3. Communication

3. Communication

Clear, transparent and as timely communication as possible has been a critical component of the DoH’s response to the COVID-19 pandemic. Effective internal communication mechanisms have ensured timely distribution of key messages and supported informed decision making, while open and transparent communication with the wider community has provided clear advice on restrictions and measures to prevent further transmission of COVID-19. The latter was particularly important during the North West outbreak, as mechanisms such as daily press conferences and emails to healthcare workers from the State Health Commander provided reassurance that strong measures were being taken to protect the community, and the rationale for the actions being taken in response to the outbreak.

The main challenges to timely communication were: the rate at which the pandemic situation evolved; how quickly policy decisions had to be made, sometimes moments prior to a public announcement; and the late evening timing of positive test results requiring public statement or immediate staff communication, particularly if there was an admitted patient. The DoH’s information and communication strategy evolved with the level of emergency response, with significant support provided by the Public Information Unit (PIU) who led the public COVID-19 messaging from early March 2020.

Key aspects of the DoH’s internal and external communications during the COVID-19 pandemic and period of the North West outbreak are outlined in greater detail below.

3.1 Internal Department of Health communication

3.1.1 Daily reporting

Daily reporting is a key means of monitoring and communicating critical information relating to the pandemic including daily case numbers, PPE levels and staffing capacity. Information is produced by key areas of the department including the ECC, North West THS and AT, with North West THS and ECC reporting commencing on 10 March 2020 and 15 March 2020 respectively. Upon the closing of the NWRH and NWPH, AT also generated hourly reporting on 13 April 2020, in order to monitor the progress of transfer of patients to the MCH, LGH, and RHH.

Daily reporting supports strategic decision making by providing the executive with critical analyses of emerging issues, gaps and risks. This information is used to highlight key issues for further investigation or inquiry and inform critical planning decisions including procurement of PPE, ventilators and consumables, statewide allocation of resources such as movement of staff to support the pandemic response, and discussions at the national level including those undertaken by AHPPC and National Cabinet.

This also formed the basis of regular updates to Cabinet Ministers. DoH notes the quality of the daily reporting improved over time as processes and systems were further refined.

3.1.2. Staff emails

Emails have been used as a key means to communicate significant information and updates to all DoH staff during the pandemic. This is an important method of communicating significant information consistently across the DoH, ranging from daily communications for all North West staff during the outbreak, to all staff emails from the State Health Commander.

The State Health Commander commenced sending all staff emails on 4 February 2020. These emails provided open and transparent information on the pandemic as it unfolded, including information on emerging issues, virus spread (including cases amongst healthcare workers), travel restrictions, PPE availability and management, emergency management and escalation levels, testing, hospital closures (and visitor restrictions), and public health Directions. These emails were a particularly important means of communication during the North West outbreak as they provided critical information on how the outbreak was being managed, including the standing up of OMTs, PPE volumes, quarantine requirements for affected healthcare workers and fact sheets on how to access assistance. All staff emails are also posted on the DoH intranet page.

From 25 March 2020, the Incident Controller produced a daily ‘What’s New’ brief by email to all staff across the DoH, to update employees on key developments including the total number of cases, the number of new cases, information on deaths, and information on any significant new action taken, such as announcements made by the Minister for Health and the Premier or announcements on hospital closures and other service changes.

‘What’s New’ also contains links to newly released public information updates and documents, both nationally and across Tasmania. These include key updates to the Tasmanian coronavirus website such as those relating to government service closures, public gatherings, media releases, and resource updates. Links are also provided to useful information sources including the Tasmanian and Australian Governments’ coronavirus websites, CovidSAFE app links, public health hotline phone numbers and mental health supports.

What’s New was sent via Mailchimp to allow for access to data analytics.  The following table provides a snapshot of employee engagement with the emails from the 24 April to 30 April 2020.

1. Email date

   Total opens

   Total clicks (within e-newsletter)

   Friday, 24 April 2020	14,552	1,610
   Saturday, 25 April 2020	16,663	2,760
   Sunday, 26 April 2020	15,364	4,813
   Monday, 27 April 2020	15,759	6,257
   Tuesday, 28 April 2020	18,068	5,723
   Wednesday, 29 April 2020	15,693	2,285
   Thursday, 30 April 2020	16,921	3,089

   From the 4 February to 30 April 2020, a total of 70 internal communications were sent to all DoH staff from a range of senior executives including the Secretary/State Health Commander, Incident Controller, Chief People Officer and Chief Information Officer.

   To support the email communication, direct SMS to employees was sent via Whisper.  This allowed more immediate communication with employees.  For example, this was used during the NW outbreak to alert the NWRH and NWPH employees to information sent via email.

   Following a drop in active cases and minimal to no new cases being reported each day, on 25 May publications moved to a thrice weekly schedule, and then once a week from 10 June.

