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.

Vaccination plan

The NSW Ministry of Health recently 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).

The first three hubs to deliver the Pfizer/BioNTech COVID-19 vaccine to healthcare workers have been identified as Royal Prince Alfred, Westmead and Liverpool hospitals.
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Each hub will be responsible for vaccinating staff in a number of Local Health Districts. The hubs will not be open to members of the public during Phase 1a.

Staff identified to receive the COVID-19 vaccination in Phase 1a will be contacted directly in the coming weeks and informed about how, when and where they will be able to get vaccinated.

You will receive a personal invitation from NSW Health to register. Invitations will be sent in stages.

​As stated by the Ministry of Health, healthcare workers that will be 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

More hubs are expected to follow as more doses of vaccine become available.

Vaccination hubs have been identified at:

• Royal Prince Alfred Hospital (RPAH)
• Westmead Hospital
• Liverpool Hospital
• Hornsby Hospital
• St George Hospital
• Nepean Hospital
• John Hunter Hospital
• Wollongong Hospital
• Coffs Harbour Base Hospital
• Dubbo Base Hospital
• Wagga Wagga Base Hospital

Position statements and supportive evidence

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

The ANMF’s policy on vaccination is here.

ANMF Evidence on the COVID vaccine is here.

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.

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.

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.

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.

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.
• 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.

Attendance at meetings and conferences

Up-to-date information about the requirements for events is available here.

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.

Other useful resources

NSW Health provides 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

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