Framework for National Reopening FRAMEWORK October 2020 Framework for National Reopening Summary and Analysis PAGE 1 Objective Build on the ‘3-Step Framework for a COVIDSafe Australia’, to nationally reopen to a state of ‘COVID Normal’, wherever it is safe to do so, by December 2020 Open Australia Table of contents While restrictions put in place through 2020 have operated to slow the spread of COVID-19. But the Australian community and industry have been heavily impacted by these limitations. Key principles Page 3 Pillars to support a COVIDSafe Australia Page 3 Best practice health components Page 4 Impacts of restrictions on industry Page 5 COVIDSafe Plan in place Page 6 Industry preparedness, restrictions and risk mitigation for business Page 7 Proposed steps and timings summary Page 8 Proposed new three step framework Page 9 Advice on next steps Page 10 Appendix A: Common Operating Picture Page 11 The aim of this framework is to provide consideration and guidance for a reopening of Australia whilst managing the health impacts and severity of COVID-19. It is acknowledged that states and territories have the decision making authority in relation to public health measures. The national strategy is suppression with a goal of no community transmission. Vulnerable Populations Air Travel Infection Prevention & Control Outbreak Management Legal Components of Public Health Preparedness Surveillance Community Test Workforce Trace Data Quarantine & Isolation For more information on the current health advice, refer to Page 4 Framework for National Reopening Summary and Analysis “Quarantine constitutes a first line of defence in preventing the importation of COVID-19. While the quarantine system should be managed to limit breaches, the robustness of elements of the second line of defence (testing, contact tracing in the community) are also crucial as it will not be possible to manage a quarantine system that is completely error free. And must be backed by a third line of defence – physical distancing, hygiene and health system capacity.” - National Review of Hotel Quarantine, 2020 PAGE 2 PILLARS TO SUPPORT A COVID NORMAL AUSTRALIA Physical distancing (1.5m), maintaining good hand hygiene, staying home if unwell and getting tested for COVID-19 if symptomatic Outbreaks are managed through a swift public health response, in line with advice from the Australian Health Protection Principal Committee All businesses have a COVIDSafe Plan in place Removal of domestic border restrictions to facilitate free movement of people and freight consistent with the virus suppression strategy and local health advice. PROTECTING THE WELLBEING, HEALTH AND SAFETY OF ALL AUSTRALIANS. KEY PRINCIPLES Measures that are proportionate Use of COVIDSafe plans, effective testing and contact tracing, strong guidance to individuals around their responsibilities, and targeted restrictions, including around gatherings and activities. Response measures and decisions are proportionate to the risk of harm and transmission, with a commitment to a nimble, targeted and localised response as informed by clear health advice, data and modelling. Consistent approach Commit to a national approach between state and territory jurisdictions to the opening up of the economy and removing border restrictions, while continuing to implement the agreed COVID-19 suppression strategy, towards the goal of no community transmission. Protect national wellbeing Decision making accounts for minimising displacement of workers and long-term damage to career paths, and considers the long term effects on mental health and wellbeing due to unemployment, social isolation and the protracted pandemic. Well communicated Community expectations are managed through clear communication of risk, balanced with messages to increase public confidence where risk is low. Ensure the public (with attention to culturally and linguistically diverse communities) and business understands and complies with the rules through consistent and timely messaging, targeted government support and appropriate enforcement. States and territories have the decision making authority in relation to public health measures. The national strategy is suppression with a goal of no community transmission. Support confidence to allow economic activity to continue and/or restart Support economic activity through community and consumer confidence. Ensure businesses understand their obligations to manage the health and safety risks that their operations present, and build business confidence and adaptive capacity through the recovery. Framework for National Reopening Summary and Analysis PAGE 3 BEST PRACTICE HEALTH COMPONENTS FOR AN UPDATED COMMON OPERATING PICTURE BY END OF NOVEMBER 2020 (See Appendix A for example COP) 1. Surveillance A streamlined system of daily reporting of cases and clusters * Robust epidemiological data around cases and clusters * Routine wastewater testing to identify undetected disease in a mix of regional and metropolitan areas * Data for the Common