Covid 19 Contingency plan for Shepparton Villages

There is a possibility a severe pandemic could hit Australia and affect the health of our residents and staff in the Shepparton Villages.

This is a severe and unusual dangerous form of a common cold virus that unfortunately leads to viral pneumonia and death in older people.  It is both highly contagious and  hard to control or treat. It poses a severe problem to patients, staff, nurses and doctors and families.

We need a plan in place to cope with all the different possibilities as there is a risk of death involve in coping with people with the infection.

A four layered approach is desirable depending on the severity and presentation of an outbreak.

General precautions, level 1.

A much stricter approach to hygiene in the hostels, kitchens and visitors administration and ground staff. The virus cannot walk, it is transmitted person to person or person to material to person.
The virus is susceptible to cleaning agents such as bleaches and all surfaces will need to be cleaned before and after visits. Any affected clothing will need to be decontaminated.
Hand sanitisation will have to be made compulsory for people entering and leaving the facility only.

The second step is to ask all people at risk to refrain from visiting patients and staff if they have have recent contact with people at risk [usually overseas travelers].
Also if they are suffering from symptoms that could be corona virus related and in particular if they have a cold.
People under this category should advise Administration by a phone call and e mail where possible and a register should be kept with a list of all notifications.

This is no time for the usual Australian bravery of going heroically to work with a cold. It is not a trivial disease any longer and other people must be protected.
Testing is not mandatory but a 2 week isolation  for people at risk would seem necessary.
If testing is warranted this should be arranged by the person with their doctor who would appreciate a phone call and text first. Testing will be available from most pathology Labs or hospitals for those with exposure or symptoms warranting investigation. People at risk should not visit medical rooms or hostels  as they might pass the infection on.

This leads to a manpower and health and safety problem of immense magnitude to our already under resourced  staff. There is no safe way to let a person with a cold come to work for 2 weeks. which means large gaps will open up particularly in winter.We need to increase our backup staff as much as possible. This may be helped by staff pooling with other institutions in the same boat ie the GV Health and other nursing homes. We could also advertise or ask for staff who worked at Murchison to be taken on part time here or on our casual list  to keep their skills up and be ready to work of needed. We might need to pay retention fees.
Administration will have to be aware that they cannot stretch the rules or downplay symptoms to employ people because there are shortages.
The final measure would be to mandate and deploy volunteers at times of crisis with appropriate safety checks.

This raises a second issue of insurance problems.
We are liable for the health of our patients, our workers and our visitors.
Premiums are likely to rise steeply or exclude corona virus from coverage.
Work cover will rise immensely and possibly wipe out the nursing homes as a viable option unless there is strong Government intervention and backing.
This always takes a while to get going so any premiums due should be paid now for as far as possible into the foreseeable future to reduce immediate shocks.
This is the second reason that hand hygeine and absolutely no personcan be employed at work with a cold or risk history. The insurance will fail unless we take these precautions and if we take these precautions we will also reduce our future risk immensely.




Level 2
Known patient or staff  exposure to someone with Covid 19.
This needs to be treated in a similar way to swine flu, HIV, hepatitis etc exposure.
On proof of presumed exposure the patient or staff member will have to self isolate and contact their doctor for further investigation, advice and treatment. The centre for communicable diseases will ahve to be notified.
A doctor and senior nursing staff will have to work with them to determine the risk and measures to follow.
Rooms will have to be cleaned by trained and willing staff with all possible precautions. Meals will have to be brought from the dining room on special trays and disinfected separate to other peoples trays and cutlery.
Clothing worn at the time may need to be bagged and burnt.
Advice will need to be sought on hazmat suits or a suitable less expensive alternative from the Department of Health.
I would propose that cleaning of any contaminated rooms be done by a small group of highly paid nursing staff aware of the risks and able to completely disinfect the protective clothing they are wearing every time.
Further a decision to set aside a special wing may need to be undertaken.
It has to be independent from all other sites and staffed by people aware of the danger [danger money] who volunteer to work in that area.

Affected patients would need to be isolated from every one else and if clear after 2 weeks return to their original facility, Perhaps the old Grevillea building could be repurposed.

Level 3 patient or staff member proven infected.
Notify Department of Health and Infectious diseases and Work cover. Nursing Union, Staff unions and all contacts. Tracing of contacts will also be done by the Government. Outside contact  people will need to go into self isolation and contact their doctor re further management.

The infected person will either be admitted to hospital or need to go into a separate self isolation  facility. The risk to others in the building, which will also go into self isolation is too high to leave them there.
Hopefully the Government will provide treatment and recovery shelters with staff but if not it will be more  burdensome on our institution. One avenue would be the smallest independent facility, Hakea , and split it into two separate sides .

Alternatively the independent living units could be commandeered and 1 person per unit  with the disease but not unwell managed by the  small dedicated hazmat or equivalent team until well and then the unit thoroughly sanitized for repeat use.

Level 4    Super infection spreading through a facility with numbers of people unwell and dying. This is a bit like the Diamond Princess scenario.
No winning options. People would have to stay and be treated as advised by the authorities . I would suggest extra independent living units for individual infected staff members  [they cannot go home] and  non symptomatic residents. A lot more help and advice will be available from the Government in such a situation and possibly army  and volunteer help.

A lot less people would be prepared to work in such immediate danger. This needs to be recognised with time off until the situation resolves , not dismissal.  A binus for working at this time shoud be announced
Again this is where the responsibility  and insurance problems will be paramount. People can sign to volunteer and waive liability but this does not stand up in a court of law. Anyone brave enough to volunteer should be recompensed  for their work but not paid a salary.
Or else be employed but work cover will be high.
This might be the best option.
These options need to be discussed by The Shepparton Villages CEO, Directors and the companies lawyers.