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Context and risk criteria

Public health recommendations related to the risk of COVID-19 infection have been issued for a number of groups of people who meet specific risk criteria. Refer to NSW Health current testing advice for up-to-date risk criteria.

If the patient has fever or acute respiratory illness, ask that they seek health advice (from their GP or by calling Healthdirect hotline on 1800 022 222) to exclude COVID-19 as well as to resolve any other health issues.

The following advice regarding community-based and outpatient health services reflects the recommendations for the above risk criteria.

Community-based and outpatient health services

Community-based and outpatient health services include activities occurring in:

  • Home visits including:
    • hospital in the home
    • acute care/post-acute care
    • early childhood health screening
    • palliative care
    • other home based services.
  • Scheduled clinics and drop-in clinics including:
    • hospital based non-admitted clinics
    • community health centre clinics
    • HealthOne Centres.

Patient includes patient, family, carers and others who may be present at the time of the service.

Guidance for home visiting

Before the home visit

Community health care providers should conduct routine risk assessment (by phone call or SMS) prior to home visiting prior. This should include asking patients whether they:

  • meet the risk criteria
  • have been unwell with a fever
  • have acute respiratory infection (e.g. shortness of breath, cough or sore throat) with or without fever (or whether anyone in their household has been unwell with a fever or cough).

The outcome of this assessment screening should be documented in the patient’s medical record.

If the patient meets the risk criteria or they have been unwell with a fever or cough

  • Consider alternate methods of conducting the appointment, if appropriate (telephone or tele-medicine)
  • If it is not possible to conduct the appointment in an alternate way, identify the timeliness of clinical care required:
    • if the appointment can be safely delayed, reschedule their appointment for as soon as possible after the 14 day exclusion or when recovered from illness
    • if it is clinically necessary to conduct the appointment, ask the patient to wear a surgical mask and follow infection control procedures. This will include standard precautions, as well as contact and droplet precautions, hand hygiene, environmental cleaning and usual waste management. 
      For additional infection control procedures, see: Infection Prevention and Control - Novel Coronavirus 2019 (2019-nCoV) – Hospital setting.  

Facilities will need to develop a system to implement the above steps, which may include appointing an appropriate person to assess whether or not it’s clinically safe to defer the service or appointment and communicating with relevant partner service organisations.

During the home visit (for those who meet the risk criteria)

  • Ask the patient to wear a surgical mask and follow infection control procedures
  • For patients at higher risk of transmission and in self-isolation: at the end of the home visit, remind patients:
    • to continue self-isolate at home for 14 days after they departed from an at risk country (or if they have had close contact with a person with confirmed COVID-19 while infectious)
    • if they develop respiratory symptoms or fever, call Healthdirect hotline on 1800 022 222 or call their GP.

Guidance for scheduled clinics and drop-in clinics

Consider options to identify people at risk in the waiting area/service provision environment, such as:

  • waiting room signage with translation
  • asking patients at reception whether they, or the person(s) attending the appointment with them, meet the risk criteria
  • identify a containment area in the centre for any person(s) who arrive with symptoms.

For patients who meet ​the risk criteria

  • Ask the patient to wear a surgical mask and follow infection control procedures.
  • Ask the patient if they have any respiratory symptoms or fever.
    • For patients who meet the risk criteria within 14 days of their appointment and who do not report any respiratory symptoms or fever:
      • the community health worker or clinician should make a clinical assessment about the presence of respiratory symptoms
      • if there are no symptoms/signs, continue the outpatient consultation as normal with the patient wearing a surgical mask
      • remind the patient to follow the above recommendations in relation to self-isolation and social distancing.
    • For patients who meet the risk criteria and who report symptoms:
Current as at: Tuesday 31 March 2020
Contact page owner: Health Protection NSW