Operating Picture (COP) and revision of metrics to inform the response * AHPPC monthly review of innovative and novel testing platforms, including international experience and published literature to enable setting-appropriate detection of disease 2. Quarantine and isolation Best practice quarantine and isolation practices in line with the findings of the Halton review Daily epidemiological data about individuals and disease detected in quarantine * 3. Testing and contact tracing Continue communication strategies to encourage testing uptake to detect disease in people with acute respiratory illness * Enable a surge laboratory capacity of 3 tests per 1000 population per day Measure test turnaround times and respond as suitable to delays of over 2 days Detect all chains of transmission by contact tracing down stream and upstream contacts with all close contacts notified within 2 days* 4. Outbreak responsiveness Rapid deployment of skilled outbreak management teams * Plans to scale up the response * Support detection of disease outside of the immediate response zone e.g. local government areas or local health networks Ensure an embedded Aged Care Response Centre in each jurisdiction * Note: Halton and Finkel reviews are subject to separate National Cabinet considerations. There is an ongoing and potentially increased risk of introduction of COVID-19 from overseas. In addition to strong quarantine and isolation, we need ongoing cooperation of the public to undertake activities in a COVIDSafe manner and to continue to present for testing. Australia’s response and continued work is based on the science and evidence around transmission of the disease. To be COVIDSafe requires continuous evaluation of the effectiveness and implementation of the plans. Measures to identify and manage localised outbreaks should be driven by public health advice, with a focus on vulnerable populations such as indigenous communities, aged care and people with a disability. COVID Normal Australia Plan Summary and Analysis PAGE 4 NATIONAL IMPACTS OF COVID RESTRICTIONS ON AUSTRALIAN INDUSTRY – as at 30 September 2020 The following provides a snap shot of the sectors that have been severely impacted by the implementation of COVID-19 restrictions., including border restrictions, limits on business and social distancing measures. While COVID-19 continues to have significant impacts on Australian businesses, these impacts continue to evolve in response to changes in restrictions and policy announcements including the Federal Budget. This does not form part of the framework and is for context only. Industry impacts vary across jurisdictions. Sticking to National Cabinet’s Three Step framework, managing health risks effectively and supporting the economy • National Cabinet’s May 2020 3 Step Framework for a COVIDSafe Australia was based on public health advice and intended to mitigate the significant risk of COVID-19 and has informed this framework. • There are widespread concerns from industry that inconsistencies between state/territory approaches to reopening continue to destabilise businesses and consumers. • These sectors are crucial enablers and have economic links with other activities – restrictions impacting them will hit the supply chain downstream and upstream. Sectors CRITICALLY AT RISK from COVID-19 restrictions. Sectors AT RISK from COVID-19 restrictions. Aviation at major airports is down more than 95 per cent on pre-COVID levels Independent food and beverage retailers expected to reduce service levels by up to 65.4 per cent. Non-food sales in Victoria up to 65 per cent lower than a year ago. Melbourne’s main retail location vacancy rates are 50 per cent higher than two years ago. Hospitality industry expects 30 per cent of businesses will close permanently this year. It is estimated 30 per cent of the tourism sector will not 126,000 arts,of sports and entertainment survive, and one third the tourism workforce services may become workers are expected to lose their jobs. unemployed. The manufacturing sector continues to be dependent on recovery in other sectors, particularly construction. Demand is expected to be down 15 per cent nationally. Australia’s universities are forecast to have significant impact to revenue due to the fall in international student tuition fees and other income. The COVID-19 pandemic could cut demand for housing in Australia by between 129,000 and 232,000 dwellings over the next three years. The number of tourism industry jobs fell by 109,000 over the year to 611,700 in the June quarter. This is the lowest number of tourism jobs since 2014. Many small businesses operating on extremely slim cash reserves, with funds for three months or less. Framework for National Reopening Summary and Analysis PAGE 5 COVIDSafe PLAN IN PLACE Workplaces must meet the relevant COVIDSafe planning and implementation obligations of state and territory jurisdictions. Each jurisdiction has published approaches on their respective websites for either a COVIDSafe Plan or COVID Safety