WEDNESDAY, 22 JULY 2020

Stay COVIDSafe by following ESSA’s three-stage Recovery Plan for COVID-19

Members in metropolitan Melbourne and the Shire of Mitchell have faced another volatile week with changes in COVID-19 requirements coming almost daily and the enforcement of mandatory face coverings effective from 11.59pm tonight (Wednesday, 22 July 2020).

Whilst overall infections are higher in Victoria, NSW's COVID-19 reproduction rate is rising rapidly, with the state in serious danger because of the higher potential risk of underlying community transmission.

The latest COVID-19 modelling paper from the Doherty Institute which includes data on estimates of the average daily number of non-household contacts shows Victorians have fewer contacts per day (5.9) than those in NSW (8.1) at 1 July 2020. Despite continued rising daily high case numbers in Victoria, strict lockdown is starting to see the actual or effective reproduction number falling.

NSW with softer restrictions mean the potential risk of 1.09 is greater than Victoria’s risk of 0.92.

According to the Doherty analysis of potential transmission, Northern Territory has the highest risk of 1.51, followed by Western Australia with a risk of 1.26, South Australia, 1.14, Queensland, 1.06. the ACT, 1.08 and Tasmania 1 (where one means the virus will neither increase nor decrease).

What all this means is that everyone still needs to remain vigilant and follow ESSA’s recommendations and various government laws to stay safe.

Our recommendation from last week to NSW members, especially those in Greater Sydney still stands. Prepare for a second lockdown and ensure you have considered the following:
• COVID Infection control training
• COVID Safe Plans (All the state requirements in ESSA’s Fact Sheet here).
• Screening processes for clients
• Upskilling reception staff on COVID risks
• Sourcing PPE
• Environmental cleaning and disinfection principles for COVID-19.

To find the links for all these resources, read ESSA’s Recovery Plan which includes all Australian requirements and recommendations. This document can now be accessed in our COVID-19 home page in the Members Lounge.

The latest on state and territory changes and border crossings is here.



Face Masks - New ESSA Policy Recommendation

Face masks are mandatory for ESSA members in lockdown or in a declared hotspot. Effective no later than 11.59pm Wednesday, 22 July 2020.

FAQs

What is a hot spot?
A hotspot is a geographical area that has a high concentration of COVID-19 cases. Hotspots are changing rapidly and are declared by state and territory governments, often by governments outside of the hotspot area. Hotspots are legally listed, so ESSA advises members to check state/territory government webpages for updates on hotspots and the need to wear masks before travelling within Australia.

What are the current hot spots (outside Metro Melbourne and the Shire of Mitchell)?
Click here. 

What kind of mask should I wear?
AEPs and AESs (under supervision of an allied health professional or working in the NDIS) delivering in-person services need to wear a level 1 or type 1 disposable surgical mask in public-facing areas as per the Victorian DHHS guidance on Personal Protective Equipment (PPE).

When do I need to wear a P2/N95 respirator instead of a surgical mask?
The Australian Government Department of Health website says P2/N95 respirators are only needed when you:
• have frequent close contact with patients with suspected or confirmed COVID-19
• are delivering procedures that generate aerosols.

How do I screen clients to determine what kind of mask I should wear?
ESSA strongly recommends you screen clients to determine if they:
• are under quarantine or investigation for COVID-19
• are suspected or confirmed to have COVID-19
• have fever or respiratory symptoms
and in these cases, recommends these clients be tested if they have not already been tested.

ESSA recommends that ESSA members do not treat clients in these categories unless you are working in a hospital environment.

Queensland Health has a COVID-19 Clinical Screening Assessment tool to enable Hospital and Health Services (HHSs) to appropriately assess the suitability for COVID-19 screening. This tool may be useful to assist your reception staff screen clients making appointments.

Please also ensure that your reception staff are using this Coronavirus (COVID-19) allied health checklist for receptionists from the Australian Government Department of Health.

What is a level 1 or type 1 disposable surgical mask?
Level 1 masks are surgical medical grade masks. More information on Level I masks is available from the Therapeutic Goods Administration here.

