Published on 11 October 2023

COVID update – Changes to Routine Screening Pathways

Western Health has continued to closely monitor the status of COVID in our facilities and across the community. Based on our experience and evidence, Western Health is now moving to a COVID Sustainability Admissions Pathway. The updated WH COVID-19 Testing Criteria, Isolation and Deisolation Algorithm reflects our sustainability strategy and can be found at the following link:

COVID-19 Testing Criteria, Risk Categorisation, De-isolation and Bed Allocation Guide

Routine surveillance testing screening pathway for inpatients using Rapid Antigen Tests is no longer required. This means we are no longer completing routine RAT surveillance on or during admission.

Anyone who develops COVID symptoms on admission or as an inpatient or is a high exposure risk should be placed in Respiratory Precautions and have a Rapid PCR taken urgently.

Authorisation is no longer required for a Rapid PCR so there should be no delays to testing.

There may be a requirement to reactivate routine RAT screening on admission if we experience high community exposure.

Changes to Western Health Return to work following exposure or COVID Diagnosis

Given the recent Department of Health recommendations Western Health has made changes to the Return to work following exposure or COVID diagnosis QRG

Return-to-work-following-exposure-or-COVID-diagnosis

In relation to exposures i.e. social, workplace, educational, close contacts: staff are required to monitor for signs and symptoms and complete a RAT or PCR only if new symptoms develop.

What hasn’t changed is staff returning to work on site MUST:

  • Be asymptomatic
  • Wear an N95 mask at work for 7 days from exposure
  • Not share break areas with mask off for 7 days from exposure

In relation to COVID positive staff Western Health staff can return to work on day 6 if they have no symptoms of COVID without the need for a RAT.

Staff can return to work earlier than day 6 if they have no symptoms of COVID and RAT test has converted from positive to negative

What hasn’t changed is staff returning to work on site MUST:

  • Be asymptomatic
  • Wear an N95 mask at work for 14 days from their first positive test
  • Not share break areas with mask off for 14 days from first positive test
  • Positive staff are required to notify their manager and complete WH’s COVID-19 Positive Staff Member – Notification of Positive Result REDCap Survey: https://survey.wh.org.au/redcap/surveys/?s=AFAFPP473D

Managers or their delegates are no longer required to report furloughed staff into the furloughed staff redcap survey.

Buruli ulcer advice for clinicians and staff

The Western Public Health Unit is leading a local response to an increase in Buruli ulcer.

We want to increase clinician recognition of the infection during the peak period for diagnosis of June to November, and to help members of the community – including staff – to recognise that an unexplained skin ulcer or lesion may be a Buruli ulcer.

If this is the case, they should seek a test from their GP, especially if they reside in a risk area.

What’s happened?

The Western Public Health Unit wishes to draw attention of Western Health staff to a significant, localised outbreak of Buruli ulcer in six suburbs. These are:

  • Brunswick West
  • Coburg
  • Essendon
  • Moonee Ponds
  • Pascoe Vale South
  • Strathmore

Buruli ulcer usually presents as a slow-growing, painless ulcer, most frequently on the limbs, and should be considered as the cause of any chronic unexplained ulcer, papule or cellulitis. Buruli ulcer is caused by Mycobacterium ulcerans infection. An ulcer can be tested for Mycobacterium ulcerans by taking a swab of the undermined inside edge of an ulcer. Ordering clinicians should specifically request Mycobacterium ulcerans culture and PCR, as it will not be detected on a routine culture. Any patient diagnosed with Buruli ulcer should be referred to the Infectious Diseases unit.

The evidence indicates that Mycobacterium ulcerans is spread to humans by mosquitoes. Staff and patients who live in or visit the affected areas can prevent Buruli ulcer by taking steps to avoid mosquito bites, especially removing water sources, putting up fly screens and using DEET-containing repellent.

Additional information on Buruli ulcer and prevention strategies are available at Buruli ulcer – WPHU and a recent Chief Health Officer advisory – Buruli ulcer bacteria identified in inner north Melbourne (health.vic.gov.au).

Regards,

John Ferraro

Chief Operating Officer