Plan, noting these are functionally the same. Generally, COVIDSafe Plans set out how workplaces are prepared to protect staff and customers to prevent infection, respond to a COVID-19 case and business recovery. Plans should address the advice of Safe Work Australia regarding identifying and controlling infection hazards, assessing and controlling risks, and case-notification steps. Work health and safety requirements depend on workplace circumstances and state and territory regulations, but should address: • a specific COVID-19 risk assessment and implementation of measures to manage identified risks • information on requirements for physical distancing and measures to ensure appropriate distancing • guidance on how workers and others can maintain good hygiene in the workplace • guidance on cleaning and disinfecting the workplace to protect workers and others from the risk of exposure to COVID-19. Industry-specific guidance that may assist with determining the risks of COVID-19 is available from Safe Work Australia. Each jurisdiction provides information on their website by industry. Safety practices can mitigate the need for restrictions where local conditions allow Where risks can be managed through health and safety practises (COVIDSafe Plans), costlier action is needed less. If state and territory health authorities judge COVIDSafe Plans not enough for certain activities, tailored ‘High Risk COVIDSafe Plan’ requirements could impose stricter standards while still allowing safe businesses open their doors. Strong testing and contact tracing systems and outbreak management, increase our capacity to identify and handle cases of community transmission. Framework for National Reopening Summary and Analysis PAGE 6 INDUSTRY PREPARDENESS, RESTRICTIONS AND RISK MITIGATION ACTIVITIES FOR BUSINESS COVIDSafe Plans All jurisdictions have requirements for either a COVIDSafe Plan or a COVID Safety Plan for businesses. Requirements vary by jurisdiction including specific industry plans, digital registrations, templates, fact sheets or flexible to pre-defined criteria and COVID Marshals. A high level summary is provided below. The role of industry in supporting the national strategy is critical. COVID Industry preparedness by jurisdiction The information below summarises each jurisdiction’s approach. There are no metrics on the number of plans created/endorsed by each state/territory. Victoria From 13 September 2020, it is mandatory for every Victorian business to have a COVID Safe Plan. High Risk industries must create a ‘HIGH RISK COVIDSafe plan’. Link NSW The NSW government provides sector based guidance, including checklists, for COVID Safety Plans for business. Link QLD The QLD government provides approved sector based COVIDSafe Industry Plans including checklists and roadmap. Link Roadmap ACT The ACT government provides guidance for COVID Safety Plans for business. The ACT does not require the use of a standard template when developing their COVID Safety Plan. Link SA The SA government provides guidance and online submissions. Link NT The NT government provides guidance for COVID Safety Plans for business including checklists. Link WA The WA government provides guidance including sector specific information. Link TAS The TAS government provides guidance for COVID Safety Plans for business including checklists. Link Businesses operating under a COVIDSafe plan should be unrestricted outside standard capacity or density caps. Activities are limited/restricted based on highest-risk and lowest economic impact, with input from evidence-based health advice and industry consultation. Activities and venues identified in the AHPPC statement on very high risk environments may continue to be restricted including: • night clubs • dance venues and events • large unstructured outdoor events, such as: music festivals food festivals schoolies graduation festivals carnivals some community sporting events other unticketed spectator events Please refer to Page 10 for further information. Community and industry communications strategies should be developed that considers consistency with previous public messaging and includes the below considerations regarding ongoing business activity. A staged reopening can expand the role of safety practices over time. Industry will be critical to self regulating and enforcing their COVIDSafe plans in order to operate. This risk-based framework is a consistent approach that can adapt to changing circumstances and tolerance for risk. As we move through the steps, COVIDSafe plans and risk assessments can become the benchmark for activities that were previously specifically restricted. Equally, should outbreaks emerge, tailored plans or restrictions may be needed for higher-risk activities in these places. Certain activities will continue to require targeted requirements beyond COVIDSafe plans during this reopening phase based on assessed risk. Freight protocol The Freight Movement Protocol and Code should continue to apply when border controls are in