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Designated COVID-19 Hospital Network

Designated COVID-19 Hospital Network Direction (No. 2)

What’s changed from 31 May 2021

  • Clarify that the Hospital and Health Service Chief Executive of a designated COVID-19 hospital can allow patients without COVID-19 to be cared for in a COVID-19 ward if there are measures in place to minimise interaction between patients.
  • Clarify that the Hospital and Health Service Chief Executive of a designated COVID-19 hospital can allow a COVID-19 ward patient to have a personal visitor.
  • Clarify that the Hospital and Health Service Chief Executive of a non-designated COVID-19 hospital can provide health care to quarantined international arrivals if the hospital has an ICU specific plan in place.

Overview

To protect the health of the Queensland community, health workers and hospital system, a best practice approach to manage people diagnosed with COVID-19 is in place.

This Direction applies to:

  • operators of hospitals with COVID-19 patients or people subject to quarantine
  • anyone diagnosed with COVID-19 who must isolate
  • Queensland Hospital and Health Service and Queensland Ambulance Service employees and contractors who may have direct contact with a COVID-19 patient
  • ambulance services or others who transport COVID-19 patients or quarantined persons to hospital.

Anyone diagnosed with COVID-19 must travel directly to a designated COVID-19 hospital to isolate in a COVID-19 ward.

Isolation means you need to stay in a room away from others while you get better, so you don’t give the virus to anyone else.

Travel

If you are diagnosed with COVID-19 outside of a designated COVID-19 hospital, you must travel by:

  • ambulance service
  • transport arranged by a government authority; or
  • as told by an emergency officer.

Leaving the COVID-19 ward

You cannot leave the COVID-19 ward of the designated COVID-19 hospital until:

  • 14 days have passed since your diagnosis, or
  • a doctor or nurse says you no longer need to isolate.

If you have been overseas in the last 14 days you will have to finish your quarantine at a nominated premises.

If you are diagnosed with COVID-19, you cannot leave a COVID-19 ward except:

  • in an emergency situation
  • for safety reasons (to avoid injury or illness, or to escape a risk of harm)
  • to attend another area of the designated COVID-19 hospital for occasional care
  • as required or permitted under a direction given to you by an emergency officer.

Visitors

Anyone diagnosed with COVID-19 cannot receive visitors, unless approved by the Hospital and Health Service Chief Executive of a designated COVID-19 hospital.

Face masks

Anyone diagnosed with COVID-19 must wear a surgical mask, personal protective equipment (PPE) and infection control measures when leaving a designated COVID-19 hospital or when told by a COVID-19 ward health service or emergency officer.

Non-designated COIVD-19 hospitals

People diagnosed with COVID-19 may need to be treated in a hospital that is not a designated hospital due to bed capacity, geographical limits or in the case of an emergency. If this occurs the operator of the hospital may require employees or contractors who have contact with the diagnosed case to have surveillance testing or wear personal protective equipment.

The Hospital and Health Service Chief Executive of a non-designated COVID-19 hospital can provide health care to quarantined international arrivals if the hospital has an Intensive Care Unit (ICU) specific plan in place.

The Hospital and Health Service Chief Executive of a designated COVID-19 hospital must ensure:

  • people diagnosed with COVID-19 or quarantined international arrivals are treated and accommodated in a COVID-19 ward, unless they need to go to another part of the hospital for occasional or intermittent care
  • the COVID-19 ward complies with the COVID-19 care infection control and safety standards
  • the COVID-19 ward has controls in place to minimise contact between people with COVID-19, quarantined international arrivals and patients without COVID-19
  • health service employees, Queensland Ambulance Service employees and contractors who work in or enter the COVID-19 ward comply with vaccination, testing and personal protection equipment (PPE) requirements
  • a record is kept of each person who enters or works in the COVID-19 ward or who provides occasional or intermittent care
  • employees or contractors receive training on and comply with the requirements of this Direction and the COVID-19 care infection control and safety standards
  • health service employees and contractors who work in a COVID-19 ward do not work in any other areas of the hospital and health service during the same roster period. This does not apply to employees who only provide occasional or intermittent care
  • the COVID-19 ward is staffed with skilled health service employees or contractors to meet the infectious disease management requirements.

