Some settings and groups are disproportionately affected by adverse health outcomes. Outbreaks in some groups can have a disproportionate effect on the community, including the provision of essential services, and these are therefore prioritised for public health management.
Higher prevalence groups and settings
A patient is considered higher risk for COVID-19 if, for example, they present with acute respiratory tract infection or they are a resident in an aged care facility where there is an exposure.
Settings with high risk of transmission
Once a confirmed case of COVID-19 occurs in these settings, the risk of rapid transmission is high.
Places where people reside in groups, for example:
- aged care facilities
- military residential settings
- boarding schools
- boarding houses
- homeless shelters
- correctional facilities
- remote industrial sites with accommodation
- Aboriginal rural and remote communities
- high-density residential buildings.
Workplace settings where large-scale amplification is more likely, for example:
- other low-temperature food processing, storage and supply chain facilities
- hotel quarantine
- healthcare services
- aged care facilities
- workplaces with highly casualised or mobile workforces.
People who are most at risk of severe illness
People in the community who are most at risk of severe illness from COVID-19, including:
- 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
- people 70 years and older
- people with compromised immune systems.
The following chronic conditions are of concern in Aboriginal and Torres Strait Islander people over 50 years and vulnerable workers over 65 years:
- chronic renal failure
- coronary heart disease or congestive cardiac failure
- chronic lung disease (severe asthma for which frequent medical consultations or the use of multiple medications is required, cystic fibrosis, bronchiectasis, suppurative lung disease, chronic obstructive pulmonary disease, chronic emphysema)
- poorly controlled diabetes
- poorly controlled hypertension.
People with compromised immune systems, including those who:
- have haematological neoplasms: leukemias, lymphomas, myelodysplastic syndromes
- are post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months or on treatment for graft versus host disease)
- are immunocompromised due to primary or acquired immunodeficiency (including HIV infection)
- are currently undergoing chemotherapy or radiotherapy
- receive high-dose corticosteroids (≥20 mg of prednisone per day, or equivalent) for ≥14 days
- receive all biologics and most disease-modifying anti-rheumatic drugs (DMARDs) as defined as follows:
- azathioprine >3.0 mg/kg/day
- 6-mercaptopurine >1.5 mg/kg/day
- methotrexate >0.4 mg/kg/week
- prednisone >20 mg/day
- tacrolimus (any dose)
- cyclosporine (any dose)
- cyclophosphamide (any dose)
- mycophenolate (any dose)
- combination (multiple) DMARDs irrespective of dose.
Critical workforces and other priority settings and groups
COVID-19 can have a disproportionate effect in critical workforces in essential services, such as:
- emergency response
- law and order
- child protection workers and other social services
- food supply chain
- energy and water.
Other priority settings include:
- childcare centres
- disability day centres
- aged care day centres
- communities with a high proportion of culturally and linguistically diverse people
- people experiencing homelessness or housing instability
- remote communities.
Reviewed 30 March 2022