place. Changes to border control measures will influence the application of the enforceable measures contained in the Freight Protocol and Code. State and territory jurisdictions are responsible for enforcement of the measures included in the Code and are likely to reduce or remove measures when border controls are removed. While variation to the Freight Movement Protocol and Code is likely, there is an enduring role in ensuring national consistency for freight when releasing restrictions. Framework for National Reopening Summary and Analysis PAGE 7 PROPOSED STEPS AND TIMINGS - SUMMARY Regional responses that are more restrictive may apply for localised outbreaks. This framework is intended to apply only to areas that are not being treated under other conditions in response to an outbreak requiring health intervention. Health imposed restrictions will supersede any step in this framework for the defined region. All steps are subject to change based on expert health advice. States and territories can implement changes based on their COVID-19 conditions, however steps should be sequential. All operating businesses must have a COVIDSafe Plan Physical distancing at 1.5 metres Stay at home if unwell Effective testing and contact tracing Frequent cleaning and disinfection COVIDSafe Plan auditing ! STEP 1: Limiting group interactions and movement New locally acquired cases indicator on the Common Operating Picture is green for 14 days AND <3 cases in either high transmission settings or hard to reach populations. Work Work from home if able. Gatherings Occupancy of venues, indoor and outdoor gatherings, and events are capacity limited to specific numbers. Travel Free movement between areas with no community transmission of COVID-19 should be permitted. Step aligns with the Third Step within the Victorian Coronavirus (COVID-19 roadmap to reopening. It will currently only apply to Victoria as other jurisdictions have already progressed beyond this step. Including another step between Step 1 and 2 in this framework is at the discretion of the jurisdiction’s local health advice. ! STEP 2: Larger gatherings, more movement New locally acquired cases indicator on the Common Operating Picture is green for 14 days AND no cases in either high transmission settings or hard to reach populations Work Work from home if and where it suits you and your employer. Gatherings Occupancy of venues and gatherings are limited to one person per two or four square metres (as determined by the jurisdiction). Travel Removal of domestic borders - Free movement between areas with no community transmission of COVID-19 should be permitted. Initial international student and seasonal worker pilots underway. Jurisdictions who are beyond the restrictions outlined in Step 2 and have no COVID-19 cases are not expected to step back into further restrictions as a result of this framework. STEP 3: COVID NORMAL All indicators on the Common Operating Picture are green for 14 days Work Return to your workplace (unless otherwise advised by public health advice). Gatherings People should maintain social distancing of 1.5 metres and stay at home if unwell and get tested. Some density limits will remain for events and large venues. Travel Interstate travel is open and there are no domestic border restrictions in place. International travel partnerships and pilot programs in place. Quarantine free international travel between New Zealand and other low risk international partners. Framework for National Reopening Summary and Analysis PAGE 8 PROPOSED NEW 3 STEP PLAN TO SUSTAIN A COVID NORMAL AUSTRALIA STEPS RELY ON THE EFFECTIVE IMPLEMENTATION OF HEALTH ADVICE, LOCAL EPIDEMIOLOGICAL DATA AND INDIVIDUAL OUTBREAK MANAGEMENT AND ARE SUBJECT TO STATE AND TERRITORY COVID-19 CONDITIONS All operating businesses must have a COVIDSafe Plan Physical distancing at 1.5 metres Stay at home if unwell Effective testing and contact tracing Frequent cleaning and disinfection Gatherings and Work Education and Childcare Retail and Sales Cafes and Restaurants Entertainment and Amusement Venues Sport and Recreation Outdoor venues and events subject to preapproved plans Outdoor contact and non-contact sport for 18 years and under All indoor venues remain closed Outdoor non-contact sport only for adults, with gathering and density limits Accommodation Weddings, Funerals and Religious Services Hair and Beauty Services Domestic Travel International Travel STEP 1: Limiting group interactions and movement Outdoor gatherings of up to 10 people Up to 5 visitors at home in addition to normal residents Work from home if able Avoid public transport in peak hour Child care centres open Retail stores open Primary and secondary schools open as per state and territory plans Retail stores and shopping centre managers have COVIDSafe plans Universities/technical colleges to increase face-to-face where possible and prioritise hands-on, skills based learning Auctions can have gatherings of up to 10 outdoors, recording contact details. Private inspections