The Hospital and Health Service Chief Executive of a designated COVID-19 hospital may allow other people to enter a COVID-19 ward if:

  • emergency care must be provided immediately
  • there are no other employees or staff available who can provide care or transport
  • needed to provide services to maintain the safe operation of the COVID-19 ward.

An employee or contractor who works in a COVID-19 ward must:

  • comply with vaccination, testing and personal protective equipment requirements of this Direction and the COVID-19 care infection control and safety standards
  • not work in any other areas of the facility during the same roster period, unless providing occasional or intermittent care.

Health service employees, Queensland Ambulance Service employees and contractors who are at a higher risk of having contact with COVID-19 patients must follow COVID-19 testing, vaccination and mask wearing requirements.

Vaccination

Health Service and Queensland Ambulance employees and contractors at higher risk of having contact with COVID-19 patients must:

  • be vaccinated for COVID-19
  • notify the Hospital and Health Service Chief Executive or Queensland Ambulance Service Commissioner (or their nominated representative) when they get their vaccine.

If you have not been vaccinated and have entered a COVID-19 ward for a permitted reason you must:

  • report your entry to the to the Hospital and Health Service Chief Executive or Queensland Ambulance Service Commissioner (or their nominated representative) as soon as practicable
  • undertake surveillance testing and wear a surgical mask at all times when working in the hospital until 14 days have passed since you entered the COVID-19 ward.

Testing

Employees and contractors who may have direct contact with a COVID-19 patient must undertake surveillance testing and notify their employer of the test.

This means you must:

  • have a saliva test each shift
  • have a weekly throat and deep nasal swab if you are away from work for 7 days or more. You must continue to be tested until 14 days have passed since you have been at work
  • have a test when directed by an emergency officer
  • continue to undertake surveillance testing if you work as a quarantine facility worker.

If you comply with surveillance testing and do not have COVID-19 symptoms, you do not need to isolate or quarantine while waiting for your result. If you are not tested, you cannot work until you comply with testing or until 14 days have passed since you were in the COVID-19 ward.

If you develop COVID-19 symptoms, you must:

  • immediately seek medical attention
  • get tested and isolate until you receive a negative result and have no symptoms
  • follow the requirements of all other Public Health Directions.

Personal protective equipment (PPE)

Health Service and Queensland Ambulance Service employees or contractors must comply with PPE requirements as required by COVID-19 care infection control and safety standards and:

  • be fit tested for a P2/N95 mask
  • perform fit checking (PDF)
  • wear a P2/N95 mask or approved purified air powered respirator when:
    • working or entering a COVID-19 ward
    • providing occasional or intermittent care in a COVID-19 ward, or outside the ward to a patient with COVID-19
    • providing care in an emergency department to a patient who has been diagnosed with COVID-19

The Hospital and Health Service Chief Executive and the Queensland Ambulance Commissioner or their nominated representative must keep a record of surveillance testing.


For full details, read the Designated COVID-19 Hospital Network Direction.

Questions and answers about this direction

Who is a health service employee, Queensland Ambulance Service employee or contractor who are considered higher risk of having contact with COVID-19 patients?

This Direction applies to all health workers. A health worker is an employee or contractor of a Queensland Hospital and Health Service or the Queensland Ambulance Service. A health worker who fits one of the categories must follow vaccination, testing and mask wearing requirements.

Any employee of a Queensland Hospital and Health Service or the Queensland Ambulance Service, or a contractor whose role:

  • includes working in or entering a COVID-19 ward within a designated COVID-19 hospital
  • provides occasional or intermittent care to someone diagnosed with COVID-19 or a quarantined international arrival at a designated COVID-19 hospital
  • provides emergency care to someone diagnosed with COVID-19 or a quarantined international arrival in an emergency department of a designated COVID-19 hospital
  • involves transporting people diagnosed with COVID-19 by ambulance or aeromedical services including from a quarantine facility to a hospital.

Who is a contractor?

A contractor means a person who performs services to a Hospital and Health Service including:

  • contractors and consultants
  • aeromedical retrieval services
  • locum workers
  • visiting medical practitioners
  • authorised practitioners of a contracted VMO
  • workers engaged under an arrangement with an employment agency or workforce labour company.

I am a health service employee, Queensland Ambulance employee or contractor, who can answer my questions?

All health service employees, Queensland Ambulance employees and contractors should talk to their employer for more information.

Which hospitals are designated COVID-19 hospitals?

