Advice for high-risk settings

Latest updates (updated 22/1/22)

High-risk settings definition

A high-risk setting is defined as:

  • a setting where there are a large number of people who are vulnerable to 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 vulnerable to severe disease.

Key information for high-risk settings

Entering a high-risk setting

High-risk settings should continue to require all staff and visitors to complete entry screening questions.

If staff or visitors answer yes to any of the screening questions, they can only visit or work under specific conditions, as described below.

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

Staff should be made aware and wear appropriate PPE when managing these patients.

Visitors

People who are in quarantine or isolation under a Public Health Direction must not visit high-risk settings unless attending for urgent medical care.

For non-urgent care or compassionate reasons, people in quarantine or isolation can only attend high risk settings if they have an approved exemption from ACT Health, supported by the relevant facility.

They 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 recovered from COVID-19 and have been cleared from isolation should not visit high-risk settings until until their symptoms are gone or they are feeling much better.
  • people who are household or high risk contacts of a COVID-19 case who have completed their quarantine period should not visit high-risk settings from days 8 to 14 after the date of exposure.
  • people who have returned from overseas in the last 14 days and are not required to quarantine should not enter a high-risk setting for 14 days after entering Australia.

People in these categories may be permitted to enter the facility for compassionate reasons (eg end of life visits), if approved by the facility.

People who have recently entered the ACT from interstate are able to enter high-risk settings, as long as they pass the screening questions. The ACT is open to all domestic travellers. 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

If you operate a high-risk setting the following questions are recommended for screening of all staff and visitors. These questions apply regardless of COVID-19 vaccination status.

  • Do you have any COVID-19 symptoms?
  • Have you been overseas in the last 14 days?
  • Are you currently in quarantine?
  • Are you a household or high risk (close) contact of a confirmed COVID-19 case and your exposure was less than 14 days ago?
  • Are you in isolation because you have COVID-19 or are awaiting the results of a COVID-19 test?
  • Do you live in a household with a person who has COVID-19 symptoms and is currently awaiting a COVID-19 test result?
  • Have you been cleared from isolation as a COVID-19 case in the last week but have ongoing symptoms or do not yet feel much better?

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.

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, physically distance as practicable, practise hand hygiene, and use the Check-in CBR app
    • 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.

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

Refer to the high risk community based and community healthcare sites risk matrix 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 or high risk contacts of a diagnosed case of COVID-19 and have completed their quarantine period should follow the instructions of their facility regarding permission to return to work and risk mitigation measures (link to HCW matrix) during day 8-14 post exposure.
  • 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*

Additional restrictions apply regarding attending work at a high risk setting after clearance from isolation.

Repeat testing is not required prior to recommencing work.

Staff should follow the recovering from COVID-19 advice.

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.

Please refer to the aged care page for more information regarding managing an exposure in aged care settings.

Please refer to the Disability care page (coming soon) for more information regarding exposure in disability care settings.

Residents/clients of a high-risk setting who are high risk (close) contacts of a COVID-19 case can be released from quarantine according to requirements for the general population (i.e. from day 8 post exposure).

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

  • 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
  • quarantine 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, quarantine or under stay-at-home requirements.

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.

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.

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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: January 22 2022