by appointment only May open and seat up to 10 patrons at one time Need to maintain an average density of 4 square metres per person Food courts are to remain closed to seated patrons Venues record contact details of all patrons for tracing purposes Venues record contact details of all patrons for tracing purposes All accommodation venues open Outdoor gatherings of up to 10 people Outdoor fitness for 10 people Up to 5 visitors at specified accommodation in addition to normal residents Venues record contact details of all patrons for tracing purposes Venues record contact details of all patrons for tracing purposes Weddings may have up to 10 guests in addition to the couple and the celebrant Funerals may have up to 20 mourners indoors and 30 outdoors Religious gatherings may have up to 10 attendees Hairdressers and barber shops open and record contact details Beauty therapy and massage therapy venues, saunas and tattoo parlours remain closed Free movement between areas with no community transmission of COVID19 should be permitted International borders are closed Entry by exception National freight movement is supported Every gathering records contact details STEP 2: Larger gatherings, more movement All gatherings adhere to 2 or 4 square metre rule Work from home if and where it suits you and your employer. Avoid public transport in peak hour Jurisdictional cap on numbers Primary and secondary schools open as per state and territory plans Universities/technical colleges to increase face-to-face where possible and prioritise hands-on, skills based learning Retail stores open Retail stores and shopping centre managers have COVIDSafe plans Auctions/open homes can have gatherings in accordance with 2 or 4 square metre rule, recording of contact details All venues, including food courts, are open for dining adhering to the 2 or 4 square metre rule Venues record contact details of all patrons for tracing purposes To remain closed: activities and venues identified in the AHPPC statement on very high risk environments All events and venues are open with social distancing of 2 or 4 square metres where possible All other venues are open with social distancing of 2 or 4 square metres where possible Events are ticketed, venues record contact details of all patrons All accommodation venues open, gatherings at venues adhere to 2 or 4 square metre rule Accommodation venues record contact details of all patrons for tracing purposes Adhere to 2 or 4 square metre rule, stay home if unwell and get tested All establishments allowed to open, adhering to 2 or 4 square metre rule Every gathering records contact details Record contact details Jurisdictional cap on numbers Unless otherwise advised by public health advice return to your workplace Localised outbreaks contained Target Date: Christmas 2020 Education centres open Retail stores open Primary and secondary schools open as per state and territory plans Retail stores and shopping centre managers have COVIDSafe plans Participate in international student pilot programs, as appropriate Free movement between areas with no community transmission of COVID19 should be permitted Initial international student and seasonal worker pilots underway National freight movement is supported Events are ticketed, venues record contact details of all patrons STEP 3: COVID NORMAL No restrictions on gatherings, stay 1.5m apart, stay home if unwell and get tested Service providers closer than 1.5m wear masks. Removal of domestic border restrictions Auctions/open homes can have gatherings in accordance with 2 or 4 square metre rule, recording of contact details All venues, including food courts, are open for dining adhering to the 1.5 metres social distancing between groups Venues record contact details of all patrons for tracing purposes Events over 500 people require approval from the relevant state/territory authority. Events under 500 people can proceed with a COVIDSafe plan Events are ticketed, venues record contact details of all patrons All events and venues are open with social distancing of 1.5 metres Gatherings at venues adhere to social distancing of 1.5 metres Events are ticketed, venues record contact details of all patrons Accommodation venues record contact details of all patrons for tracing purposes No restrictions, stay 1.5m apart when possible, stay home if unwell and get tested Every gathering records contact details All establishments allowed to open, stay 1.5 metres apart Service providers closer than 1.5m wear masks. Record contact details Removal of domestic border restrictions. Free movement between areas with no community transmission of COVID19 should be permitted Quarantine free international travel with New Zealand and other low risk cohorts. International student and seasonal worker pilot programs expand. <---------------------------------------------------------------------------------------------Auditing COVIDSafe plans and adherence--------------------------------------------------------------------------------- COVID Normal Australia Plan Summary and Analysis PAGE 9 HIGH LEVEL TIMELINE & ADVICE ON NEXT STEPS NATIONAL CABINET NATIONAL REVIEW OF HOTEL QUARANTINE 16 OCTOBER Received 13 NOVEMBER 11 DECEMBER Endorsed recommendations in place 11 DECEMBER Development of framework for stratifying quarantine risk of international cohorts 30 OCTOBER FINKEL REPORT Review 1 NOVEMBER 13 DECEMBER Implementation of endorsed recommendations Recommendation to National Cabinet 1 NOVEMBER COP 13 14 NOVEMBER NOVEMBER Development of new COP based on best practice health components National Review of Hotel Quarantine The findings from the National Review of Hotel Quarantine, led by Jane Halton AO, will be considered at National Cabinet in parallel with this framework. 