3.1.3 Communication at the North West Regional Hospital

Clear communication with all healthcare workers has been an important component in effectively preparing for, and responding to, the COVID-19 pandemic. As the North West outbreak emerged and evolved, effective communication became critically important for healthcare workers in affected hospital settings in particular. As the outbreak evolved rapidly and required key decisions and actions to be quickly implemented, a number of communication methods were used to provide key information to North West staff.

Up to the first week of April, existing staff communication mechanisms such as the “NNeWs Insider” communiqué were used to communicate COVID-19 specific information such as links to useful information and case number updates. From 17 March 2020, the NWRH Commander provided an additional daily COVID-specific communiqué to all North West staff. These included updates on significant changes such as activation of new response units, visitor restrictions, and the response phases in the major hospitals.

Alongside these regular updates, the RHEMT also conducted thrice weekly clinical stakeholder briefings with senior department leads. Staff emails and memos were also utilised, covering specific issues such as training requirements for PPE and infection control, shutdowns occurring in different units and wards, establishment and operation of testing clinics, and testing and self-isolation requirements. Verbal meetings and staff debriefs on current response measures and training were also held by members of the RHEMT and NRWH management, and posters placed around the NWRH with information relating to hand hygiene and PPE use.

Following the announcement of the closure of the NWRH and NWPH and staff and their households being required to quarantine, the State Health Commander distributed a frequently asked questions factsheet for these staff relating to the quarantine requirements and how to access support and assistance.

3.2 Communication with the community

Effective communication with the broader Tasmanian community has been an important focus of the COVID-19 response, especially during the NWRH outbreak. As noted above, the DoH placed strong importance on being open and transparent with the community about the seriousness of the outbreak and the importance of compliance with quarantine and other restrictions, as well as providing reassurance that strong measures were being taken to protect the community and bring the outbreak under control as soon as possible.

A broad range of strategies have been used to communicate and engage with the Tasmanian community throughout the pandemic, including via daily public press conferences led by the Premier, Minister for Health and DPH, media releases, social media and advertising. Certain existing strategies proved invaluable to the COVID-19 response, such as the use of social media and the Public Health Hotline.

The DoH also engaged in whole-of-government communication processes including via the PIU within the SCC. The PIU is stood up in an emergency, drawing resources from multiple state service agencies to coordinate nonoperational public information. The DoH has provided health related information to the PIU since it was first activated in response to the pandemic in mid-March 2020. This includes critical health information for the Tasmanian coronavirus website (coronavirus.tas.gov.au), which provides information on:

• case numbers and testing updates
• current restrictions
• how to keep yourself safe
• stimulus and support
• tailored information for key groups including families and community, business and employees, and travellers and visitors.

3.2.1 Press conferences and media releases

Public press conferences and media releases have been provided on an almost daily schedule throughout the course of the pandemic. These conferences and media releases have provided updates on critical health related information to the Tasmanian community on case numbers, deaths, response planning and public health restrictions.

Press conferences were a particularly important means of communicating critical information and decision making during the outbreak, with a focus on explaining key decisions made to manage the outbreak and providing reassurance to the community.

Most press conferences and media releases have been provided by the Premier the Hon Peter Gutwein MP, the Minister for Health the Hon Sarah Courtney MP, and the DPH Dr Mark Veitch. For matters relating to system wide health preparedness or Tasmanian hospitals, the State Health Commander, Kathrine Morgan-Wicks or the Chief Medical Officer, Professor Anthony Lawler, would attend. This is consistent with the approach taken in all other states and territories where the Director of Public Health (or equivalent) has been a critical source of public health advice to the Premier and Minister, and more broadly to the community.

Regular coronavirus updates are made publicly available on the Tasmanian coronavirus website (https://coronavirus.tas.gov.au/media-releases). Updates began being uploaded from 25 March 2020. During the time of the North West outbreak, the updates were released daily, and included information on the number of new cases, the location of the cases, and whether the cases were healthcare workers, close contacts, or patients

3.2.2 Social media, television, print and radio advertising

The DoH Facebook page, administered by the DoH Communications Unit, has been utilised as a means to provide information on COVID-19 including updates on critical information relevant to the North West outbreak such as case numbers, hospital and aged care visitor restrictions, access to testing and testing requirements, quarantine requirements, COVID-19 safe behaviours, and essential traveller information.

This was a particularly useful communication mechanism during the period of the North West outbreak when the situation was rapidly changing. Along with general updates, the DoH Facebook page streamed the daily press conferences during the outbreak and posted public health alerts and information about the hospital closures and recommissioning. Between the start of March and mid-June 2020 there were over 200 COVID-19 related posts on the DoH Facebook page, and the posts often reached tens of thousands of Facebook users.

Throughout the pandemic, the number of Likes and Followers of the DoH Facebook page has increased significantly, indicating greater public consumption of the DoH messaging. Between the start of the year and mid-July, there was a 412 per cent increase in Likes and a 452 per cent increase in Followers. As outlined in the table below, these numbers increased significantly over the period of the North West outbreak between April and May 2020.