What kind of mask should a client wear?
The general public who can wear a scarf, a bandana or a hand-made face covering.
Masks for the public do not have to be medical grade and the public can make their own.

When should clients wear masks?
It will depend on what your clients are doing. Where they are doing any exercise or physical activity where they are out of breath or puffing or they are affected by a relevant medical condition - including problems with their breathing, a serious skin condition on the face, a disability or a mental health condition, then are not required to wear a face covering.

If you were just talking to clients in a non-exercise environment, then they should wear a face covering (apart from the exceptions above). Clients must have a face mask with them and wear it when they finish exercising.



Mask Resources

Fact Sheet for Clients
The Australian Government Department of Health has updated its Fact Sheet on ‘When should masks be worn in the community, in Australia?’ as of 9 July 2020.

COVID-19 Infographic for Clients – Do I need to wear a mask? (Released 17 July 2020)
This infographic from the Australian Government Department of Health explains when you need to wear a mask and how to use a mask properly. This infographic is also available in many other languages here.

Video: Coronavirus (COVID-19) wearing personal protective equipment for allied health professionals
Alison McMillan, Australia’s Chief Nursing and Midwifery Officer, demonstrates how to wear personal protective equipment (PPE) for allied health professionals here. Other resources on PPE are available here.

This video is part of a larger suite of COVID-19 resources for health professionals, including aged care providers, pathology providers and health care managers available from the Australian Government Department of Health.



State News/Requirements/Recommendations

Victoria

NEW RESTRICTIONS
New Victorian Government Stay at Home Directions (Restricted Areas) (No 3) come into force at 11.59pm on 19 July 2020 and replace the Stay at Home Directions (Restricted Areas) (No 2).

From 11:59pm on 22 July, if you live within metropolitan Melbourne or Mitchell Shire, you must wear a face covering whenever you leave your home, unless an exception applies.

This Direction allows you under leave home for only four reasons:
• Shopping for food and supplies
• Care and caregiving
• Exercise
• Study and work – if you can’t do it from home

Your clients can leave home for essential health and medical services as per this FAQ from the DHHS website:
Can I leave my home to access allied health services?
Yes. The Stay at Home restrictions do not impact allied health services. You should speak to your allied health professional if you have any concerns about your upcoming appointment. Allied health services include physiotherapy, optometry, audiology, speech pathology, occupational therapy.

Please also note the same Direction also restricts travel for general exercise:
“Unreasonable travel would include travel within the Restricted Area to exercise or outdoor recreation where that type of exercise can be done closer to home.”


WHAT EXERCISE SERVICES CAN AN AES DELIVER DURING A LOCKDOWN
Indoor services: During the current COVID-19 lock down in the listed 32 councils (metro Melbourne and the Shire of Mitchell), non-essential indoor health services and non-essential workplaces (gyms, fitness centres, health studios and swimming pools) need to close.

An AES can provide exercise services in the following ways:
• Essential NDIS services as either a personal trainer OR as an allied health assistant (supervised). Essential services provided under the NDIS are those deemed by the NDIS participant to be an essential service.
• As an allied health assistant under supervision of an allied health professional e.g. such as assisting the delivery of an essential clinical service in an AEP or multidisciplinary practice.

Under lockdown conditions, the AES cannot continue to deliver exercise services indoors to healthy populations or provide personal training.

Outdoor services: The current restrictions in Victoria for exercise services are limited to 1 instructor and 2 participants in an outdoor setting such as a park.

Online services: You can still operate online.


WHAT EXERCISE SERVICES CAN AN AEP DELIVER DURING A LOCKDOWN
Accredited Exercise Physiologists working in metro Melbourne and the Shire of Mitchell (the listed 32 councils) need to revert to using ESSA’s Recovery Plan for Stage 1 listed here for the next six weeks, at least until 19 August 2020. This means only delivering essential clinical care for a specific clinical condition or defined clinical pathway in line with current best evidence.

