Download as PDF: : COVID-19 clinics rapid deployment plan

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.

Lao Buddist templet pop-up clinic: Engagement with local community

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

Overview of demand escalation and actions

Demand Testing actions
Positive cases in NSW but minimal localised demand Clinics, Drive-through, Pop-up and mobile services.
Increase in demand due to positive case findings or areas for increased concern Expand services within the local area.
Increase in demand due to local cluster/s in high risk settings and potential for rapid spread (e.g. high density living or institutions or vulnerable populations)

Expand services within the local area.

Deployment of mobile "squad team" to high risk setting.

Wide spread community transmission across NSW

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

Stand down

LHD's require the flexibility to stand down at short notice. Stand down activities will focus on:

  • Supporting and maintaining quality care
  • Ceasing activities that are no longer needed, and transitioning activities to seasonal or interim arrangements
  • Monitoring for a second wave of the cluster, or the development of antiviral resistance
  • Communications activities to support the return from pandemic to normal business services
  • Evaluating systems and revising plans and procedures.

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

COVID-19 negative sms trial: Expansion of a drive though

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.

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.

Mobile squad

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

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

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​

Current as at: Thursday 1 October 2020
Contact page owner: Health Protection NSW