This article provides current public health advice on management of Covid-19 in the Victorian community to guide the development of policies and procedures in various settings and communities as required at this time.

Protective behaviours in sensitive settings

There are extra recommendations for people visiting, or working in, sensitive settings. These are places where there are many people vulnerable to the severe effects of COVID-19, including:

• residential care facilities, including aged care, disability and other services
• other care facilities
• healthcare premises, including when health care services are provided in people’s homes.

• Anyone who has COVID-19 or symptoms of COVID-19 should avoid visiting or working in sensitive settings for at least 7 days.
• Workers who are close contact should be asymptomatic and follow testing recommendations if they are required to work in sensitive settings during their 7 day close contact period.
• Close contacts who are not workers in sensitive settings should not attend any sensitive setting during their 7 day close contact period.

Vaccination – Workers in sensitive settings are particularly recommended to keep up to date with their vaccination status. Many workers in sensitive settings will be required to be fully vaccinated.

Testing – Everyone should undertake a COVID-19 test before visiting sensitive settings.
Masks – Masks should continue to be worn by staff and visitors to sensitive settings.

Ventilation – Sensitive settings are strongly recommended to optimise ventilation in indoor settings to protect the most vulnerable.

Reporting outbreaks – Sensitive settings should report outbreaks of COVID-19 to the Department of Health so that Local Public Health Units can provide support managing the outbreak. This can be done online: https://dhvicgovau.powerappsportals.com/outbreak-notification/.

What should I do if I test positive for COVID-19?

If you test positive for COVID-19, you should:

• seek medical advice
• stay home for at least 5 days and until your symptoms resolve
• not go to a sensitive setting where there are people vulnerable to severe effects of COVID-19, such as hospitals, aged care facilities, disability services
• report your RAT to the Department of Health online, or by calling 1800 675 398. You don’t need to report your result if you tested positive from a PCR test as pathology labs will handle reporting directly.
• wear a mask if you have to leave home in an emergency
• not go to work or school for at least 5 days and until your symptoms resolve – discuss with your workplace or education facility about when you should return
• tell people and places you have recently been in contact with, including your workplace, school and household members.

The common symptoms of COVID-19 are runny nose, sore throat, cough, fever, chills, sweats and/or shortness of breath.

If you test positive for COVID-19, you may be infectious for up to 10 days, but you are most infectious in the two days just before your symptoms start, and while you have acute symptoms (runny nose, sore throat, cough and fever).

Most people get symptoms and do a test a couple of days after they first became infected and infectious.
A negative RAT result is a helpful tool to determine when you are likely no longer infectious.

You should not go to work if you are unwell or test positive to COVID-19 – especially if you work with people at higher risk of serious illness due to of COVID-19 or work in an essential service such as healthcare.

What should I do if I am a close contact of someone who has COVID-19?

If you share a house or have had close contact with someone who gets COVID-19, you will be at risk of developing COVID-19 yourself in the days that follow your last close contact with that person.

You should test regularly in the period following your last contact with the person who has COVID-19 and if you develop any symptoms, you should stay home and take a test. If you test positive for COVID-19 you should follow the recommendations above.

How many vaccines do I need to be fully protected?

It is important to stay up to date with COVID-19 vaccinations to ensure you have the most protection from COVID-19 that you can get.

The Australian Technical Advisory Group on Immunisation (ATAGI) has made recommendations on the use of COVID-19 vaccines in Australia. These recommendations are updated regularly and differ depending on your age and medical history.

For more information visit the ATAGI website: https://www.health.gov.au/initiatives-and-programs/covid-19-vaccines/who-can-get-vaccinated.

Is it safe to go back to work on-site?

With COVID-19 case numbers currently relatively low in Victoria, workers may safely return to the office, but workplaces should continue to have ‘COVIDSafe Plans’ (or similar policies) to manage risks associated with COVID-19.

Employers and staff may still consider remote working arrangements that are most appropriate for their workplace and employees based on individual requirements.

There are some steps you can take to protect yourself and your colleagues from COVID-19:

• Be up to date with your vaccinations
• Wear a mask indoors and where you can’t physically distance
• Let fresh air in
• Stay home if you are unwell
• Get tested if you are symptomatic
• Get early treatment for medicines if you are eligible for COVID-19 medicines.

Workplaces can be susceptible to outbreaks of COVID-19 where there are many people working closely together. COVID-19 is a highly infectious virus and has become more infectious with newer variants. Many workplaces provide important services, so if a COVID-19 outbreak creates the absence of many staff members at the same time, this can create major disruptions.

It is recommended that all workplaces maintain a ‘COVIDSafe Plan’ (or similar policies) for managing the risks associated with COVID-19. Policies are recommended to cover how the workplace will help prevent COVID-19 outbreaks, when staff are expected to test themselves, whether staff need to report if they are a positive case, and how the workplace will respond if there is a positive case in the workplace.

Some workplaces will continue to need specific requirements for their workforces.

How do I improve ventilation and let fresh air in?

