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.
SHEOC Operations is the central coordination point for NSW Health's COVID-19 rapid deployment of resources, or enquires and is available via email to MOH-SHEOC-COVID19Operations@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).
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:
In August 2020, a COVID-19 pop-up clinic was established to encourage the Lao community to come forward for testing.
South Western Sydney Local Health District (SWSLHD) and NSW Multicultural Health Communication Service identified a gap in COVID-19 testing for the Lao community. A pop-up clinic was established in association with a Lao Buddhist Temple in Fairfield LGA.
South Western Sydney Local Health District, NSW Multicultural Health Communication Service and Lao community representatives worked together to understand how to best deliver a culturally accessible and appropriate site for the Lao community.
This model is being rolled out further in local community centres and places of worship to encourage people to come forward amid concerns of misinformation around safety and cost.
See SBS report: Extra clinics are being set up in NSW multicultural communities to help bust coronavirus myths
Expand services within the local area.
Deployment of mobile "squad team" to high risk setting.
SHEOC will act as the centralised coordination point for distributing resources on a need's basis including but not limited to the following Emergency Services and Supporting agencies:
HealthShare NSW, NSW Health Pathology, Private Pathology Providers, NSW Ambulance, Primary Health Networks (PHNs), State Emergency Operations Controller (SEOCON), Regional Emergency Management Officers (REMO), Department of Communities and Justice (DCJ), Resilience NSW, NSW Police, Transport for NSW, volunteer organisations (e.g. St John Ambulance), and other bodies included in the SHEOC and SEOC structures
LHD's require the flexibility to stand down at short notice. Stand down activities will focus on:
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:
In August 2020, a COVID-19 negative test results SMS trial was undertaken to determine the most effective SMS messaging that would increase the likelihood of the public to re-test.
By using a clear call out to "Come back as soon as you have symptoms again" the likelihood to re-test increased from a mean intention of 8.2 out of 10 (BAU) to 8.7. That is, 11% more people say they are very likely to get retested if they get sick again.
The Behavioural Insights Unit conducted this trial at St Vincent's Health Network (SydPath) laboratory COVID-19 clinic sites over a 3 week period. Over 30,000 SMS's were sent and over 4,000 survey responses received. Survey responses not only provided preference for the SMS "Come back as soon as you have symptoms again", there was high praise given to the COVID- 19 clinics for their excellence in service provision (service rating of 9.5 mean out of 10).
As a result of the trial, St Vincent's (SydPath) are now using this SMS and have implemented several other changes as a result of the survey feedback. The Bondi drive-through has tripled its peak capacity with the ability to further surge up and down as required and reduced wait times to less than 1 hour at peak morning times and 5min otherwise, by expanding to 4 lanes instead of 1 and increased staffing at peak times.
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:
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).
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).
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.
In Early August 2020 a Residential Aged Care Facility (RACF) in Ashfield with approximately 150 residents had a staff member test positive that was working during the infectious period.
Sydney Local Health District led an outbreak management team using a mobile squad response to contain the potential outbreak. Access to the facility was restricted to essential services only.
The rapid deployment of the mobile team was implemented to test staff and residents. All staff and residents were tested, with repeat testing in accordance with public health guidance.
There were no further cases. The Mobile Squad Team succeeded in containing the possibility of an outbreak in a high risk, high density setting.
See ABC report: How this Sydney aged-care home averted a coronavirus disaster
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:
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:
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