Date published:
18 March 2020
Intended audience:
General public
Early learning and childcare
The Australian Health Protection Principal Committee met on Wednesday 18 March to consider the issue of childcare centre closures in relation to the community transmission of COVID‑19. The Committee’s advice is that pre‑emptive closures are not proportionate or effective as a public health intervention to prevent community transmission of COVID-19 at this time.
There is currently limited information on the contribution of children to transmission of COVID-19. The WHO-China Joint Mission noted the primary role of household transmission and observed that children tended to be infected by adults in the household. In China, 2.4% of total reported cases were under the age of 19 years. Worldwide, of those cases under 19 years of age, very few were severe or critical. This contrasts distinctly with the severity pattern observed with other respiratory viruses, where young children are particularly at risk of severe disease. AHPPC will continuously review emerging evidence of COVID-19 in children to inform public health policy.
Previous studies suggest that the potential reduction in community transmission from pre‑emptive school and childcare closures may be offset by the care arrangements that are in place for children who are not at school. Children may require care from older carers who are more vulnerable to severe disease, or may continue to associate (and transmit infection) outside of school settings.
Broadly, the health evidence on school closures from previous respiratory epidemics shows the costs are often underestimated and the benefits are overestimated. This may be even more so in relation to COVID-19 as, unlike influenza, the impact on otherwise healthy children has been minimal to date.
AHPPC considers childcare centres are essential services and should continue at this time, but with risk mitigation measures in place. These should include:
- exclusion of unwell staff, children and visitors,
- reduce mixing of children by separating cohorts (including the staggering of meal and play times),
- enhanced personal hygiene for children, staff and parents
- full adherence to the NHMRC childcare cleaning guidelines
- excursions other than to local parks should be discouraged
- influenza vaccination for children, staff and parents
There may need to be consideration of alternative arrangements for highly vulnerable children. AHPPC recommends these parents seek medical advice.
Recommendation on public gatherings
General Population – Indoor Gatherings
Non-essential indoor gatherings of greater than 100 people will no longer be permitted. Risk mitigation should be applied to gatherings of fewer than 100 people including the following:
- In a given occupied space, there must be a density of no more than one person per four square metres of floor space.
- Availability of hand hygiene products and suitable waste receptacles, with frequent cleaning and waste disposal.
- Promotion of the Department of Health recommendations for unwell individuals to isolate at home and not attend.
- For settings where there is ongoing movement and an increased number of interactions between individuals, an individual’s attendance should be less than two hours duration.
- For settings that are primarily static such as theatres, restaurants, cinemas, sporting events, an individual’s attendance should be limited to four hours duration.
Examples:
- Cinemas and theatres to implement decreased density of patrons, which could include alternate seating, staggered seating and alternate rows, except for family groups who may be seated together.
- Seated restaurants may need to undertake a significant capacity reduction in order to meet the above density requirements.
- Weddings and funerals will need larger spaces, staggered attendance or a reduced number of attendees to meet the above density requirements.
- A symphony orchestra or choir will need to consider the measures mentioned above and amend practices to comply with recommendations.
Safe food and utensil handling statement for catering
The primary transmission route for COVID-19 is person-to-person; it may therefore be transmitted via utensils or plates that have been handled by someone who has COVID-19.
- For catering, advise staff if they feel unwell to stay at home, and deny entry to staff who are unwell.
- All food, including pre-packaged foods such as boxed lunches, should be prepared by staff trained in safe food handling practices.
- Ensure hand washing facilities are accessible for staff and supplied with adequate soap and paper towels.
Social venues, pubs, clubs and nightclubs
The total number of people in a venue, including staff, must be fewer than 100 per uninterrupted space and the four square metres per individual rule must apply.
Gyms and indoor fitness activities
Settings like gyms and indoor fitness centres are not required to close at this time providing they meet these requirements for social distancing and hand hygiene. Such venues should take actions to ensure regular high standards of environmental cleaning take place.
Transport
All Australians should reconsider the need for unnecessary travel. If unwell, people must stay at home, unless seeking medical care.
Domestic air travel
The risk of acquiring COVID-19 on planes is low. However, in order to minimise the spread of infection over long distances, unnecessary travel should be reconsidered.
Public transport (trains, trams, buses, ferries)
Most public transport is considered essential, however employers should strongly consider offering staggered work times and remote working arrangements to employees to reduce the risk of overcrowding at peak traffic times. Operators should consider increasing the frequency of transport options to reduce passenger density.
Operators should increase the frequency of cleaning, particularly of those surfaces that are frequent touch points. Commuters must practise hand hygiene, which should also be promoted on vehicles and at transport hubs.
Long distance bus or train services pose a higher risk, and should be reconsidered if not essential. The Spirit of Tasmania ferries are regarded as essential transport.
Taxis and ride share vehicles
If possible, passengers should sit in the back seat, and hand sanitisers should be available for passengers and drivers to utilise. The air conditioner/heating setting should be set to external airflow, as opposed to recycled.
Transport of vulnerable populations
Mass transport of vulnerable people, including the elderly, should be avoided or have risk mitigation strategies implemented, such as seating people at a greater distance from one another.
General Population – Outdoor Events
Outdoor events of fewer than 500 attendees may proceed. There are general measures that all events should follow.
- In a given occupied space, there must be no more than one person per four square metres of ground space.
- Availability of hand hygiene products and suitable waste receptacles, with frequent cleaning and waste disposal.
- Promotion of the Department of Health recommendations for unwell individuals to isolate at home and not attend.
Food markets are exempt from the 500 person limit, however must undertake additional measures, such as control of patronage level numbers or stall density reduction to decrease the risk of COVID-19 transmission.
Special exemptions for limitations on indoor and outdoor gatherings
There may be other gatherings that are not specifically mentioned here that are considered essential. It is at the discretion of the individual state and territory Chief Health Officers or equivalent to assess each on their merits, and determine whether they can continue if mitigated by social distancing measures.
The development of any guideline requires continual re-evaluation and amendments or new guidelines may be released as the COVID-19 pandemic continues to progress.