Designated COVID-19 hospitals are listed in Schedule 2 of the Direction.

What is occasional or intermittent care?

Occasional or intermittent care is health care provided to a person diagnosed with COVID-19 or a quarantined international arrival that is not part of the usual care provided in a COVID-19 ward. For example, specialist consults, dialysis, palliative care, obstetrics, nuclear medicine, or allied health care or medical imaging.

Occasional or intermittent care can be provided within the COVID-19 ward or another area of the designated COVID-19 hospital.

What is a COVID-19 ward?

A COVID-19 ward is an area in a designated COVID-19 hospital that:

  • is a separate area from the rest of the hospital
  • has airflow that is isolated from other areas of the hospital
  • has an entry and exit used exclusively for the COVID-19 ward and measures in place to monitor and record entry and exit
  • has had an assessment of airflow by a qualified engineer
  • is clearly identified through signage or other means that it is a COVID-19 ward.

COVID-19 wards can only treat or accommodate diagnosed persons and quarantined international arrivals unless the Chief Health Officer has given approval to the Chief Executive of the Hospital.

What are the COVID-19 infection control and safety standards?

The COVID-19 infection control and safety standards are:

Questions about vaccination requirements

What are the vaccination requirements for employees and contractors?

You must comply with vaccination requirements if you may have direct or indirect contact with a COVID-19 patient. This means you must:

  • be vaccinated for COVID-19
  • notify the Hospital and Health Service Chief Executive or Queensland Ambulance Service Commissioner (or their nominated representative) when you get your vaccine.

Can I continue to work if I haven’t received my first dose? / Can I continue to work if I have received my first dose but haven’t had my second dose in the appropriate time?

You may continue to work in a Hospital and Health Service or for the Queensland Ambulance Service as long as you do not work in an area that has a higher risk of coming into contact with a confirmed COVID-19 patient . This means you cannot work in a COVID-19 ward or in an area with COVID-19 patients.

The Hospital and Health Service Chief Executive or Queensland Ambulance Service Commissioner will ensure you are temporarily moved to another work unit until you are vaccinated.

If this is not possible, you must discuss this with your line manager and consult with the local Human Resources Team for other options.

What happens if I enter a COVID-19 ward or an area where a COVID-19 patient is located and haven’t started the vaccination process?

If you do not comply with vaccination requirements and enter an area where a COVID-19 patient is located, you must:

  • report what happened to the Hospital and Health Service Chief Executive or the Queensland Ambulance Commissioner (or their nominated representative) as soon as possible; and
  • undertake surveillance testing until 14 days have passed since you entered the COVID-19 ward.

If you do not follow these reporting and testing requirements, you may be fined.

Do I need to be tested while away from work if I have been vaccinated?

Yes. You must still have a throat and deep nasal swab every 7 days while you are away from work, even if you have been vaccinated for COVID-19. You must continue to be tested until 14 days have passed since you have been at work.

I need to provide evidence I have been vaccinated, how can I do this?

You can use your immunisation history statement as evidence. This is available from the Australian Government through:

For more information see the Australian Government website.

Questions about testing requirements

What if I am already undertaking surveillance testing as a quarantine facility worker?

If you are already undertaking surveillance testing as a quarantine facility worker at a quarantine hotel you can continue to follow those testing requirements.

How do I get tested if I am travelling somewhere that does not have easy access to testing facilities?

Health workers can be tested at a number of locations including:

  • at their work facility when pathology staff are present
  • Queensland Health fever clinics
  • any other private pathology provider.

If you are travelling to a location where testing facilities are not available, talk to your Queensland Health contact to understand what you will need to do.

How do I get tested if I’m travelling interstate?

All states and territories have agreed that health workers will be able to be tested and do not need to quarantine if they have no symptoms.

You should inform your employer before any expected absence (this includes leave and having no rostered shifts). Queensland Health will provide you with the pathology test forms to be used during your time away, anywhere in Australia.

What does away from work mean?

Away from work includes:

  • planned or unplanned leave
  • finished a scheduled deployment
  • no longer working for a health service (for example you quit, your employment was terminated, or you resigned)
  • casual and part time workers who don’t have a rostered shift for more than 7 days.

Can I visit a residential aged care facility, disability accommodation service or hospital if I am waiting for the result of my surveillance test?

If you are still waiting for your surveillance test results and you do not have any COVID-19 symptoms, you may enter a residential aged care facility, disability accommodation service or hospital.

