Advice for high-risk settings

Latest updates (updated 20/5/22)

  • Key information for high-risk settings has been updated, including information for visitors and entry screening questions. The wording of the entry screening questions has also been updated.
  • There have been changes to the  requirements for household contacts  as well as changes to the recommendations for people who have had a high or moderate risk exposure.
  • Household contacts can leave quarantine for necessary activities that cannot be postponed or delayed if they can follow certain actions to reduce the risk to others when leaving the home.
  • Household, high and moderate risk contacts who work, visit or live in high-risk settings, should continue to be managed in the same way as they were managed prior to these recent changes.
  • Household contacts should continue to not enter a high-risk setting for 14 days after someone in their household last tested positive.
  • Read the latest ACT COVID-19 updates.

High-risk settings definition

A high-risk setting is defined as:

  • a setting where there are a large number of people who are at risk of severe disease from COVID-19 (for example, due to age or chronic medical conditions), and/or
  • where there is a higher risk of COVID-19 transmission due to close proximity and difficulties maintaining physical distancing.

High-risk settings include:

  • hospitals
  • residential aged care facilities
  • correctional and detention facilities
  • residential accommodation facilities that support people who require frequent, close personal care and who are at risk of severe disease from COVID-19.

Key information for high-risk settings

Entering a high-risk setting

High-risk settings should require all staff and visitors to complete the health screening tool using the Check In CBR app.

Staff or visitors are not permitted to attend high-risk settings if they are:

Household and high-risk contacts are advised to limit their entry into a high-risk facility from days 8 to 14 following their last exposure.

If entry is necessary, seek approval from the relevant facility prior to entry.

People who are restricted from entering high-risk settings can attend hospitals for urgent health care at any time.

Staff and visitors entering high risk settings are required to wear a mask.

Visitors

People who have COVID-19 and are in isolation under a Public Health Direction are not permitted to enter high-risk settings unless they are seeking urgent medical care.

For non-urgent care or compassionate reasons (e.g. end of life visits), people in isolation can only attend high-risk settings if they have an approved exemption from ACT Health, supported by the relevant facility. People in isolation will need to apply for an exemption from ACT Health by emailing  COVID.Exemptions@act.gov.au. Exemptions will only be considered in exceptional circumstances.

The following people should also avoid visiting high risk settings:

  • people who have completed their COVID-19 isolation period but continue to experience symptoms should not visit high-risk settings until their symptoms are gone or they are feeling much better.
  • people who are household or high-risk contacts of a COVID-19 case must not visit high-risk settings for 7 days after the last date of exposure or the last time someone tested positive in their household unless they are attending for urgent medical care.
    • From day 8 to 14 they are advised to limit their entry to high-risk settings unless prior approval has been granted by the facility, or if attending for urgent medical care.

People in these categories may be permitted to enter the facility for compassionate reasons (e.g. end of life visits), with prior approval  from the facility.

People who have recently entered the ACT are able to enter high-risk settings, as long as they pass the screening questions. Please see entering and leaving the ACT for more details.

For more information about visitors please see advice for staff and operators of aged care facilities.

Entry screening questions

High-risk settings are recommended to use the following questions, also now available on the Check In CBR app, to screen all staff and visitors.

These questions apply regardless of COVID-19 vaccination status.

  1. Do you have any COVID-19 symptoms?
  2. Do you live with a person who has tested positive for COVID-19 within the last 14 days?
  3. Are you a high-risk contact of a person who tested positive for COVID-19 within the last 14 days?
  4. Are you in isolation because you have COVID-19 or you are waiting for results of a COVID-19 test?
  5. Do you live with a person who has COVID-19 symptoms and is currently waiting for results of a COVID-19 test?
  6. Have you recovered from COVID-19 in the last week but have ongoing symptoms?

If a person answers yes to any of the above questions, they should not enter the facility, unless prior approval from the facility is granted.

Note: a recovered case (that is, someone who has completed their COVID-19 isolation and received clearance via SMS or email within the last 12 weeks) is not required to follow the risk mitigation guidance for household and high-risk contacts.

Recovered cases can use their clearance SMS/email as proof of their status if they answer “yes” to questions 2 and 3 above.

