Primary care guidance for the response to COVID-19 risks

Advice on legal requirement post pandemic orders

Based on the National Cabinet’s decision to end the COVID-19 isolation period, the Victorian Pandemic Declaration and the Pandemic Order expired from 11:59 pm Wednesday 12 October.

Vaccination requirements

Vaccine mandates will only remain for some healthcare workers (via a Secretary’s Direction) in:

• public health services
• public hospitals
• denominational hospitals
• private hospitals and day procedure centres
• ambulance services
• patient transport services that are engaged by a health service or Ambulance Victoria
• public sector residential aged care services
• Forensicare (via Ministerial Directions, influenza only)

Current directions can be found at Vaccination of healthcare workers.

Under the Victorian Occupational Health and Safety Act 2004 (OHS Act) employers will still be required to provide a safe working environment for its employees, so far as reasonably practicable. Where a risk to health is identified at a workplace, employers must eliminate the risk so far as is reasonably practicable and when elimination is not possible, reduce the risk so far as is reasonably practicable.

As such there is an onus on employers to provide and maintain a working environment for their employees that is safe and without risks to health and that other persons (clients/customers) are not exposed to health and safety risks arising from the employer's activities.

Under Victoria’s OHS laws, employers are able (but not required) to implement policies requiring workers to be up to date with their vaccinations. Consistent with these obligations, employers can choose to determine a policy of requiring their workers to be vaccinated and enforce this as a condition of employment where they are required to attend a place of work away from their normal place of residence. This would be an employer by employer responsibility.

Legal requirements for mask wearing, isolation for staff and to maintain a COVID safe plan

There are no longer any legal requirements related to these public health measures, in part because there is no instrument outside of pandemic orders to continue these mandates.

The department’s public health advice continues to strongly recommend measures for mask wearing, isolation and retaining COVIDSafe Plans.

Employers continue to have a duty to provide and maintain, so far as is reasonably practicable, a working environment that is safe and without risks to the health of employees. This includes preventing risks to health (including psychological health) and safety associated with potential exposure to COVID-19. Like other OHS risks, it would be a decision for individual settings to assess what is reasonably practicable for their own workplaces and employees, with guidance provided being a strong indicator of meeting the standard of behaviour expected of a reasonable person in the employer’s position.

Visit Business and work for information on keeping your workplace COVIDSafe and for public health recommendations.

Infection prevention control resources

There is a free Infection Prevention Helpline (1800 312 968, 9am–5pm weekdays) for general practice, community pharmacists, and Aboriginal Community Controlled Health Organisations.

General practices and community pharmacies should contact their local PHN network to access Personal Protective Equipment (PPE) supply. If you are experiencing an urgent PPE supply issue, please contact COVID19primarycommunitycare@health.vic.gov.au.

The Department has a range of infection prevention control resources to support workplaces to reduce the risk of COVID-19 infection in primary care settings. Topics include:

• infection prevention guidelines and IPC (Infection Prevention and Control) eLearning
• personal protective equipment (PPE)
• COVID self-assessment tools
• ventilation
• cleaning
• waste disposal

Steps you can take to protect yourself and your colleagues from COVID-19

Vaccination

It is important to keep your vaccination status up to date.

Masks

Masks should continue to be worn by all staff and clients in publicly accessible indoor primary and community health care settings. More information about face masks can be found on the Department’s Face masks website.

Physical distancing

Physical distancing in the workplace should still be practised between both employees, patients and clients particularly in workplaces with small consultation rooms. This includes:

• separating waiting room chairs by at least 1.5 metres
• distancing interactions between staff
• remaining 1.5 metres from patients unless doing a clinical examination or procedure
• using droplet and contact precautions (gown, gloves, eye protection and single-use face mask) when assessing a patient with respiratory symptoms in a community setting

COVIDSafe plan

Primary care settings should have an up to date plan.

Anyone who tests positive to COVID should report their RAT to the Department of Health online, or by calling 1800 675 398. You don’t need to report your result if you tested positive from a PCR test. You should call your workplace, let them know you have COVID-19 and you should isolate for at least 5 days or until symptoms resolve.

