Respiratory infection advice to residential disability care facilities (RDCF)

​​​​​​​As of 18 December 2024

Residential disability care facilities (RDCF) include:

• supported independent living and/or specialised disability accommodation provided under the National Disability Insurance Scheme (NDIS)
• disability group homes
• Assisted boarding houses.
  

This advice includes information about:

1. Residents
   
1. ​Vaccination for residents​
   
2. Pre-assessment for testing and antiviral medicines​ 
   
3. COVID-19 and influenza antiviral medicines
   
4. Residents who test positive to COVID-19 
   
2. Visitors
   
1. Entry restrictions for visitors 
   
2. Mask wearing for visitors 
   
3. Staff
   
1. ​Entry restrictions for staff 
   
2. Staff exposed to COVID-19 
   
3. Testing staff for COVID-19 
   
4. Mask wearing for staff 
   
5. Vaccination for staff​ 
   
4. Ventilation

All NSW residents are recommended to stay at home if they develop any cold or flu symptoms (runny nose, sore throat, cough, fever). People at higher risk of severe illness should also do a test if they have cold or flu symptoms so they can access early treatment.

RDCFs may have residents who are at higher risk of severe illness if they develop COVID-19, influenza and respiratory syncytial virus (RSV) infections. Providers of residential disability care need to balance their responsibilities to reduce the risk of COVID-19, influenza and RSV transmission in RDCFs while meeting the physical, social, and emotional needs of residents.

Facilities should have preparedness plans in place to ensure a timely response to acute respiratory infections (ARIs). The plan should consider the wellbeing of the case/cases as well as the vulnerability of others living within the facility. Facilities should refer to Guidance for disability care facilities on the public health management of acute respiratory infections (RDCF ARI Guidance) for outbreak management advice.

Residents

Vaccination for residents

• It is strongly encouraged that residents stay up to date with all recommended vaccinations to protect them from severe illness. GPs should be encouraged to assess the resident's vaccination status as part of their annual health assessment and planning. The COVID-19 vaccine can be given on the same day as influenza vaccine. Read the latest vaccination advice on:
• COVID-19
  
• Influen​za
• Use the COVID-19 eligibility checker to check if a COVID-19 vaccination is due.
  
• An RSV vaccine is available to adults 60 years and above. Residents who are 60 years and above can talk to their GP about the benefits of, their eligibility and the out-of-pocket cost of the RSV vaccine. Please see the ATAGI advice for the RSV vaccine for more information.
• Facilities can contact their Primary Health Network (PHN) for help finding primary care vaccination options, including for services provided on-site.
  

Pre-assessment for testing and antiviral medicines​

• GPs and RDCFs are encouraged to establish and annually update the Pre-assessment action plan for respiratory infections for if the resident develops COVID-19 or influenza. This supports timely testing and access to antiviral medicines.
• Administering antiviral treatment as soon as possible after symptom onset or diagnosis, especially for people with COVID-19 reduces the risk of severe disease and can prevent hospitalisation and death.

COVID-19 and influenza antiviral medicines

• COVID-19 antiviral medicines are available on the Pharmaceutical Benefits Scheme (PBS) for eligible RDCF residents.
• For further information on antivirals, refer to COVID-19 and influenza antiviral medicines – Advice for people at higher risk of severe illness.

Residents who test positive to COVID-19

• NSW residents who have tested positive to COVID-19 are advised to stay at home until their symptoms have resolved, and not to visit people at high risk of severe illness, hospitals, and aged and disability care facilities for at least 7 days.
• For the latest guidance on managing acute respiratory infections in RDCFs see the Guidance for disability care facilities on the public health management of acute respiratory infections (RDCF ARI Guidance).
• Residents who have tested positive to COVID-19 should be supported to contact their doctor as soon as possible to discuss care and medical support.
• NDIS funded providers should notify the NDIS Quality and Safeguards Commission when the implication of COVID-19 (or another change or event) has a significant adverse effect. For more information see the NDIS notice of changes and events.

Visitors

Receiving visitors is essential for wellbeing and helps to reduce social isolation. Facilities can determine their own advice to support visits while minimising risk to residents. Visits are allowed to occur even if there are COVID-19 cases in the facility.

The risk of spreading COVID-19 and other respiratory viruses can be reduced by supporting visits to occur in the safest possible way. Risk mitigation strategies include:

• highlighting that visitors should not enter RDCFs when respiratory symptoms are present
• where possible, visits should be held outdoors or in well-ventilated areas.

Entry restrictions for visitors

Visitors should not enter the facility if they have:

• Tested positive for COVID-19 - visitors should not enter an RDCF for at least 7 days after their positive test, unless for compassionate reasons
• any acute respiratory symptoms. For further information please refer to Advice for people exposed to COVID-19.

If a visit must occur, it is strongly recommended the visitor wears a mask whilst in the facility and that the visit occurs in an area with natural ventilation.

Mask wearing for visitors

All visitors are encouraged to wear a mask indoors when respiratory viruses are circulating at moderate or high levels in the community as indicated by the NSW respiratory surveillance report.

Staff

Entry restrictions

Staff, including students, contractors, volunteers, pathology collectors and therapists should not enter an RDCF if they have:

• tested positive for COVID-19. Staff should not enter an RDCF for at least 7 days after their positive test and until symptoms have resolved. Facilities should follow Table 1, Page 8, of the RDCF ARI Guidance to determine when it is safe for staff to return to work.
• any acute respiratory or influenza-like symptoms
• been in close contact with a person who has COVID-19. See below for further information.

Staff exposed to COVID-19

• If the exposure has been in the workplace, managers should refer to Appendix 2 of the RDCF ARI Guidance for when staff can safely return to work, particularly if they are critical to service delivery.
• If the exposure has been outside of the workplace, staff should refer to the Advice for people exposed to COVID-19. Facilities are encouraged to determine their own advice for when it is safe for employees to return to work.

Testing staff for COVID-19

Facilities are encouraged to provide free RATs to staff to promote but regular surveillance testing is not required when there are low levels of COVID-19 in the community a indicated by the NSW Health Respiratory Surveillance Report. Staff with respiratory symptoms should not attend work even with a negative RAT result.

Mask wearing for staff

• Masks should be worn by staff particularly when there are moderate or high levels of respiratory viruses in the community as indicated by the NSW respiratory surveillance report. The impact of COVID-19, influenza and RSV in a RDCF will vary depending on the facility and individual residents. Facilities are encouraged to refer to their COVID-19 occupational health and safety plan.
• When the facility is in an outbreak, refer to the RDCF ARI Guidance for additional PPE advice.

Vaccination for staff​

• Staff are strongly encouraged to stay up to date with all recommended vaccines including COVID-19 and influenza.
• Providers should review staff COVID-19 vaccination records and facilitate access to vaccination for those who are due. For information on recommended COVID-19 vaccination see the latest advice.
• For further information please see the Department of Health and Aged Care information for disability service providers about COVID-19 vaccines.

Ventilation of premises

Ventilation is an important factor in minimising spread of COVID-19 and other respiratory viral infections. The key principle is to bring in fresh air to dilute the indoor air; simply re-circulating indoor air (for example, a fan) is not effective. Natural ventilation should be used wherever possible. RDCFs can consider seeking professional advice from an occupational hygienist or ventilation engineer. Carbon dioxide (CO2) monitors and HEPA filters may play a role but require users to have a good understanding of how to use them.