, extensive overtime due to COVID-19 workload.

To note:

• Use of the accommodation option is voluntary and is not mandated by the employer.
• Different arrangements will be provided for COVID-19 and non COVID-19 affected staff.  For example, if someone has COVID-19 they will be required to isolate.
• Hotels near hospitals have been identified and will be used for health worker accommodation where ever possible.
• Meals will be included.
• Booking will be undertaken by the PHO using government approved processes and not by the individual health worker.

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Vulnerable Staff

The Australian Health Protection Principal Committee (AHPPC) considers that, based on the limited current evidence, the following people are, or are likely to be, at higher risk of serious illness if they are infected with the virus:

• 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. Conditions included in the definition of ‘chronic medical conditions’ will be refined as more evidence emerges. The most current list can be accessed on the Department of Health website
• People 70 years and older
• People with compromised immune systems (see Department of Health website)

AHPPC recommends that where vulnerable workers undertake essential work, a risk assessment must be undertaken. Risk needs to be assessed and mitigated with consideration of the characteristics of the worker, the workplace and the work. This includes ensuring vulnerable people are redeployed to non-customer based roles where possible. Where risk cannot be appropriately mitigated, employers and employees should consider alternate arrangements to accommodate a workplace absence. In this case, those workers should be able to access the paid special leave (for COVID-19).

AHPPC recommends that special provisions apply to essential workers who are at higher risk of serious illness and, where the risk cannot be sufficiently mitigated, should not work in high risk setting. (AHPPC advice, 30 March 2020)

There is limited evidence regarding the risk in pregnant women. Currently there is no evidence of an increased risk of miscarriage, teratogenicity or vertical transmission of the COVID-19 virus. There is a possibility of an increased incidence of premature birth but there is insufficient evidence at this point in time. The Royal Australian and New Zealand College of Obstetricians and Gynaecologists recommends that, where possible, pregnant healthcare workers be allocated to patients, and duties that have reduced exposure to patients with confirmed or suspected COVID-19 infection.

Further information on PPE

Further information for private health nurses and midwives

The NSWNMA will continue to provide further updates for members as we receive them. Contact us here.