Protective behaviours in sensitive settings

There are extra recommendations for people working in sensitive settings. These are places where there are many people vulnerable to the severe effects of COVID-19, including:

• residential care facilities, including aged care, disability, and other services
• other care facilities
• healthcare premises, including when health care services are provided in people’s homes

Anyone who has COVID-19 or symptoms of COVID-19 should avoid visiting or working in sensitive settings for at least 7 days.

Workers who are close contacts should be asymptomatic and follow testing recommendations if they are required to work in sensitive settings during their 7-day close contact period.

Close contacts who are not workers in sensitive settings should not attend any sensitive setting during their 7-day close contact period.

GP Respiratory Clinics

GP Respiratory Clinics are open across Victoria to care for people with mild to moderate respiratory and COVID-19 symptoms. These clinics:

• increase access to respiratory care for people of all ages
• provide GPs with a referral option for patients who require face-to-face respiratory assessments if their practice is unable to do so
• provide an alternative care pathway other than a presentation to an emergency department
• provide telehealth, which can be accessed even if you do not live close by to the clinic

Visit GP Respiratory Clinics for locations and further information.

COVID Positive Pathways

The COVID Positive Pathways program has played a critical role during the period of Victoria’s pandemic emergency. It has supported close to 2.5 million Victorians diagnosed with COVID-19 via telehealth nursing, remote monitoring and access to health and social support services. We are immensely proud of how health services and community health organisations have worked together to care for our community.

With a range of supports now available for Victorians with COVID-19, the COVID Positive Pathways Program has ceased, with the final patients enrolled on 1 June 2023.

COVID-19 medicines

There are a range of medications available to treat patients with COVID-19 who are early in their infection and at risk of severe disease. Tixagevimab and cilgavimab (Evusheld™) is also available in Victoria for use in high-risk people for pre-exposure prophylaxis of COVID-19.

Visit medications for patients with COVID-19 for:

• prescribing resources for both COVID-19 early therapies and Evusheld™ pre-exposure prophylaxis
• details of the pharmacy helpline to support prescribing of antivirals and Evusheld™
• a list of pharmacies with oral antiviral and Evusheld™ stock across the state
• COVID-19 treatment templates for download, to support GPs in engaging at-risk patients
• product and consumer medication information

Long COVID

There are resources available to support primary care providers and patients to treat and manage long COVID.

• National COVID-19 Clinical Evidence Taskforce live document includes:
  • Australian guidelines for the clinical care of people with COVID-19 (magicapp.org)
  • care after COVID-19 guidance
  • flowchart for care of people after COVID-19
• WHO Clinical management of COVID-19 patients: living guideline (magicapp.org): see section 19 Rehabilitation for patients with COVID-19
• Health Pathways Melbourne: clinical guidance and referral options for managing patients experiencing issues with their physical and mental health
• RACGP Patient resource: Managing post-COVID symptoms.
• translated long COVID fact sheets and audio recordings produced by The Centre for Ethnicity and Health

Staff support and wellbeing

It is important to continue to look after your health and actively support the wellbeing of healthcare workers. Safer Care Victoria has a suite of health and wellbeing resources available for health workers.

Health and wellbeing resources

COVID-19 is still affecting our lives in many ways. Here are some helpful resources for your workforce or your patients:

• Financial and other support- some financial and other supports are available to some people affected by COVID-19
• Orange Door - free family violence support services for adults, children and young people who are experiencing or have experienced family violence, and families who need extra support to care for children.
• Safe Steps - a 24/7 family violence crisis service (1800 015 188).
• the Partners in Wellbeing helpline (1300 375 330). Provide phone support to Victorians impacted by COVID-19 aged 16 and over, including people who identify as LGBTIQA+, multicultural, Veterans, Aboriginal or Torres Strait Islander People and international students. This free and confidential service provides specialist support for small businesses, including business advisory and financial counselling.