To improve ventilation in your home and business you can:

• Make the most of natural ventilation such as opening windows and doors
• Make use of existing heating and cooling systems to bring in fresh air
• Consider using portable filtration units, such as HEPA filters
• Use ceiling and pedestal fans in combination with greater airflow (e.g. open windows)

If you can’t improve ventilation, you should consider going outside or limiting the number of people in a space and consider wearing a mask.

How do you get COVID-19? When and where is the risk greatest?

COVID-19 usually spreads from person to person via tiny droplets of viruses released when people breathe, speak, cough or sneeze. These tiny droplets float in the air and can linger in a room for a long time. Another person can breathe in these droplets and become infected.

The risk of transmission is highest where there is an overlap of the “three C’s”:

• Crowded places
• Close contact settings (such as face-to-face conversations)
• Confined or enclosed spaces

Examples of these include public transport, major events, many workplaces and family gatherings at home. This is why masks, and self-exclusion when positive or symptomatic, are highly recommended in these situations.

I’ve had COVID-19 and I didn’t get very sick? Is it really that serious?

COVID-19 is now a leading cause of death in Victoria.

• More than 4,000 people have died from COVID-19 in Victoria during 2022. This is twice as many as 2020 and 2021 combined.
• July 2022 was the deadliest month of the entire pandemic in Victoria with 683 deaths.
• Although older people are more likely to become very sick from COVID-19, people from all age groups have been hospitalised and died of the virus.
• Deaths in aged care facility resident account for over 47 per cent of all COVID-19 deaths recorded in Victoria since the pandemic began.
• Victorians living in areas of most socioeconomic disadvantage have had 1.5 times more hospitalisations and 2.2 times more deaths than those in areas of least disadvantage.

There is growing evidence that people who get COVID-19, including younger people, are at risk of significant long-term consequences, including ‘long COVID’ symptoms such as fatigue and difficulty concentrating, and an increased risk of heart attacks or strokes.

COVID-19 continues to have a disproportionate health, social and economic impact on particular groups of people: older people, residents of aged care facilities, people with certain comorbidities and disabilities, Aboriginal and Torres Strait islander people and people experiencing socioeconomic disadvantage. These groups face a far higher burden of morbidity, mortality, social and economic disruption from COVID-19.

When will the COVID-19 pandemic be over?

It is expected that Victoria will continue to experience regular waves of COVID-19 transmission, hospitalisations and deaths every three to six months over the next few years.

With ongoing significant levels of global transmission, the virus has continued to mutate rapidly, and new variants of concerns continue to emerge. Future waves are likely to be driven by a combination of more infectious or immune-evasive variants of the virus, and the waning of the protection provided by vaccines and recent infection.

Recent expert modelling indicates that future more infectious, immune-evasive or severe variants could cause further waves, with hospitalisations and deaths comparable to or worse than the wave in July 2022. Previous modelling was accurate in predicting the likely outcomes of the July 2022 wave so this modelling warrants close consideration.

When will the next wave in the pandemic occur?

Even without a new variant of concern, waning population immunity is expected to cause another wave in late 2022 or early 2023. Expert modelling based on current variants suggests the wave could lead to 400-500 hospitalisations per day at the peak of the wave.

Waves of increased COVID-19 cases, hospitalisations and deaths are likely every three to six months in Victoria for the next few years. New variants of concern will emerge that may have greater transmissibility, immune evasion and could result in more severe disease. Population immunity will wane resulting in diminished protection against severe disease.

How will we know when the next wave is starting, and whether it is serious enough to increase restrictions?

The Department of Health continues to actively monitor the COVID-19 pandemic.

To stay up to date with the latest epidemiology and current situation in Victoria, please see the Chief Health Officer Update published weekly.

What is long COVID? Who does it affect?

Long COVID is a condition where people continue to experience symptoms that last beyond three months from when they were initially infected with COVID-19. There are a wide range of symptoms, such as fatigue, headache, shortness of breath, memory loss and loss of sense of taste.

Symptoms vary from person to person, ranging from mild to severe. People with severe long COVID find they have a limited ability to undertake their ordinary day-to-day activities, such as work.

3.3 per cent of Victorians are estimated to be currently experiencing or have experienced a form of long COVID at some point during 2022. Around 0.6 per cent of Victorians are estimated to have experienced a severe and debilitating form of long COVID.

Long COVID is much more common in adults but can also affect children. Some people are more likely to experience long COVID: people with existing health conditions, people who were unvaccinated when they got COVID-19 and people who were hospitalised due to COVID-19.

When will better vaccines and treatments be available?

Currently available vaccines and treatments are safe and effective.

Bivalent vaccines specifically targeted at the Omicron variant (along with the original strain of the COVID-19 virus), are likely to become available in Victoria by late October.

Science and technology continue to advance but it will be challenging for vaccine development to stay ahead of new variants.

Many innovations are being developed to address COVID-19 including next-generation vaccines, better tests, preventative measures, treatments and ventilation technologies.

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