Will the people I live with have to quarantine/get tested too?

No. People you live with will only have to get tested if they develop COVID-19 symptoms or come into contact with someone who has tested positive.

I thought you could only be tested if you had symptoms?

According to the Australian Health Protection Principal Committee (AHPPC) there are benefits in testing asymptomatic people who work in environments that have a high risk of COVID-19 transmission. This includes people who provide health care to confirmed COVID-19 cases.

Large-scale testing of asymptomatic people in areas that are not high risk is not supported.

What should I do if I miss my routine test?

If you were unable to have a saliva test for a shift because testing wasn’t available before, during or after your shift, you should let your employer know and you must get a saliva test at your next shift.

If you have not started the vaccination process and are unable to attend testing times for your throat and deep nasal swab that are available onsite, you can visit a fever clinic.

When you’re are attending a Queensland Health COVID-19 testing facility, you should identify yourself as a Hospital and Health Service or the Queensland Ambulance Service employee or contractor who works with COVID-19 positive patients. This will allow you to be tested, even if asymptomatic, and you will be prioritised for testing.

How will I receive my results? How long will it take?

Results are usually available within a couple of days after the test was taken.

If the result is positive, you will receive a call from a public health doctor or nurse who will tell you what to do next.

If the result of your throat and deep nasal swab is negative, you will be contacted by public health clinical support staff, this may be by phone or by SMS.

You will not be notified of the results of your saliva test, unless it is positive.

Can I still go to work while waiting for my test results?

If you do not have COVID-19 symptoms you can keep working while you wait for your test results. You do not have to isolate at home.

If you do have COVID-19 symptoms, no matter how mild, you must isolate until you have received a negative test and have no symptoms.

What happens if I test positive?

If your test is positive, it is important that you isolate from others. If your clinical condition is such that you require hospital care, you will be transferred for isolation in hospital and further care.

If you live with others, they must quarantine.

Find out more on what happens if you test positive to COVID-19.

If I have to quarantine while I wait for my results, will I still be paid?

You should speak to your employer as they will be able to advise on their human resource policies regarding payment when quarantining.

What is saliva testing and how does the saliva test work?

Saliva testing is a test that uses the saliva from your mouth to test for COVID-19.

The test is painless and simple. It may be collected by a healthcare worker or you may be asked to collect it yourself under supervision from a healthcare worker.

Saliva testing is only able to detect the presence of COVID-19 in the saliva, a positive test may mean you either have COVID-19 or it may show evidence of a previous COVID-19 infection. The test is not able to detect other respiratory viruses, or drug substances, or whether you are pregnant.

The test can be conducted daily without any side effects.

Does the saliva test detect anything other than COVID-19 (alcohol, other medications, recreational drugs, pregnancy)?

No. Saliva testing only tests for COVID-19. The test is not able to detect other respiratory viruses, or drug substances.

How accurate is saliva testing?

The throat and deep nasal swab remain the best test for anyone with symptoms because it is more accurate. At this time, the saliva test is only used as a screening test for some people without symptoms who will need frequent testing (people who are asymptomatic).

If you develop any symptoms of COVID-19, you should not go to work and get a COVID swab test from a fever clinic or through your local doctor.

If I have a saliva test and develop symptoms later in the day or the next day, what should I do?

If you experience symptoms, no matter how mild, between your regular tests you must get tested immediately and isolate. You cannot attend your workplace until you receive a negative result and no longer have symptoms.

Does saliva testing hurt?

No. The saliva testing is painless, not invasive and takes about one minute.

What are the risks with frequent saliva testing? Will my mouth get sore? Are the chemicals safe to have every day?

There are no risks associated with frequent testing.

How must surveillance testing records be kept?

The Hospital and Health Service Chief Executive and the Queensland Ambulance Service Commissioner (or their nominated representative) must keep a record of surveillance testing.

This information must be stored in a secure database that is only accessible to authorised persons.

The Department of Health must also be notified as soon as possible of any report of direct or indirect contact by an employee or contractor who has not started the vaccination process.

Questions about face masks, P2/N95 masks and personal protective equipment (PPE)

When do I have to wear a face mask? / What are the requirements for respirators?