Note: ACT Ambulance Service personnel undertake screening at the beginning of the shift and implement risk mitigation measures for relevant individuals. No further screening or action needs to be taken at the individual facility level for ACT Ambulance personnel.

Check in CBR Health Screening Tool

ACT Health has expanded the functionality of the Check in CBR app to include a Check in CBR Health Screening Tool, which is available for use in high-risk settings only (at this stage).

The health screening questions on the app mirror those under ‘Entry screening questions’ on this page.

The health screening tool is not mandatory for use by providers but provides an optional, consistent and familiar resource for individual facilities to use and implement if their current system is no longer adequate.

A new Check in QR code is not required, however facilities are required to notify ACT Health that they wish to incorporate the Tool into their existing Check in CBR QR Code.

Those facilities who have not previously registered for Check in CBR can also apply for the Check in CBR Health Screening Tool.

To register for access to the health screening tool, high-risk settings should complete this form.

For more information see Check In CBR app.

Residents leaving facilities

  • Residents/clients of high-risk settings can leave the setting to attend family gatherings or for other reasons but must follow the current public health directions in place.
  • While there is significant community transmission, it is recommended that residents/clients who are partially or unvaccinated only leave the facility to attend small gatherings to protect them from the risk of COVID-19 exposure. They should practise COVID-safe behaviours.
  • Visitors to facilities and residents/clients leaving the facility should consider the following measures to reduce risks:
    • outdoor gatherings are recommended where possible
    • COVID-safe behaviours – wear a mask where one is required, physically distance as practicable, practise hand hygiene, and use the Check-in CBR app (where required)
    • those attending gatherings should not have any COVID-19 symptoms, be in quarantine or under stay-at-home conditions, be awaiting a COVID-19 test result or live with someone awaiting a COVID-19 test result

Strategies to reduce likelihood of transmission in staff

High-risk settings should limit contact between staff who are working different shifts. For example:

  • conduct handovers via the phone instead of in person
  • minimise staff contact across a facility by cohorting staff to working in certain areas/wings
  • minimise staff mixing across shifts by rostering the same staff on together where possible
  • limit social contact between staff working different shifts
  • hold meetings virtually
  • ensure staff working change over shifts are not using the same locker room or shared facilities at shift change over
  • have strategies in place to avoid staff spending time together unmasked in tea rooms – this may require rostering of meal breaks and/or staff eating outside if weather permits.

Mask advice for high-risk settings

Surgical face masks must be worn by staff and visitors who are 12 years and over in high-risk settings.

Visitors and staff may remove their masks under certain circumstances such as eating and drinking.

Staff who work in high-risk settings

What does a staff member need to do if they are identified as a contact?

The staff member needs to advise their manager that they are a contact as soon as possible and follow the advice applicable to their contact classification. For more information see the Information for people exposed to COVID-19.

What does the staff member’s manager need to do?

Refer to the tools used to assess high-risk community sites and consider staffing and risk mitigation issues in relation to that staff members quarantine and return to work.

Staff who are contacts returning to work in a high-risk setting*

  • Staff who are household, high risk or moderate risk contacts of a diagnosed case of COVID-19 should follow the instructions of their facility regarding permission to return to work. Risk mitigation measures should be practised by returning staff during the 7 days after the date of moderate risk exposure, or 14 days after the date of high risk exposure or the last time someone in their household tested positive for COVID-19.
    • People who have been cleared from COVID-19 in the past 12 weeks, do not need to follow the requirements for household, high-risk or moderate contacts. If they develop symptoms within 12 weeks after being cleared from COVID-19, they should discuss with their healthcare provider.
  • Staff working in a CHECC site should follow CHECC guidance in relation to attending work.

CHECC sites should refer directly to CHECC advice on COVID-19 requirements for staff working in ACT Health facilities for information about management of household and high risk (close), moderate risk (casual) contacts among ACT Health facility staff.

*This advice should also be followed for providers of home-based care.

Return to work should be overseen by the organisation providing care.

Returning to work in a high risk setting after having COVID-19*

Staff who have been cleared from isolation by ACT Health can attend work in a high-risk setting if either their symptoms are gone or they are feeling much better. For more information see Recovering from COVID-19.

