Overview

In the event of a cluster of COVID-19 cases within NSW this rapid deployment plan has been developed to facilitate the rapid deployment of resources to areas of concern within 24 hours to conduct rapid COVID-19 screening and testing on NSW residents.

Governance

SHEOC Operations is the central coordination point for NSW Health's COVID-19 rapid deployment of resources, or enquires and is available 24/7 on 02 8741 5340 or via email to MOH-JasminCovid19Ops@health.nsw.gov.au

The local health district (LHD)/specialty health network (SHN) is responsible for developing and implementing a management plan to rapidly deploy resources (staffing and equipment) to areas of concern within 24 hours in the event of a major cluster.

LHDs/SHNs identify an officer responsible to plan, co-ordinate and manage logistics in a major cluster and to liaise with SHEOC Operations.

The officer responsible ensures the location and nature of the proposed rapid deployment of resources is communicated to relevant parties (e.g. SHEOC Operations team, NSW Health Pathology, local Primary Health Network, local community services, Local Emergency Management Officer (LEMO)/Local Emergency Management Committees (LEMCs).

Possible triggers for engagement

Request from the NSW Health Chief Health Officer or SHEOC to an LHD/SHN to deploy additional resources

• A LHD/SHN may be requested to rapidly deploy resources to areas of concern within 24 hours to provide COVID-19 screening and testing services in the event of a major cluster.
• In these instances, the Chief Health Officer (CHO) will contact the Chief Executive of the LHD/SHN with a request for a service to be established. The LHD/SHN liaises with the SHEOC 24/7 via MOH-JasminCovid19Ops@health.nsw.gov.au
• SHEOC Director of Operations or delegate officer notifies State Emergency Operations Controller (SEOCON) who will work together to identify gaps and prioritise resources.
• SHEOC Director of Operations or delegate identifies required outcome and specific need to implement NSW Health's rapid deployment plan

LHD/SHN identifies area/s to deploy additional resources

• A LHD/SHN identifies the need to rapidly deploy resources as a result of a local cluster. In these instances, the LHD/SHN will contact the SHEOC 24/7 on 02 8741 5340 or via email to MOH-JasminCovid19Ops@health.nsw.gov.au
• The officer responsible engages the local Emergency Management Committee (LEMC) who will work with their local council/s to plan and implement a range of strategies to assist with establishing COVID-19 screening services within the community. The Regional Emergency Management Officer (REMO) for your region will be able to advise the most appropriate contact. See Emergency Management Regions
• SHEOC Director of Operations or delegate provides assistance if required with engagement of other providers for adjunct staffing and equipment to facilitate rapid clinic set up by LHD/SHNs

Early engagement with local community stakeholders

Early and ongoing engagement and communication with the local community and community leaders is essential to maintain trust with any public health actions. This is especially important when deploying resources to areas of concern to rapidly undertake COVID-19 testing in the event of a major cluster.

LHDs/SHNs should know their populations, especially the location and nature of their more vulnerable communities to be able to address specific needs. This involves:

• Using established local community resources including community health centres, faith based organisations and community leaders to communicate with local communities.
• Working with the LHD/SHN Multicultural Health teams based in hospitals and community centres to ensure all rapid deployment services are culturally appropriate and accessible to people from culturally and linguistically diverse background (CALD) communities. The NSW Health Multicultural Health Communication Service is a state-wide health service that provides a range of services including multilingual health information and translation services. For translated resources see COVID-19 (Coronavirus) resources
• Work with the LHD/SHN Aboriginal Health Unit to ensure all rapid deployment services are culturally appropriate and accessible to Aboriginal people. NSW Health Centre for Aboriginal Health and the Aboriginal Health and Medical Research Council (AHMRC) have developed a range of information and resources (including, fact sheets, brochures and posters) about the prevention and management of COVID-19. See COVID-19 Aboriginal health resources
• SHEOC Operations and SHEOC Communications are able to assist with coordination of messaging and linkages with other community stakeholders.

Overview of demand escalation and actions

Expansion of services (drive throughs - pop ups - mobile services)

Goal: Expand service capacity to increase testing and case finding

Expanding COVID-19 screening services (drive throughs - pop ups - mobile services) in areas of concern to cope with increased demand. SHEOC Operations is able to provide support in the provision of additional resources and coordination of logistics. The officer responsible should notify SHEOC Operations of the need for support prior to expanding the service i.e. when reaching capacity. A guideline for screening clinics is available at Guideline for COVID-19 Screening Clinics (Drive-Through, Pop-up and Mobile Van). SHEOC Operations support includes:

• Working with State Emergency Operations Controller (SEOCON) to identify gaps and prioritise resources with Regional Emergency Management Officer (REMO)
• Identify suitable areas for additional pop-up screening and testing clinics, for example, sports fields and car parks.
• Expand where possible and enhance existing drive through services, for example multiple lanes instead of a single lane, portable lighting for after daylight hours service

Information to consider prior to expanding your existing services:

