Managing a COVID-19 outbreak in residential aged care

Understand what an outbreak is, what you must do if one occurs in your facility, and what resources you can access to help manage the outbreak effectively.

What is a COVID outbreak?

COVID-19 is infectious illness that may spread with-in residential aged care homes, from staff, visitors and residents, resulting in what we refer to as an outbreak. Outbreaks of infectious illnesses, such as COVID-19, in residential aged care homes are a risk to the health and wellbeing of residents, staff, and families.

An outbreak of COVID-19 occurs when 2 or more residents test positive to COVID-19 within a 72-hour period and residential aged care homes should activate outbreak management plans

The National Statement of Expectations on COVID-19 Management in Aged Care Settings 

The National Statement of Expectations on COVID-19 Management in Aged Care Settings is a reference document that sets out the Commonwealth’s expectation of the actions aged care providers need to take when preparing for and responding to the impact of COVID-19. It provides specific guidance to the aged care sector (for residential and care at home services) on responsibilities for preparing and responding to the impact of COVID-19. 

Key principles

As COVID-19 continues to circulate through Australian communities, older people will remain at a significantly greater risk of severe outcomes from COVID-19.

It remains crucial for aged care services to make sure elderly Australians, for which they are responsible, in all service settings, receive appropriate protection from and management of any COVID 19 infections in their surrounds. 

Aged care services should be delivered in a manner that is: 

  • Risk based
  • Proportionate
  • Scalable
  • Human rights focused

Services should also consider:

  • planning and preparedness
  • testing and case identification 
  • managing COVID-19 infections
  • access to treatment and services
  • reporting and communications/

The National Statement of Expectations on COVID-19 Management in Aged Care Settings, provides further details on these and should be read in conjunction with other approved guidelines, including those issued by the Communicable Diseases Network Australia.

Read more about the National Statement of Expectations on COVID-19 Management in Aged Care Settings.

Reporting all COVID-19 cases and positive resident deaths via the My Aged Care COVID-19 provider portal

To determine the impact of COVID-19, the department requires residential aged care homes to report all resident, worker and visitor COVID-19 cases through the My Aged Care provider portal. This data is important as it allows the department to maintain a contemporary view of current COVID-19 cases in residential aged care homes and helps us gauge the level of Government support required by the sector. It is important that you keep the information up to date by reporting additional cases as they occur and then closing the record at the end of the episode.  

COVID-19 positive resident deaths should also be reported through the portal. A COVID-19 positive resident death is when a resident passes away from COVID-19 or with COVID-19 when a clear alternative cause of death has not been determined. Where there has been a complete recovery from COVID-19 prior to death, meaning all symptoms have passed, this should be excluded and does not need to be reported via the Portal. 

Updates to resident death data can be made within 28 days after the resident’s confirmed COVID-19 positive test. Reporting a COVID-19 positive death can be reported 28 days after an outbreak or exposure notification has been closed in the Portal. 

There are a range of materials to assist you with your COVID-19 reporting including:

Please call the My Aged Care Provider and Assessor helpline on 1800 836 799 if you need assistance accessing the portal.

Responding to an outbreak

Please refer to the national guidelines on Acute Respiratory Illness outbreaks in residential care facilities for advice on how to plan, prepare, detect and manage outbreaks.

The National Statement of Expectations on COVID-19 Management in Aged Care Settings provides specific guidance for the aged care sector on their responsibilities in preparing for and responding to the impact of COVID-19:

Additional guidance is available to help you manage specific parts of an outbreak:

All states and territories have issued public health directions for aged care providers.

Check with your local state or territory health department.

Outbreak management plan

To prepare for a COVID-19 outbreak, providers must have an outbreak management plan.  

In the event of an outbreak, providers should activate their outbreak management plan and distribute it to all stakeholders so they are across the plan.

Staffing during an outbreak

You should have a workforce management plan with contingencies for an outbreak. Your plan should include finding staff through recruitment agencies and within the wider sector. If you have questions about finding additional staff, these FAQs on aged care workforce contingencies will help.

During an outbreak, you must also make sure that staff:

  • do not move between their allocated room/section and other areas of the home
  • only care for the residents they are assigned
  • are familiar with the proper use of PPE including correct procedures on how to  doff and don PPE
  • continue to monitor themselves for signs and symptoms of COVID-19 and do not attend work if unwell, even if symptoms are mild.

Isolating COVID positive cases

The Australian Government released the National COVID 19 Community Protection Framework which provides advice on what public health measures states and territories might put in place to manage COVID-19, including high risk settings such as aged care facilities. 

Aged care providers and workers are expected to maintain infection prevention and control measures in line with current guidance including:

  • all residential aged care workers should not attend the workplace for at least 7 days if they test positive for COVID-19 or while symptoms persist.
  • all aged care workers are encouraged to stay home if they have respiratory symptoms, to reduce the risk of infecting others.
  • residents who test positive for COVID-19 should be isolated or cohorted in line with IPC best practice, and for no longer than is clinically necessary.

Emergency leave for residents

An emergency leave type is available for permanent aged care residents that allows them to stay with friends or family during COVID-19. Emergency leave is available until 30 June 2023. 

Read more about emergency leave.

Declaring an outbreak over

A decision to declare an outbreak over should be made by the Public Health Unit or the Outbreak Management Team. An outbreak can be declared over:

  • 7 days after the last COVID-19 case tests positive or the date of isolation of the last COVID-19 case in a resident, whichever is longer.

Repeat testing may be recommended by the Public Health Unit in the 7 days following an outbreak being considered “over”.

More information on declaring an outbreak over is available in the CDNA ARI Guidelines.

Recovering from an outbreak

The focus of recovery actions for your home should:

  • support and maintain quality of care for residents, and in particular address any deterioration in the residents’ condition that may have occurred during isolation
  • return staff to the home after the public health unit has cleared them fit to return
  • return residents to the home if they were hospitalised during the outbreak.

After the outbreak is declared over, the Outbreak Management Team should consult with the local Public Health Unit to consider holding a debrief of the situation. The debrief should identify:

  • strengths and weaknesses in the response and investigation
  • any policies, practices or procedures that should be improved for future outbreaks.

We have commissioned a number of independent reviews into COVID-19 outbreaks in residential aged care facilities that examined lessons learned from COVID-19 outbreaks.

Staying informed

We have an aged care COVID-19 newsletter ‘Protecting Older Australians’ with up to date advice on matters relating to COVID-19 in aged care.

To stay up to date on aged care and COVID-19:

Your local public health agency will have more information on the latest advice and resources in your state or territory.

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