New approach to COVID-19 exposure management
***Updated 8 October 2021***
As outlined by Professor Rhonda Stuart during our Employee Forum this week, the public health approach to managing exposure risk is changing because of increasing vaccination rates and large numbers of cases in the community among people who are not yet vaccinated. A summary of the changes are provided below.
No longer listing Tier 2 exposure sites or following secondary close contacts in community
The first changes are that we are no longer listing Tier 2 exposure sites and we are no longer following secondary close contacts in the community.
Primary close contacts and community confirmed cases automatically released on Day 14
Additionally, primary close contacts and confirmed cases in the community will be automatically released on Day 14.
In the hospital setting, however, we will still be considering a longer time to release from isolation given that hospitalised patients are much sicker and potentially able to transmit COVID-19 longer than 14 days.
Risk assessed approach to furloughing employees
Internally within Monash Health we are also changing our approach, led in the main because of our high vaccination rates among employees. We are currently at 86% double vaccinated, allowing a change to our approach to furloughing in a hospital setting. We also have excellent adherence to the correct use of PPE, surveillance testing in place and, like many health providers, workforce pressures to ensure our employees can care for those who need it most.
The Department of Health have developed a risk matrix framework, which we will apply when assessing COVID-19 exposures in our workplace. Each exposure will have a risk assessment that takes into account:
- Vaccination status of the healthcare worker
- PPE use by the healthcare worker
- Closeness and duration of the contact with the case
- The infectiousness of the case (including whether there were aerosol generating procedures with the case and if they were wearing a mask)
- Whether we have identified any other transmission in relation to that case
Every case is different, which is why the risk assessment outcome may differ from exposure to exposure.
When we make a risk assessment, there will be four risk categories of primary close contacts (PCC):
- Baseline risk (e.g. new business as usual – Tier 3 PPE observed, little contact)
- Continue to work with routine surveillance
- Low risk PCC (e.g. N95/face shield, minimal touching of positive patient)
- Medium risk PCC (e.g. shared tearoom briefly with no masks with positive case)
- High risk PCC (e.g. PPE breach, extensive physical contact)
Employees can return to work after being deemed either a low risk or medium risk PCC
We now have a number of scenarios when employees can return to work after being deemed either a low risk or medium risk PCC. This can occur if the employee is:
- Double vaccinated
- Returns a negative baseline COVID-19 test result
- Remains asymptomatic
- Takes part in surveillance
If these conditions can be met, low and medium risk PCCs can return to work sooner than has been the case previously.
- Low risk PCCs can continue to work while awaiting the baseline test result.
- Medium risk PCCs will be able to return to work after a baseline and a Day 5 negative test result.
Importantly, this applies for working within Monash Health. Those deemed close contacts will still (at this point in time) have to comply with the Public Health requirements to isolate at home until release at Day 14. However, they are given an exemption, by the Director of Monash Health’s South East Public Health Unit, to allow them to come to work at a Monash Health site.
The protection provided by vaccination allows us to move to this model, supported by our excellent PPE use and surveillance program. The advice from our Infection Prevention team and from the Department of Health is that this is a safe and appropriate measure.
Guide to new furlough approach in a hospital setting
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Pre-conditions which must be met by the employee:
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| Risk Factors | Length of furlough |
| Baseline | No furlough |
| Low risk PCC | Return to work after negative baseline test. Still require negative Day 13 test to be released from home isolation |
| Medium risk PCC | Return to work after negative baseline test and negative Day 5 result. Still require negative Day 13 test to be released from home isolation |
| High risk PCC | 14-day furlough, return after negative Day 13 test |
If you have any questions or concerns, please speak with your manager or contact the Employee Coronavirus Hotline on 9594 5815 from 7am to 8pm, seven days a week.
Thank you for your ongoing efforts to care for our community and each other.
Andrew Stripp
Chief Executive
All managers are requested to share these updates with their teams and discuss at stand-ups and handovers. Please print a copy and display it in communication books and on employee noticeboards.
As advice and information evolve, please consult the latest updates and visit the Department of Health and Human Services and Monash Health COVID-19 website for employees regularly for the latest.