The Australian Health Protection Principal Committee (AHPPC), on the advice of the Communicable Diseases Network Australia (CDNA), has revised the previous AHPPC statement on 6 July 2020 on managing health risks as COVID-19 measures lift.
AHPPC is pleased to note the increasing uptake of COVID-19 vaccination across Australia. Data from clinical trials and real-world evidence demonstrates that COVID-19 vaccines available in Australia are very effective against hospitalisation and death from COVID-19.
Even where there is community transmission of COVID-19, increased vaccination coverage in Australia will allow people, including those at higher risk of becoming severely ill from COVID-19, to continue attending work and other settings with appropriate precautions in place where public health restrictions allow.
- monitor current public health advice
- get vaccinated
- continue physical distancing
- wear a mask as directed by local public health authorities
- use hand and respiratory hygiene and
- stay home and get tested when acutely unwell.
Individual risk factors
Anyone who gets COVID-19 can develop severe disease. However, the likelihood of getting severe COVID-19 illness increases with older age and the presence of certain health conditions. This risk can be reduced by getting vaccinated against COVID-19.
Age is by far the strongest risk factor associated with disease and death. Risk increases as people age. There is a very substantial increase in risk of severe COVID-19 illness in unvaccinated people over 70.
Some medical conditions may also increase risk. People at high risk of severe COVID-19 illness include those who are unvaccinated and who:
- have had an organ transplant and are on immune suppressive therapy
- have had a bone marrow transplant in the last 24 months or are on immune suppressive therapy for graft versus host disease
- have a haematologic (blood) cancer e.g. leukaemia, lymphoma or myelodysplastic syndrome
- have non-haematological cancer diagnosed within the past 5 years or on chemotherapy, radiotherapy, immunotherapy or targeted anti-cancer therapy.
Other chronic conditions are associated with a risk of severe COVID-19. For more information on chronic conditions which increase risk of severe illness see advice for people with chronic health conditions.
First nation’s peoples are thought to be at higher risk in public health emergencies. Unvaccinated Aboriginal and Torres Strait Islander peoples may be at increased risk of severe disease and should be considered a priority population when assessing potential risk related to COVID-19.
People with concerns about their risk can ask their health care provider to help them make a risk assessment and organise their COVID-19 vaccination.
Activities and settings
It is important to remember that regardless of age or medical conditions, COVID-19 vaccination reduces an individual’s risk of severe COVID-19. In addition, the risk of exposure to COVID-19 is reduced as more people in the community are vaccinated against COVID-19.
When assessing which activities and interactions to participate in, all people need to ensure they maintain appropriate risk mitigation controls, including vaccination and physical distancing. People should also consider:
- their personal or individual risk of severe disease
- the level of transmission of COVID-19 where they live and travel
- which interactions and activities are important to them and how they can be done safely
- whether and when they are comfortable to participate in these activities and when they are not. For most people this will depend on the number of cases in the community
- the public health restrictions in place.
Some higher-risk settings, such as residential aged care facilities, have different protections and are considered separately.
There are different degrees of virus exposure risks, depending on the activity, setting or event. Some types of activities, events and settings may increase the risk of contracting COVID-19. These include activities that:
- are in closed or indoor environments
- have large numbers of people in close contact over an extended period. (For example, public transport at peak hour, sporting events, protests or other large gatherings)
- require physical activity and close contact (for example, dancing or contact sport)
- require vocalising in an indoor environment. (For example, choirs, singing in church or close communication such as shouting in a noisy environment)
- require sharing objects with others (for example, utensils at a buffet)
- require sharing accommodation or amenities with . (For example, hostels, university dormitories, boarding schools)
- are longer (the risk for exposure and transmission increases with time).
When there are higher case numbers or community transmission, and a person is at a higher risk of severe disease, (for example, because they are unvaccinated), attendance at such activities or settings, should be carefully considered or avoided.
Some work settings may also place employees at higher risk of COVID-19 exposure, either through:
- potential exposure to infected people, such as in health or aged care settings
- working conditions where physical distancing is difficult to maintain (for example, working in the disability or aged care sector)
- work with multiple face-to-face interactions with others
- working in a setting that has been associated with increased virus transmission (for example, meat processing).
Those at higher risk of more severe illness with COVID-19 may consider developing an individual workplace COVID-19 action plan with their employer.
Workplaces need to have a COVIDSafe risk mitigation strategy consistent with the code of practice How to manage work health and safety risks (2018). This also applies to organisations that employ workers and engage volunteers. See Safe Work Australia’s information on volunteers. These organisations should provide the same workplace protections to volunteers as for paid workers.
- COVID-19 action plan to help you manage your risk related to COVID-19.
- Living well in the COVID-19 pandemic to help people make COVIDSafe decisions about work, transport, and social activities in the COVID-19 pandemic.
- Guide for general practitioners to inform shared decision making with patients around risk of severe illness related to COVID-19.
- Chung H, He S, Nasreen S, et al. Effectiveness of BNT162b2 and mRNA-1273 COVID-19 vaccines against symptomatic SARS-CoV-2 infection and severe COVID-19 outcomes in Ontario, Canada: a test-negative design study. 2021. Available from: https://doi.org/10.1101/2021.05.24.21257744 (Accessed 24 August 2021).
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