For in-person AEP services, up to 10 practitioners and clients in total in a clinic at any one time (e.g. could be 2 x AEPs delivering group classes for 3 clients in each class and 2 x AEPs providing individual consults) providing all social distancing and density requirements can be met.
If a practicum student is involved, then the student is counted in the total of 10 people.

For in-person group AEP services, 3 clients in a group and 1 AEP (4 people in total) for essential allied health clinical care for in-person group AEP classes based on clinical judgement of AEP.
Up to two groups in separate spaces at one time if density and social distancing requirements can be met.
If a practicum student is involved with a group class, then only two clients are allowed (4 people in total).

What is essential allied health clinical care?
Clinical care is defined by the Australian Commission on Safety and Quality in Health Care as the care clients should be offered by health professionals and health services for a specific clinical condition or defined clinical pathway in line with current best evidence.

Stay at Home restrictions will be in place until at least 19 August 2020 for members living in the listed councils.


New NDIS advice for Victorian providers
The NDIS has updated advice for providers here.

Victoria Police can issue on the spot fines of up to $1,652 for individuals and up to $9,913 for businesses. The fine for not wearing a face covering will be $200.

More information here for Victorian members on state specific requirements.

There have been changes to the requirements around masks in ESSA’s overview of Australian requirements and recommendations (more information below). This document can now be accessed here in our COVID-19 home page in the Members’ Lounge.



NSW

A second gym in Sydney (Anytime Fitness Gym in Merrylands) triggered an isolation warning for staff and patrons after a positive case visited the gym.

NSW Health is concerned about transmission in venues such as hotels and restaurants, gyms and social gatherings and has changed its advice to the public on 19 July 2020:
“Don’t go to the gym unless the equipment is thoroughly cleaned before and after customer use by supervising staff or yourself, and there is good spacing between machines and customers.”

On Channel 9 news on 19 July 2020, NSW Health's Deputy Chief Health Officer, Jeremy McAnulty, called on NSW residents to "redouble their efforts to stop the virus spreading" while "cases resulting from community transmission continue to be reported".

"People are urged to avoid non-essential travel and gatherings. Of particular concern is transmission in venues such as hotels and restaurants, the gym and social gatherings," Dr McAnulty said.


Updated Advice for NSW providers of Home Care
As COVID-19 outbreaks in Victoria and now in NSW continue to emerge, it is crucial that all home care service providers maintain vigilance to prevent the introduction of COVID-19 into their services.

Given the current risk of COVID-19 now in the community, NSW Health recommends the implementation of the following measures:
Any staff with fever or respiratory symptoms, even mild, should be excluded from work. They should be advised to isolate at home and seek COVID-19 testing.
Any staff who have been in Victoria in the last two weeks should be excluded from providing home care services.

Any staff who reside in the Fairfield, Liverpool, Campbelltown, Camden, Wingecarribee and Wollondilly local government areas, must wear a surgical mask while providing services until at least the end of July.

When providing care to clients who live in, or have visited the above local government areas, staff must wear a surgical mask while providing services until at least the end of July.
Staff actively ask clients about symptoms on arrival. If staff become aware of a client with symptoms, that client should be isolated from others, and arrangements made for COVID-19 testing.

Read the NSW Chief Health Officer Dr Kerry Chant’s letter to in-home care providers here.



Job Keeper and Job Seeker Extensions
The Australian Government announced on 21 July 2020 that both schemes would be extended.

Job Keeper Extension
A summary of the Job Keeper 2 Extension details are as below:

The same eligibility criteria apply and businesses and not-for-profits will still need to demonstrate that they have experienced a decline in turnover of:
• 50 per cent for those with an aggregated turnover of more than $1 billion;
• 30 per cent for those with an aggregated turnover of $1 billion or less; or
• 15 per cent for Australian Charities and Not for profits Commission-registered charities
(excluding schools and universities).

If a business or not-for-profit does not meet the additional turnover tests for the extension period, this does not affect their eligibility prior to 28 September 2020.

The JobKeeper Payment will continue to remain open to new recipients, provided they meet the existing eligibility requirements and the additional turnover tests during the extension period.