Demand management

• Understand the daily capacity of the clinic and the physical constraints of the site
• Do you have long queues at current services on different days of the week or different times of the day? Consideration should be given to:
• additional staffing to cope with demand at peak times
• opening additional lanes of a drive-through at peak times
• diversion of traffic to COVID-19 clinics close by - see COVID-19 Clinics
• Traffic flow assistance through a Traffic management plan and Traffic Controller.
• Seek early support from LEMC who will work with local council
• SHEOC Operations is able to provide assistance with engagement of other providers for adjunct staffing and equipment to facilitate rapid clinic set up

Community engagement

• Utilise local community resources including community health centres, churches/mosques, community leaders to communicate with local communities
• Utilise Translating and Interpreting Service (TIS National) for patients who require translation services when at a COVID-19 screening clinic Ph:131 450

Human resources management

• COVID-19 screening is currently conducted by a range of individuals to provide COVID-19 symptom checks. Consideration should could be given to expanding to other providers capable of fulfilling this role i.e. volunteers.
• COVID-19 swabbing is currently conducted by medical, nursing and allied health staff within NSW Health using appropriate PPE and swabbing technique. Consideration should be given to expanding to other providers capable of fulfilling this role.

Clinical preparedness

• Personal Protective Equipment (PPE) guidance, training and resources are available via the Clinical Excellence Commission (CEC)
• Swabbing technique:
• NSW Health guideline for collection of nasal and throat swabs for respiratory virus testing
• Coronavirus Disease 2019 (COVID-19) CDNA National Guidelines for Public Health Units
• PHLN guideline: COVID-19 swab collection:Upper respiratory specimen

Testing in high-risk areas and populations

Goal: COVID-19 screening and testing is offered appropriately to a known population in high risk settings

A number of exercises have been undertaken across NSW to test scenarios where an outbreak or cluster has occurred in high density settings. The learnings from these exercises can directly be applied to settings such as residential aged care facilities or similar.

In NSW Health, every effort should be made to ensure appropriate care is provided to vulnerable people living in high-density communities (for example, high-rise towers, aged care facilities, correctional and detention facilities, military barracks, boarding schools, hostels and factories).

Early engagement and communication with facility managers, and the community and community leaders is essential to maintain trust with any public health actions. LHDs should know their population, especially vulnerable communities, to be able to address specific needs (See Early engagement with local community stakeholders).

In developing a local 'incident response plan' consider:

• stakeholder and community engagement and communication
• logistics and social welfare arrangements
• public health actions including testing, prevention of spread etc.

Expanding services within the local area

Consider expanding COVID-19 screening services (drive throughs - pop ups –mobile services) in the high risk area or population. Please refer to Expansion of services (drive throughs - pop ups - mobile services).

Door to door testing

Consideration of door to door testing should only be warranted when targeting asymptomatic testing as it is heavily resource intensive.

Advanced notification to community is required using appropriate, non-threatening communications materials/strategies in multiple languages (refer to resource links).

• consider 'mobile squad team'
• in the event of a positive test, a risk assessment will be undertaken by the LHD Public Health Unit
• home isolation should be considered where possible and if it is not possible the LHD is to facilitate accommodation via established channels
• if the person is identified as a high public health risk who will not comply with home isolation a Public Health Medical Officer is authorised to place the person under a Public Health Order.

Mobile 'squad team'

Mobile squads are a group of clinicians and support staff that can be rapidly deployed to an area of concern. Some LHDs have established these models to rapidly stand up a mobile screening clinic or service for specific populations.

An example of the components of a mobile squad team includes: Team leader, screening staff, swabbing staff, administration staff (patient administration system experience necessary), social worker, security on standby, logistical support (infrastructure, waste, toilets, food storage, PPE etc.) and Wi-Fi to access patient administration system.

Accessing COVID-19 testing for vulnerable people

There are residents in the community who are unable to access a clinic, drive-through, or pop up due to a range of reasons (e.g. elderly, disabled, non-ambulant). In these circumstances, utilising the persons existing health networks is the preferred mechanism for individual arrangements for accessing COVID-19 testing (e.g. An individual's GP).

Other options include:

• contacting their local community health units and/or public health units to enable a home visit
• communicating with your PHN network to provide testing services to known vulnerable or disadvantaged cohorts
• arranging alternative patient transport options to a testing service
• establishing an outreach screening and testing team (adapt door-to-door 'squad team').