1 DECEMBER Published Finkel Review Coordinating public health response Finkel Review Coordinating public health response to COVID-19 Dr Alan Finkel AO, has been appointed to lead a review of the systems and operations in all jurisdictions to strengthen capacity and capability to effectively test, trace and isolate COVID-19. . Outputs from the review will inform a national approach to: All jurisdictions should consider the recommendations of the review and implement them as part of their reopening process. • Streamlining and measuring national testing, contact tracing, quarantining and isolating, and outbreak management • Exchanging data between jurisdictions in a timely and transparent way that supports nationally supported contact tracing and outbreak management • Enabling a national standing surge capacity • Determine the state of preparedness for an open society and fully-active economy by Christmas. Ongoing COVID identification and management In order to monitor and maintain Australia’s national strategy for suppression, various initiatives are underway to support gathering data and evidence including but not limited to: COVID Testing, monitoring and reporting information on ongoing clinical testing and clinics is available through jurisdictional websites and the Department of Health. Ongoing reporting and epidemiology form part of a suite of data to inform the national strategy. Wastewater testing for COVID-19 various jurisdictions are undertaking wastewater testing, analysis and monitoring as part of a surveillance strategy, particularly for outbreaks and an early warning tool to alert communities to infections. Framework for National Reopening Summary and Analysis Genome sequencing and tracing leading research institutes are undertaking genome sequencing to track COVID-19 including viral mutations and provide early warning signals of emerging strains and detection. Australia’s Medical Research Future Fund (MRFF) has provided a $3.3 million grant through UNSW Sydney’s School of Medical Sciences to establish the network. COVID-19 vaccine development and testing the Department of Health lead the COVID-19 Vaccine and Treatment Strategy which supports access to, and delivery of safe and effective COVID-19 vaccines and treatments, as soon as they are available. PAGE 10 APPENDIX A: COMMON OPERATING PICTURE Maintain. Monitor and Report Targeted Adjustments Needed Harder, Wider, Different Response No Associated Threshold Metric National ACT NSW NT Qld SA Tas Vic WA 70 80 0 0 1 1 0 0 1 0 0 0 0 0 68 78 0 1 10 0 3 0 0 0 0 6 1 New interstate acquired cases in the past 7 days compared to the week prior 1 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 New overseas acquired cases in the past 7 days compared to the week prior 33 34 0 0 23 11 0 0 2 4 4 1 0 0 0 0 4 18 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 Not applicable < 20 cases <20 cases < 20 cases < 20 cases < 20 cases < 20 cases 0.66 < 20 cases 214K 301K 1.9K 3.7K 59K 111K 2.4K 2.7K 27K 47K 16K 20K 3.5K 3.6K 85K 95K 18K 16K 0.05% 0.00% 0.04% 0.00% 0.01% 0.02% 0.00% 0.08% 0.02% 1.2 0.7 1.0 1.4 0.8 1.4 0.9 1.8 1.0 1 2 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 0 6 16 0 0 0 0 0 0 0 0 0 0 0 0 6 16 0 0 Number and proportion of outstanding case notifications (>24 hours since health department notified of positive result) 0 (0%) No cases 0 (0%) No cases No cases 0 (0%) No cases 0 (0%) No cases Number and proportion of outstanding case interviews (>24 hours since health department notified of positive result) 0 (0%) No cases 0 (0%) No cases No cases 0 (0%) No cases 0 (0%) No cases Number and proportion of identified close contacts awaiting notification (>48 hours since health department notified of positive result) 0 (0%) No cases 0 (0%) No cases No cases No cases No cases 0 (0%) 0 (0%) Public health workforce status including own surge capacity (Qualitative measure, within capacity, under strain, saturated) Within capacity Within capacity Within capacity Within capacity Within capacity Within capacity Within capacity Within capacity Within capacity % of occasions that test to notification is within 2 days 100.0% No cases 100.0% No cases 100.0% 100.0% No cases 100.0% 100.0% ICU due to COVID-19 4 (0%) 0 (0%) 1 (0%) 0 (0%) 1 (0%) 0 (0%) 0 (0%) 2 (0%) 0 (0%) 2001 22 