Hospital and Health Service Chief Executives and the Queensland Ambulance Service Commissioner must ensure Health Service and Queensland Ambulance Service employees or contractors comply with PPE requirements as required by COVID-19 care infection control and safety standards and:

  • be fit tested for a P2/N95 mask
  • perform fit checking (PDF)
  • wear a P2/N95 mask or approved purified air powered respirator when:
    • working or entering a COVID-19 ward
    • providing occasional or intermittent care in a COVID-19 ward
    • providing care in an emergency department or intensive care unit to a patient who has been diagnosed with COVID-19.

What if I can’t wear a P2/N95 mask or approved purified air powered respirator?

If you are unable to wear a P2/N95 mask or approved purified air powered respirator you must not enter a COVID-19 ward, provide occasional or emergency care or transport a patient diagnosed with COVID-19 or a quarantined international arrival.

What is fit testing?

The fit testing (PDF) of PFR or P2/N95 respirators in the respiratory protection program guidance outlines the safe and practical integration of fit testing into respiratory protection programs.

What happens if the fit testing fails? / Can I continue to work with COVID positive patients if fit testing fails?

You can continue to work in a Hospital and Health Service or for the Queensland Ambulance Service as long as you do not enter COVID-19 ward, provide occasional or emergency care or transport a patient diagnosed with COVID-19 or a quarantined international arrival.

The Hospital and Health Service Chief Executive or Queensland Ambulance Service Commissioner (or their nominated representative) will ensure you are moved to another work unit.

If this is not possible, you must discuss this with your line manager and consult with the local Human Resources Team for other options.

Do I have to shave my beard?

You will have to shave your beard to pass fit testing (PDF). You will not be made to shave your beard. If you do not wish to shave your beard, you can continue to work in a Hospital and Health Service or for the Queensland Ambulance Service as long as you do not enter COVID-19 ward, provide occasional or emergency care or transport a patient diagnosed with COVID-19 or a quarantined international arrival.

The Hospital and Health Service Chief Executive or Queensland Ambulance Service Commissioner will ensure you are moved to another work unit.

Enforcement

What happens if I refuse to be vaccinated, tested or wear a PFR or P2/N95 respirator when required?

If you refuse to follow the vaccination, testing or personal protection equipment requirements in this Direction and continue to work with COVID positive patients, you may be given an on-the-spot fine of $1,334 (vaccination and testing) or $200 ( P2/N95 mask or purified air respirator), a court-imposed penalty of up to $13,345 or 6 months' imprisonment.

Questions about isolation

Where do I isolate if I am diagnosed with COVID-19? How do I get to a designated care facility?

Anyone diagnosed with COVID-19 must travel directly to a designated COVID-19 care facility to isolate. You must travel by:

  • ambulance service
  • transport arranged by a government authority; or
  • as told by an emergency officer.

When can I leave isolation?

You cannot leave a COVID-19 ward until:

  • 14 days have passed since your diagnosis, or
  • a doctor or nurse says you no longer need to isolate.

If you have been overseas in the last 14 days you will have to finish your quarantine at a nominated premises.

You can leave a COVID-19 ward:

  • in an emergency situation
  • for safety reasons (to avoid injury or illness, or to escape a risk of harm)
  • to attend another area of the designated COVID-19 hospital for occasional care
  • as required or permitted under a direction given to you by a public health emergency officer.

Anyone diagnosed with COVID-19 must wear a surgical mask, personal protective equipment (PPE) and follow infection control measures when leaving a designated COVID-19 hospital or when told by a COVID-19 ward health service or emergency officer.

What’s the difference between quarantine and isolation?

While both will limit your movements, quarantine is what people are required to do in case they have come in contact with a confirmed case.

Isolation is the term used when asking people who are suspected or confirmed to have COVID-19 to stay in a COVID-19 ward until they are no longer infectious.

I’m feeling better, do I need to stay in isolation for the full 14 days?

Everyone experiences COVID-19 differently. Some people experience severe symptoms for weeks, while others can recover quickly, and feel better within a few days. To effectively manage the spread of COVID-19, it is very important that everyone who is diagnosed with COVID-19 continues to stay at a COVID-19 ward for the full 14 days of isolation, or until they are told by a doctor or nurse they can leave.

If you have been overseas in the last 14 days you will have to finish your quarantine at a nominated premises.

How do I report someone who should be isolating but isn’t?

If you need to report COVID-19 compliance breaches, please contact Police Link on 131 444 or via their online form.