Resources and links to useful information

• Aboriginal Health and Medical research Council of NSW
  The Aboriginal Health and Medical Research Council (AH&MRC) is the peak body for Aboriginal Community Controlled Health Services (ACCHSs) across NSW
• Alcohol and other Drugs Contact information, support and treatment services
  Alcohol and other drug information, support and treatment is available through publicly funded and private services across New South Wales.
• Australian Health Management Plan for Pandemic Influenza (AHMPPI)
  AHMPPI outlines Australia's strategy to manage an influenza pandemic and minimise its impact on the health of Australians and our health system.
• Centre for Aboriginal Health
  The Centre for Aboriginal Health (CAH) is a Centre within the Population and Public Health Division of the NSW Ministry of Health.
• Clinical Excellence Commission (CEC) COVID-19 Infection Prevention and Control
  Education Resource. Infection Prevention and Control COVID-19 Resources for health and other workers in NSW
• Coronavirus Disease 2019 (COVID-19) Communicable Diseases Network Australia (CDNA) National guidelines for public health units
  Recommendations for surveillance, infection control, laboratory testing and contact management for coronavirus disease 2019 (COVID-19).
• Communicable Diseases Network Australia (CDNA) Outbreaks in Correctional and Detention Facilities in Australia
  CDNA National Guidelines for the Prevention, Control and Public Health Management of COVID-19 Outbreaks in Correctional and Detention Facilities in Australia.
• Communicable Diseases Network Australia (CDNA) Outbreaks in residential aged care facilities in Australia
  CDNA national guidelines for the prevention, control and public health management of COVID-19 outbreaks in residential care facilities in Australia
• COVID-19 (Coronavirus) resources
  COVID-19 resources including translated resources
• COVID-19 Aboriginal health resources
  COVID-19 Aboriginal health poster and flyer resources
• COVID-19 Case Alerts
  Find locations with reported cases, areas and suburbs with increased testing, or read the latest news, alerts, media releases and social posts
• COVID-19 Clinics
  COVID-19 clinic locations for the public to access COVID-19 testing
• COVID-19 information for people with disability
  COVID-19 information and support for people with disabilities
• COVID-19 Clinic forms
  Patient registration, assessment and medical certificate/discharge advice forms, are available form NSW state forms catalogue. Product codes: NH700583 (POD item) and NH700583A (self-print).
• COVID-19 Mental Wellbeing Services
  If you're feeling anxious or stressed, you're not alone. There are services that can support you through these difficult times.
• COVID-19 testing prioritisation
  Prioritisation of COVID-19 testing is for public health purposes, maintaining essential services and supporting HSC students, the laboratory request form is clearly marked so testing can be prioritised.
• Department of Communities and Justice (DCJ)
  DCJs brings together Family and Communities and Justice Clusters to work together to help create a safe, just, resilient and inclusive NSW.
• Guideline for COVID-19 screening clinics (drive-through, pop-up and mobile vans)
  Pop-Up, Drive-Through and Mobile Van COVID-19 Screening Clinics can be rapidly established to promote testing within the community and increase local testing capacity.
• Local Emergency Management regions and contacts
  NSW is divided into 11 Emergency Management Regions. Each Region is made up of local government councils. Resilience NSW provides contacts for Emergency Management Regions.
• Local Government NSW
  Local Government NSW helps member councils deliver improved services and better outcomes to their local communities
• Multicultural NSW
  Multicultural NSW is the lead agency for implementing the policy and legislative framework to support multicultural principles in NSW
• NSW Multicultural Health Communication Service
  Established in 1987 to effectively and appropriately communicate with people from culturally and linguistically diverse (CALD) backgrounds and coordinate the provision of multilingual health information.
• NSW Public Health Units
  In NSW calling 1300 066 055 will direct you to your local Public Health Unit
• Residential aged care facility outbreak management
  NSW Health is working in close partnership with the Commonwealth to support residential aged care facilities as they manage a COVID-19 outbreak.
• Resilience NSW
  Resilience NSW is the lead disaster management agency for NSW, responsible for all aspects of disaster recovery and building community resilience to future disasters
• Self-Isolation guidelines and information
  You must self-isolate if; you have COVID- 19, you are a close contact of someone with COVID-19, you are a returned traveler exempt from hotel quarantine or you have been tested for COVID-19 and are awaiting results.
• St John Ambulance assisting with resources for NSW Health during COVID-19
  Provide adjunct staffing and equipment to facilitate rapid set up of services by LHD/SHNs. The request form is included in Appendix 3 of the Guideline for COVID-19 Screening Clinics (Drive-Through, Pop-up and Mobile Van).
• Traffic management
  Traffic Management literature and resources.
• Translation and Interpreting (TIS)
  National Contact Centre 131 450
  The Translating and Interpreting Service (TIS National) is an interpreting service for people who do not speak English and for agencies and businesses that need to communicate with their non-English speaking clients.

Document information

Purpose:To facilitate the rapid deployment of resources to areas of concern to conduct rapid COVID-19 screening and testing of NSW residents in the event of a major COVID-19 cluster in NSW.

Objectives:

1. Provide guidance and information to enable rapid deployment of resources to areas of concern within 24 hours.
2. Outline example of models for rapid deployment of resources to promote early detection of community-acquired COVID-19 cases as determined by need.
3. Encourage community engagement to promote early detection and support effective management of community-acquired COVID-19 cases.

Developed by: COVID-19 Clinics Team, Health Service Operations Team, State Health Emergency Operations Centre (SHEOC)

Consultation: Public Health Physician, Office of the Chief Health Officer; PHEOC Laboratory Team; SHEOC Director of Operations; PHEOC Deputy Incident Controller

Endorsed by: SHEOC Deputy Incident Controller​