855 10 345 168 51 436 114 Not applicable 1.12 0.93 1.57 1.04 1.08 1.30 0.59 1.33 New locally acquired cases within state and under investigation in the past 7 days compared to the week prior Cases New cases (day of report) Regional and remote cases in the past 7 days compared to the week prior Reff – Effective reproductive number – where there are more than 20 cases in the past 7 days * Testing Tests (sum) in the past 7 days compared to the weekly mean of previous month % positive in the past 7 days Capacity Aged Care Mean tests per 1,000 population per day in the past 7 days Number of cases reported in residents in RACF in the past 7 days compared to the week prior Number of cases reported in staff in RACF past 7 days compared to the week prior ICU capacity – open, staffed and equipped beds (pre-surge) TP Common Operating Picture Modelled state-wide transmission - based on current settings and behaviours * Data presented are as at 7 October 2020 Where there is an '*' these data are as at 2 October 2020 Framework for National Reopening Summary and Analysis Weekly cases by source of acquisition Please refer to page 12 for further details and resources PAGE 11 Traffic light classification for cases Metric Green New locally acquired within state and under investigation in the past 7 days compared to the week prior • New locally acquired – interstate travel in the past 7 days compared to the week prior • New overseas acquired cases in the past 7 days compared to the week prior • Regional and remote cases in the past 7 days compared to the week prior (Based on ABS area classification mechanism. Includes very remote, remote, and outer regional postcodes) Reff – Effective reproductive number – where there are more than 20 cases in the past 7 days • • • Traffic light classification for cases in aged care facilities Amber Red Rationale Metric <50 cases per day • nationally, limited geographic spread • Rate of <0.2/100,000 population per week calculated into number for each state • 50 – 100 cases per day nationally • Rate 0.2 – 0.4/100,000 population per week calculated into number for each state >100 cases per day nationally Rate >0.4/100,000 population per week calculated into number for each state Managing a very small number of new COVID-19 infections is possible, however as numbers increase, intervention is required to ensure new cases do not outstrip testing, tracing and health system capacity. Any new locally acquired or under investigation case is concerning Number of cases reported in No facilities with resident residents in RACF in the past cases 7 days compared to the week prior <50 cases per day • nationally, limited geo spread • Rate of <0.2/100,000 population per week calculated into number for each state Rate <0.04/100,000 • population per week calculated into number for each state • 50 – 100 cases per day nationally • Rate 0.2 – 0.4/100 population per week calculated into number for each state >100 cases per day nationally Rate >0.4/100,000 population per week calculated into number for each state Managing a very small number of new COVID-19 infections is possible, however as numbers increase, intervention is required to ensure new cases do not outstrip testing, tracing and health system capacity. Number of cases reported in No facilities with staff cases staff in RACF in the past 7 days compared to the week prior Rate 0.04 • 0.06/100,000 population per week calculated into number for each state 0.04-0.06/100,000 • population per week (Represents <10 cases nationally) Rate >-0.06/100,000 population per week calculated into number for each state Seeding of cases is more likely with a higher rate of importation. The rate is lower than above because arrivals are in supervised quarantine. >=0.06/100,000 population per week (Represents >=10 cases nationally) Threat of outbreak – outbreak is extending and covering a greater geographical area. <0.04/100,000 • population per week (Represents <10 cases nationally) <20% probability that Reff is >1 20% - 49% probability that Reff is > 1 Health system capacity – regional communities have a large proportion of elderly and vulnerable people and less health care resources. 50% probability that Reff is In areas with active cases, an Reff greater >1 than one indicates unlikely to control/decrease new case numbers. This means the outbreak is expected to continue to grow. Reference numbers by state and territory by rate Outer regional Locally and remote acquired cases and (all) overseas acquired Application rate 100,000 Week rate 100,000 Week rate 100,000 Week rate 100,000 Week Population Australia 0.04 71 0.06 107 0.2 356 0.4 713 25,464,11 6 ACT 0.04 1 0.06 2 0.2 6 0.4 12 428,10 0 NSW 0.04 23 0.06 34 0.2 114 0.4 227 NT 0.04 1 0.06 1 0.2 3 0.4 7 Qld 0.04 14 0.06 21 0.2 72 0.4 143 SA 0.04 5 0.06 7 0.2 25 0.4 49 Tas 0.04 1 0.06 2 0.2 7 0.4 15 Vic 0.04 19 0.06 28 0.2 93 0.4 186 8,118,000 245,600 5,115,500 1,756,500 535,500 6,629,900 WA 0.04 7 0.06 11 0.2 37 0.4 74 2,630,60 0 Traffic light classification for testing Metric