Additional turnover tests
In order to be eligible after 27 September 2020, businesses will have to meet a further decline in turnover test for each of the two periods of extension, as well as meeting the other existing eligibility requirements for the JobKeeper Payment.

In order to be eligible for the first extension period of 28 September 2020 to 3 January 2021, businesses will need to demonstrate that their actual GST turnover has significantly fallen in the both the:
• June quarter 2020 (April, May and June) and
• September quarter 2020 (July, August, September)
relative to comparable periods (generally the corresponding quarters in 2019).

In order to be eligible for the second extension period of 4 January 2021 to 28 March 2021, businesses and not-for-profits will again need to demonstrate that their actual GST turnover has significantly fallen in the:
• June quarter
• September quarter and
• December 2020 quarter
relative to comparable periods (generally the corresponding quarters in 2019).

Read the Fact Sheet (21 July 2020) here. Additional information is available here.



Job Seeker Extension
The Coronavirus Supplement will be extended until 31 December 2020 for JobSeeker and other eligible income support payment recipients:

Adjusted income taper test
Changes are being made to the Payment income tests to improve incentives for individuals to re-enter the workforce or take on additional work as the economy recovers.

From 25 September 2020 until 31 December 2020, the income free area for JobSeeker Payment will increase from $106 to $300 per fortnight.me

This means that recipients of these payments can earn income of up to $300 per fortnight and still receive the maximum payment rate of JobSeeker Payment.


Extra requirements
From August onwards, people will be required to apply for four jobs a month. The assets test and Liquid Assets Waiting Period, which requires people with cash reserves to face a wait of up to 13 weeks for support, will be reintroduced in late September.

More information is available in the Fact Sheet (21 July 2020) here.



Department of Health (DoH) COVID-19 Primary Care and Allied Health Webinar
The next webinar is tomorrow Thursday, July 23 2020 2:30 pm to 3:00 pm AEST. The link is here. The focus of this webinar will be on masks.



Incorrect advice on telehealth from Department of Health tweet
A tweet today (22 July 2020) referred to the need for clients to have had an appointment with an health professional within the previous 12 months before they can make a telehealth appointment. This tweet is NOT CORRECT and the actual Department of Health website advice is correct. Allied Health Professions Association has taken this up with the Department and the Minister's office as a matter of urgency.



COVID-19 Financial Impact Index
The Taylor Fry COVID-19 Financial Impact Index provides a weekly snapshot of the financial impact of COVID-19 on the Australian population, relative to pre-pandemic levels.



Resources

COVID-19 Restriction Checker
The government-funded healthdirect.com.au service has a COVID-19 Restriction Checker which allows you to choose an activity and a state to get the advice on:
• Accommodation
• Cafes and Restaurants
• Domestic Travel
• Entertainment Venues
• Education and Childcare
• Gatherings and Work
• Hair and Beauty Services
• Retail and Sales
• Sport and Recreation
• Wedding, Funeral and Religion


Mental Health App
TEN – The Essential Network, an app supporting Health Professionals to manage life and work through COVID-19

‘TEN’ is a mobile app that connects and provides fast, easy, anytime access to evidence-based tools, resources, programs and specialists.

Developed by health professionals for health professionals, it’s a one stop resource and help centre, providing self-assessment, self-management and treatment for stress, anxiety and symptoms of depression. At the core is an online clinic screening tool designed to recommend relevant resources and online tools based on report outcomes.

The app will also facilitate a streamlined online referral process for telehealth consultations with specialist clinicians.

More details here.


Updated Fact Sheet COVID-19 and children
This fact sheet here contains information on COVID-19 and children (updated 20 July 2020).


News

Insight Plus Blog Medical Journal of Australia: “Telehealth: latest changes may exclude some patients in need”
This article highlights which patients not having an existing and continuing relationship with a GP will be disadvantaged by the changes in eligibility for Medicare benefits for the temporary Medicare Benefits Schedule (MBS) COVID-19 general practice telehealth (video) services and phone services.