Coronavirus (COVID-19)

1 OFFICIAL Coronavirus ( covid -19) Case and contact management guidelines for health services and general practitioners DATE 15 April 2021 Version OFFICIAL Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 2 OFFICIAL Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 3 OFFICIAL Contents Glossary .. 7 Background .. 9 Public health response objectives .. 9 Checklist for general practitioners .. 10 Checklist for health services .. 11 Case definitions .. 13 Reporting .. 13 Confirmed case .. 13 Laboratory definitive 13 Historical case .. 13 Laboratory suggestive 13 Clinical evidence .. 14 Epidemiological evidence .. 14 covid -19 deaths .. 15 Outbreak definition .. 15 Contact definitions.

2 15 Primary close contact .. 15 Aircraft determining close contacts .. 16 Higher risk exposures and close contacts .. 17 PPE and close contacts .. 17 Healthcare workers who are cases .. 17 Secondary close contact .. 18 Casual contact .. 18 Priority groups and settings .. 18 Higher prevalence groups and settings .. 18 Settings with high risk of transmission .. 19 People at high risk of severe disease .. 19 Chronic medical conditions .. 20 Critical workforces .. 20 Other priority settings and groups .. 20 Exposure sites .. 20 Victoria .. 20 Australian Capital Territory .. 21 South Australia .. 21 New South Wales .. 21 Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 4 OFFICIAL Northern Territory .. 21 Queensland .. 21 Tasmania .. 21 Western Australia.

3 21 Other countries .. 21 Who should be tested for covid -19? .. 22 Asymptomatic testing .. 22 Suspected case .. 22 Other clinical symptoms .. 22 Hay fever and asthma .. 23 Deceased people and testing .. 24 Tests available for covid -19 .. 24 Polymerase chain reaction PCR .. 25 Rapid and point of care PCR testing .. 25 Saliva-based PCR testing .. 25 Rapid antigen testing .. 27 Serological testing .. 27 Interpreting serology results .. 29 Genome sequencing .. 30 Transfer, triage and management of patients on arrival to health services .. 31 High- and low-risk suspected 31 Signage and triage of people presenting to health and other services .. 31 Patient transfers and destination health service .. 32 Ambulance 32 Arrival to hospital and triage .. 33 PPE .. 33 Ambulance triage .. 33 Emergency department admissions.

4 33 Mass respiratory casualty events .. 34 Assessment and management of patients for covid -19 testing .. 34 Medical assessment .. 34 Isolation .. 35 People waiting for test results .. 35 Exclusion of covid -19 .. 35 Case management .. 36 Notification to the department .. 36 Isolation .. 36 Education .. 37 PCR positive tests in asymptomatic or pre-symptomatic 37 Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 5 OFFICIAL Clinical management of confirmed cases .. 38 Inpatient discharge criteria .. 38 Release from isolation of a confirmed case .. 38 Release from isolation criteria .. 38 Cases who have been released from isolation .. 43 Checklist of key actions for the department for confirmed cases .. 44 Checklist of key actions for the clinical team for confirmed cases.

5 44 Communications and media .. 44 Contact management .. 45 Quarantine .. 45 Testing during quarantine .. 47 Quarantined people requiring treatment .. 48 Close contacts .. 49 Clearance from quarantine .. 49 Potential source ( upstream or acquisition ) contacts .. 49 Primary close contacts .. 50 Secondary close contacts .. 50 Healthcare workers .. 51 Casual contacts .. 51 Infection prevention and control .. 51 Laboratory testing for covid -19 .. 52 Testing advice for clinicians .. 52 Sample labelling .. 52 Prioritising specimens for laboratory testing - priority groups and labelling protocol .. 52 Guidance for clinicians regarding priority sample labelling .. 55 Guidance for laboratories regarding priority sample labelling .. 55 Specimens for testing .. 56 Specimen collection for covid -19 testing combined oropharyngeal and deep nasal swab.

6 56 Specimen collection and transport .. 57 Preparation for specimen collection .. 57 Specimen collection process .. 58 Referral of positive samples .. 60 Handling of specimens within diagnostic laboratories .. 60 Indeterminate test results .. 60 Healthcare services management of healthcare workers with suspected or confirmed covid -19 .. 62 The disease .. 63 Infectious agent .. 63 Reservoir .. 63 Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 6 OFFICIAL Mode of transmission .. 63 Incubation period .. 63 Infectious period .. 63 Clinical presentation .. 64 Information resources .. 64 Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 7 OFFICIAL Glossary Casual contact Person believed to be at somewhat increased risk of contracting a communicable disease because of brief contact with an infected person.

7 Defined in section Casual contact Close contact Person at increased risk of contracting a communicable disease because of prolonged contact with a potentially infected person or a known case. Defined in section Contact definitions Confirmed case Defined in section Reporting Both confirmed and historical cases must be reported to the department using the online covid -19 notification form or by telephone 1300 651 160. People who have previously been diagnosed and managed overseas or in another Australian jurisdiction do not need to be notified as a confirmed or historical case. Confirmed case Contact tracing Process of identifying people who are close contacts of a case, and ensuring they are quarantined for the maximum incubation period (14 days) after last close contact with the case covid -19 Coronavirus disease name of the disease caused by SARS-CoV-2; initially referred to as novel Coronavirus (2019-nCoV) and later just Coronavirus Ct Cycle threshold number of times sample had to be amplified for viral material to be detected.

8 Lower thresholds mean more virus. DH, department Victorian Department of Health or its predecessor, the Department of Health and Human Services Fomite Objects or materials likely to carry infection, particularly high touch surfaces. HCW Healthcare worker High risk See sections Priority groups and settings Historical case Defined in section Historical case Incubation period Period of time between exposure to the disease and the onset of symptoms. For covid -19 likely mean incubation period ~5 days, with range of 1-14 days. Infectious period Same as communicable period period during which an infected person can transmit an infectious agent to a susceptible person. For covid -19 likely commences 2 days prior to symptom onset, reducing significantly >5 days post symptom onset. See section Infectious period for current definition used in contact tracing and isolation.

9 Isolation Physical separation of people infected with a communicable disease ( covid -19) from those who are healthy National Incident Room (NIR) The National Focal Point for Australia. Coordinates national responses to health emergencies, significant events and emerging threats, where there is an impact on human health or health systems includes information on Coronavirus ( covid -19): Case and contact management guidelines for health services and GPs DATE 15 April 2021 Page 8 OFFICIAL cross-jurisdictional and international movement of people with notifiable diseases. Outbreak See section Outbreak definition PCR polymerase chain reaction see section Tests available for covid -19 PPE Personal protective equipment. Clothing or equipment designed to be worn by someone to protect them from the risk of illness. For covid -19, this usually means a mask, eye protection, gown and gloves.

10 See < > for latest recommendations. Priority groups and settings Settings and groups prioritised for public health management include those: disproportionately affected by adverse health outcomes, or where outbreaks may have a disproportionate effect on the wider community. Quarantine Physical separation of people who are well but who may have been exposed to a communicable disease and are potentially infectious, to see if they develop the disease . RNA Ribonucleic acid the viral genetic code identified by PCR testing Primary close contact Defined in section Primary close contact SARS-CoV-2 Severe acute respiratory syndrome Coronavirus 2 the virus that causes covid -19 Secondary close contact Close contact of a Primary close contact. Defined in section Secondary close contact. Suspected case See section Suspected case Transmission Spread of an infectious agent from one host (person or animal) to another.