Repeat testing is not required prior to recommencing work.

COVID-19 exposures in a high-risk setting

High-risk settings and facilities will activate their COVID-19 business continuity planning and contact tracing following any relevant exposure or outbreak.

ACT Health will continue to support risk assessments for exposures or outbreaks within high-risk settings and facilities.

Tools used to assess COVID-19 exposures in high-risk community sites

These tools are updated over time so please refer to the website for the most up to date version.

Facilities/workplaces should use the ACT risk assessment matrix to assess the risk to clinical and non-clinical staff and residents/clients of high risk settings who are exposed to a COVID-19 case while in that setting.

This individualised risk assessment approach acknowledges the importance of the continuity of healthcare services and takes into account the PPE that the staff member was wearing, and the type of contact they had with the case to determine whether the staff member is considered to be a contact.

Actions for staff identified as contacts from a COVID-19 exposure at a high risk community site

Staff identified as contacts in these risk assessments or from outside of work exposures should follow return to work advice below.

Staff who are identified as household or high-risk contacts from a COVID-19 exposure in the community or workplace may be allowed to return to work in the event of workplace shortage with use of relevant risk mitigation strategies.

This should be discussed with your manager or designated contact at your facility.

Additional information supporting workplaces following an exposure to COVID-19 is available:

Please refer to the aged care page for more information regarding managing an exposure in aged care settings, including advice on how to manage a resident who is a household or high-risk contact.

Please refer to the disability care page for more information regarding exposure in disability care settings, including advice on how to manage a resident who is a household or high-risk contact.

From day 8-14 post exposure residents/clients should:

  • Have a day 12-13 test
  • should wear a mask when in any common areas
  • avoid time spent in common areas
  • practise physical distancing wherever possible
  • undertake relevant testing for COVID-19
  • immediately isolate if they develop symptoms during this time.

Staff should wear appropriate PPE for contact with residents/clients of a high-risk setting who are in isolation or quarantine.

PPE use during a COVID-19 exposure or outbreak in a facility

During a COVID-19 outbreak, staff will need to wear appropriate PPE to protect themselves from exposure to COVID-19. Appropriate PPE means:

  • P2/N95 mask
  • eye protection (for example, face shield or goggles, not prescription glasses)
  • long-sleeved impermeable gown
  • gloves.

Please ensure you have adequate supplies of PPE available immediately for use in a COVID-19 outbreak.

Residents and clients of a high-risk setting

Residents or clients who test positive for COVID-19 should receive their usual care.

Those providing this care will need to wear PPE in order to protect themselves and other clients and residents.

Residents or clients who test positive for COVID-19 will be cleared from isolation by ACT Health 7 days after their positive test date.

Care providers may continue to utilise PPE (including P2/N95 mask and eye protection) and request the resident/client to isolate until their symptoms have resolved or they are feeling much better, this should not be for more than an additional 7 days.

Managing COVID-19 in disability care settings

For steps you should take if a COVID-19 case has had contact with a disability client or provider while infectious, please refer to the Managing COVID-19 in disability residential care facilities page.

This is public health advice intended to inform your response to a COVID-19 exposure and is not a requirement under a Public Health Direction.

Managing COVID-19 in Residential Aged Care Facilities

For steps you should take if a COVID-19 case has had contact with a residential aged care facility resident or staff member while infectious, please see the Residential aged care facilities page. This is public health advice intended to inform your response to a COVID-19 exposure and is not a requirement under a Public Health Direction.

Medical contraindications or temporary exemptions to COVID-19 vaccination

COVID-19 vaccination has become a mandatory condition of employment for some workforces and situations in the ACT.

In these situations and under public health directions, people will be required to provide evidence of their COVID-19 vaccination status, or of an authorised exemption to vaccination.

Please see information for employees that require vaccination. It includes information related to exemptions to vaccination.

acknowledgement icon
Acknowledgement of Country

We acknowledge the Traditional Custodians of the ACT, the Ngunnawal people. We acknowledge and respect their continuing culture and the contribution they make to the life of this city and this region.

Last Updated: May 31 2022