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.

The Commonwealth Department of Health website contains detailed guidance for health sector workers and is updated regularly.

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

Personal Protective Equipment (PPE)

CEC guidelines around Respiratory Protection in Healthcare state:

In NSW, LHDs/SHNs are required to implement respirator fit testing in their facilities for health workers (HWs) performing respiratory Aerosol Generating Procedures (AGPs) on patients with COVID-19 or providing clinical services to patients on airborne precautions in high risk areas.

When staff are directed to work with patients who are COVID-19 positive or COVID-19 symptomatic the CEC guidelines state, in all circumstances:

• staff are to wear PPE as prescribed in the CEC guidelines
• staff are not to undertake or be required to undertake tasks requiring PPE if the PPE is not available for use. Any such tasks are not to proceed until required PPE is available.

Where staff are performing tasks requiring P2/N95 mask use under the CEC guidelines and where the employee has fit checked the available P2/N95 mask sizes and these sizes are not a correct fit, then the employee is to be temporarily redirected to work which does not require the use of a P2/N95 mask until suitable masks with correct fit become available.

For more detailed advice on PPE, visit this page.

Green Alert

The NSW Health Service has now gone from Amber to Green Alert, under the newly established and released COVID-19 Infection Prevention and Control Response and Escalation Framework. This sets out the framework to address and respond to COVID-19 on an ongoing and far more transparent basis, and introduces a greater degree of predictability as to what risk management processes and mechanisms will be initiated under the Green, Amber and Red alerts.

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.

For example, surgical masks in the hospital outside of such settings (or those required due to the clinical setting) will only be mandated for health workers in Emergency Departments when caring for patients. Vulnerable workers may well continue to wear a surgical mask while in a clinical setting and this should be considered in any risk assessment. Refer to the framework for more detailed information.

Risk Escalation Panel

These decisions and alert status for the state (or an individual LHD if necessary) will be assessed weekly by a Risk Escalation Panel (which includes the Chief Health Officer, CEC) and will be based upon data publicly available via the NSW Health Critical Intelligence Unit, including a Risk Monitoring Dashboard, which gives a succinct summary of the current COVID-19 situation in the state.

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.

Special paid leave

Thanks to ongoing NSWNMA negotiations around leave entitlements, NSW Health employees have access to 20 days of paid special leave (for COVID-19) prior to a 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 (exclusions apply)
• 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

After the 20 days total paid special leave has been used, employees may access accrued leave entitlements (in accordance with normal processes).

The 20 days 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.

Those who travelled overseas from 16 March 2020, despite current notifications, will NOT be granted paid special leave to cover isolation upon return to Australia.

For travel prior to 16 March 2020, the entitlement to paid special leave will be dependent on the Smartraveller advice level on the date of their departure (see previous advice dependent if alert status was Level 1, or Levels 2-4).

Use of annual leave

The Association has had reports of members being ‘requested’ or directed if they had excess annual leave to take individual days of annual leave to cover specific shifts (due to low demand and occupancy). These are only to be via agreement between the employer and employee and must be in full compliance with the Award.

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.

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.
• Staff will be accommodated in motels and hotels (the use of Bed and Breakfasts and Airbnbs may be considered later, subject to the capacity of the motel and hotel sector.)  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.

Staff parking

The NSW Government has guaranteed health workers that staff parking on public hospital premises will be at no charge with any automatic and recurring deductions facilitated by HealthShare NSW to be suspended. Those staff who park in facilities with parking managed by private operators will also have this benefit applied – albeit direct discussion will be necessary between the LHD, private provider and staff member(s). Some Local Councils are also making provisions to allow free parking for health staff.

Employees who remain overseas and are unable to return

Available FACS leave can be used for employees unable to return home due to COVID-19. Districts should be flexible with other leave requests (e.g. ADO, Annual and Long Service Leave and Leave without pay if FACS leave has been exhausted). Special paid leave is not granted for this purpose.

Staff Returning from Overseas Travel

From 12am on 16 March 2020, return to Australia from any overseas travel requires 14 days isolation.

In settings where the absence of the healthcare worker will have a significant impact on health services, a case-by-case risk assessment will be undertaken with input from the Public Health Unit. Work from home arrangements may be arranged where appropriate.

Official Work Related Travel Arrangements for All Overseas and Domestic Travel (Including TESL)

All official overseas travel is to be cancelled. Domestic travel remains restricted to essential travel only.

Attendance at meetings and conferences

Agencies should review any planned events which involve meetings of large numbers of staff to minimise the absence of staff who are needed to assist with surge planning and service delivery.

Consideration should be given to postponing these events or managing them in a different way (e.g. webinars,
circulation of papers, etc) and:

1. Non-essential meetings or conferences of workforce especially critical workforce such as healthcare professionals and emergency services should be limited. Proactive measures for compliance with social distancing advice to keep a safe distance (1.5 metres) between staff should be maintained in all circumstances where possible to do so.
2. Outdoor gatherings of more than 500 people and indoor gatherings of more than 100 people are not to proceed in accordance with the public health orders on 23 March and 24 March. NOTE: An indoor gathering takes place within a single enclosed area (i.e. a single room or venue).

Essential activities such as healthcare settings, pharmacies, food shopping, schools, workplaces and public transport are not included in this restriction. However, social distancing and good hygiene practices should be applied in these settings where possible.

Previous full advice by the Committee includes the specific recommendation that mitigation strategies include: “limiting non-essential meetings or conferences of critical workforce e.g. healthcare professionals and emergency services”.

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.

A $2.4 billion health package has been released to support primary care, aged care, hospitals, research and the national medical stockpile.

Other useful resources

NSW Health is continuing to provide comprehensive information, fact sheets and updates about COVID-19 here.

• Personal Protective Equipment (PPE)
• Public Health Workforce Surge Guidelines

More COVID-19 / Flu clinics are being established within all Local Health Districts to assess and diagnose patients with possible COVID-19 infections and other respiratory illness, such as influenza, as winter approaches.

NSW Health has existing policies for an operational response to COVID-19 and the emergency department preparedness for an influx of patients. Both guidelines below are from the NSW Health Influenza Pandemic Plan:

• Intensive Care Guidance for COVID-19
• Emergency Department Guidance for COVID-19

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.