Australian Health Protection Principal Committee (AHPPC) statement on recommendations for managing of health risk as COVID-19 measures lift
A statement from the Australian Health Protection Principal Committee (AHPPC) about how to manage health risks as COVID-19 measures lift.
The Australian Health Protection Principal Committee (AHPPC), on the advice of the Communicable Diseases Network Australia (CDNA), has revised the previous AHPPC statement on 30 March 2020 on managing vulnerable workers.
AHPPC is pleased to note the continued stable low number of cases of COVID-19 in most communities in Australia. This has permitted progressive relaxation of travel and other physical distancing restrictions.
As the current level of COVID-19 cases is low, people, even those at higher risk of becoming severely ill from COVID-19, can return to work and other settings with appropriate precautions in place.
Australians should monitor current public health advice and continue physical distancing, using hand and respiratory hygiene and stay home if acutely unwell.
Current risk of contracting COVID-19
The risk of becoming infected with SARS-CoV2 (the virus that causes COVID-19) depends on the chance of being close to someone with COVID-19 or coming into contact with surfaces contaminated by the virus.
Because of this the local pattern of disease is the most important determinant of risk of contracting COVID-19 illness in any community. If there are no cases or a low number of cases and no evidence of community transmission, then the risk of exposure is low regardless of age or health conditions.
Currently, in Australia there are low numbers of cases. This means the risk of being exposed to someone with COVID-19 is currently low in most communities.
Each person has a personal responsibility to protect themselves, to protect loved ones and the wider community. Even if cases remain low, people still need to:
- practise physical distancing
- practise good cough and hand hygiene
- consider downloading the COVIDSafe app
- get influenza vaccination
- stay at home and get tested for COVID-19 if unwell with even mild cold or flu-like symptoms
It is also important to stay up to date on COVID-19. Read more information on areas with elevated risk of local transmission of COVID-19 or on jurisdictional sites.
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.
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 people over 70.
Some medical conditions may also increase risk. People at high risk of severe COVID-19 illness include those who:
- have had an organ transplants and on immune suppressive therapy
- have had a bone marrow transplants 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 (diagnosed within the last 5 years)
- are having chemotherapy or radiotherapy
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.
Evidence suggests having 2 or more conditions may increase risk, regardless of age. More severe disease and/or poor control of the condition may also increase the risk of severe disease.
First nation’s peoples are thought to be at higher risk in public health emergencies. 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. It would also be appropriate to develop an individual COVID-19 action plan. The best time to do this is now while there are low rates of COVID-19 in the community.
Activities and settings
The current level of COVID-19 cases in most communities is low. This means that people, even those at higher risk of more severe disease, can return to normal activities and interactions with social distancing and other appropriate controls in place.
All people need to 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)
Some higher-risk settings, such as residential aged care facilities, have different protections and are considered separately.
Work and volunteer settings
It is important to remember that regardless of age or medical conditions, if there are few cases in the community, then the actual risk of contracting COVID-19 is low. It is important to stay up to date.
The current number of COVID-19 cases is low in most communities. Therefore, people, even those at higher risk of more severe disease, can return to work and other settings (such as volunteering) with appropriate controls in place.
Those at higher risk of more severe illness with COVID-19 may consider developing an individual workplace COVID-19 action plan with their employer.
What if case numbers increase?
If case numbers increase people need to think about their activities and interactions and how these might affect their risk of exposure to COVID-19.
There are different degrees of virus exposure risks, depending on the activity, setting or event. Some types of activities, events and settings may increase 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 others (for example, cruise ships)
- 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, attendance at such activities or settings, should be carefully considered or avoided.
It is also important to remember that travel to an area with higher case numbers, or going to an event with people from an area with higher case numbers, may also increase risk of contracting COVID-19.
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)
When there is community transmission or increasing COVID-19 cases in the local community, people at increased risk of severe disease may need to apply additional controls to manage their risk at work in accordance with their workplace COVID-19 action plan if they have one.
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 to 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
- Garg S, K.L., Whitaker M, et al, Hospitalization Rates and Characteristics of Patients Hospitalized with Laboratory-Confirmed Coronavirus Disease 2019 — COVID-NET, 14 States, March 1–30, 2020. MMWR Morb Mortal Wkly Rep, 2020;69(15):458-464. Published online April 8, 2020. DOI: 10.15585/mmwr.mm6915e3.
- Petrilli, C.M., et al., Factors associated with hospital admission and critical illness among 5279 people with coronavirus disease 2019 in New York City: prospective cohort study. BMJ, 2020;369:m1966. DOI: 10.1136/bmj.m1966.
- Docherty, A.B., et al., Features of 20 133 UK patients in hospital with covid-19 using the ISARIC WHO Clinical Characterisation Protocol: prospective observational cohort study. BMJ, 2020. 369:m1985. DOI: 10.1136/bmj.m1985
- Williamson, E., et al., OpenSAFELY: factors associated with COVID-19-related hospital death in the linked electronic health records of 17 million adult NHS patients. 2020: DOI: 10.1101/2020.05.06.20092999.
- Guan, W.J., et al., Comorbidity and its impact on 1590 patients with Covid-19 in China: A Nationwide Analysis. Eur Respir J, 2020. Published online March 26, 2020. DOI: 10.1183/13993003.00547-2020.
Read previous statements from the AHPPC.