Green Tests (sum) in the past 7 days compared to the week prior Modelling is underway to determine optimal testing rates for populations with community transmission and populations with no community transmission. Declines in testing rates (*), especially where there is no community transmission, should be interpreted with caution. Testing recommendations currently advise and prioritise testing of anyone with acute respiratory illness (ARI) symptoms; if community rates of ARI are low this will affect the number of people presenting for testing. % positive below 0.25%. % positive 0.25% to 0.5% % positive >0.5% Assuming testing rates remain high and well distributed, amber or red indicate that the incidence of COVID-19 in the community is increasing and intervention could be required. % positive in the past 7 days compared to the week prior Mean tests per 1,000 population per day in the past 7 days Green Amber Red Rationale Modelling is underway to determine optimal testing rates for populations with community transmission and populations with no community transmission. Framework for National Reopening Summary and Analysis Amber Red Rationale The number of cases in residents is not zero. Compared to the week prior, case numbers have: increased by less than or equal to ten; or decreased by greater than or equal to ten. The number of cases in staff is not zero. Compared to the week prior, case numbers have: increased by less than or equal to ten; or decreased by greater than or equal to ten. Compared to the week prior, the number of cases in residents has: increased by greater than ten; or decreased by less than ten Residents within aged care facilities are particularly vulnerable to COVID-19. Any number of facilities with active resident cases should require concern (amber). Compared to the week prior, the number of cases in staff has: increased by greater than ten; or decreased by less than ten Aged care staff are in close contact with many aged care residents. An infectious staff member has the potential to transmit COVID-19 to a large number of vulnerable residents (who in turn have a higher mortality rate). Traffic light classification for capacity Metric Number and proportion of outstanding case notifications (>24 hours since health department notified of positive result) Number and proportion of outstanding case interviews (>24 hours since health department notified of a positive result) Number and proportion of known contacts awaiting notification (>48 hours since health department notified of a positive result) Public Health Workforce Status including own surge capacity Timeliness of test notification for positive results Green Zero Amber Proportion: >0-5% Red Proportion: >5% Rationale Rapid contact of cases enables disease control by early isolation and quarantine Zero Proportion: >0-5% Proportion: >5% Rapid contact of cases enables disease control by early isolation and quarantine Zero Proportion: >0-5% Proportion: >5% Rapid contact of contacts enables disease control by early quarantine Within capacity Under strain Saturated >90 % reported within 2 days 75-90% reported within 2 days <75% reported within 2 days ICU due to COVID-19 (presurge) <15% of available ICU beds are COVID patients > 30% ICU beds are COVID patients >30% ICU beds go to surge Qualitative measure for this encompasses many aspects of the response, each of which can be a critical point This is the turn around time from the time the test is taken, transported to a suitable laboratory, test conducted and results reported to the health department. Results within 2 days enables early identification of contacts from cases, and ensures that cases are in isolation. An indicator of when surge capacity is going to be needed to support patients with COVID-19 in ICU. 15 – 29% of available ICU beds are COVID patients Data sources and additional resources The Communicable Diseases Network Australia (CDNA) and the Australian Health Protection Principal Committee (AHPPC) have informed the traffic light thresholds in the operating picture. Data are sourced from: - the National Notifiable Diseases Surveillance System (NNDSS); the Critical Health Resource Information System; aged care facility report; modelling; and daily reports from state and territory health departments. Most metrics use a rate or proportion rather than a raw number, to account for variability between state and territory populations. Due to the dynamic nature of jurisdictional daily reports and thus NNDSS data, data in this report are subject to retrospective revision and may vary from data reported in published NNDSS reports and reports of notification data by states and territories. Additional resources Daily updates: https://www.health.gov.au/news/health-alerts/novel-coronavirus-2019-ncov-health-alert/coronavirus-covid-19-current-situation-and-case-numbers Fortnightly epidemiology report: https://www1.health.gov.au/internet/main/publishing.nsf/Content/novel_coronavirus_2019_ncov_weekly_epidemiology_reports_australia_2020.htm PAGE 12