Table 1

In order to reach as broad an audience as possible, the PIU, supported by the DoH, also ran COVID-19 advertising through traditional media including television, print and radio. Information was tailored to specific regions where possible. As an example, when mobile clinics were travelling to certain regions, details about those mobile clinics would be included in the region’s local newspaper.

Specific regional advertising was important during the outbreak, as the North West was placed under stricter restrictions than the rest of the state. Key information from the Premier’s and Minister for Health’s 12 April 2020 media release relating to the closure of the NWRH and NWPH, the further business restrictions for a period of 14 days to certain municipal areas in the North West, and further details on the Directions made under the Public Health Act, were communicated in newspaper advertisements and radio announcements with messaging targeted to the North West community. Emergency SMS was also activated to communicate key quarantine and closure information to impacted North West geographic regions

3.2.3 Public Health Hotline and COVID-19 Response Centre

Calls to the Public Health Hotline from both the public and health professionals began to increase during the initial emergence of COVID-19 cases in Australia. Planning commenced early to prepare for an expected surge in calls following any positive cases in Tasmania.

The Public Health Hotline takes inbound calls from medical practitioners and health professionals, as well as other communicable disease-related and environmental health-related calls. Any inbound calls that require professional or clinical response are managed through the PHEOC including providing support to individuals in self-isolation.

The Tasmanian Emergency Information Service (TEIS) was activated on 13 March 2020 to support the handling of calls from the general public related specifically to COVID-19, and to assist in the triaging of calls for the Public Health Hotline.

On 23 March 2020, under the instruction of the State Controller, a COVID-19 Response Centre opened at the former Vodafone Contact Centre to provide additional capacity to manage calls in relation to COVID-19, including for community and general advice, and GP and health worker support. It has also been responsible for Public Health Hotline related activities, COVID-19 testing assessments, contact management, and responding to queries in relation to quarantining.

These measures have been important components of the statewide response to the COVID-19 pandemic. During the North West outbreak, they helped ensure the community had timely access to general advice on restrictions, testing and quarantining. They also provided a means to more easily escalate any specific concerns or questions arising from calls to clinical workers, which would not have been possible without the activation and expansion of the TEIS in response to the significant surge in calls.

3.3 Communication with private hospitals and the primary care sector

As outlined in section 1 of this submission, there has been significant engagement with both private hospital operators and the primary care sector throughout the COVID-19 pandemic. As these are key partners in the delivery of efficient and effective healthcare in Tasmania, it has been vital to ensure a coordinated effort with the private hospital and primary care sectors in the response to COVID-19.

The DoH has strong collaborative relationships with the private hospital sector in Tasmania, and these existing networks supported information sharing and early planning which assisted in sustaining total hospital capacity prior to, and during, the outbreak.

The DoH was also able to leverage existing communication mechanisms to support engagement with the primary health sector. The Public Health primary care updates (‘FaxStream’) is a long-standing communication mechanism used by the DPH to provide vital public health information to primary health services including GPs and hospital emergency departments about emerging public health issues, including communicable disease outbreaks. The purpose is to alert primary care providers to risks, engage primary care providers in surveillance activities and provide information about the public health management of patients. It is also used to provide updates about vaccination including alerts, schedules and availability/ordering of vaccines.

The FaxStream has been used throughout the COVID-19 pandemic to provide general updates on the spread of the virus and level of risk, but focuses on information targeted at primary care clinicians, including:

• nationally agreed definition of suspected cases;
• testing guidelines and processes;
• infection prevention and control (including use of PPE);
• referral pathways;
• information about patients at high risk of severe illness; and
• general management of suspect and probable cases.

As the amount of information increased, a GP Information Sheet was added to provide stand-alone, detailed information about the management of suspected cases. While traditionally disseminated via fax, from January 2020, FaxStreams have been forwarded by email by Primary Health Tasmania to primary care providers. Updates were also available initially via the DoH website and subsequently the www.coronavirus.tas.gov.au website.

The first COVID-19 specific FaxStream was circulated on 24 January 2020, and thereafter was provided weekly in the early stages of the pandemic. The frequency increased in March and April 2020, driven by frequent changes to the national response as more information became available about the virus and the disease, and by increased local risk and response, especially during the North West outbreak.

The distribution list for COVID-19 FaxStreams has grown to include:

• all general practice primary contacts
• all GPs and nurses working in general practice
• key contacts at the Royal Australian College of General Practice (Tasmania branch), and Australian Medical Association (Tasmania branch)
• key contacts in the Pharmaceutical Society of Australia (Tasmania branch) and Pharmacy Guild (Tasmania branch)
• private hospitals and clinics
• those involved in the response from private and public laboratories, infection prevention and control staff across the public and private health system, the ECC, PHEOC, THS EOC, AT EOC, and the GP hotline.

Throughout the response, PHEOC has provided opportunities for the ECC and THS EOC to contribute to the FaxStream. This has included information about hospital closures and rearrangements, changes to the Patient Travel Assistance Scheme, and updates about testing clinics.

Every FaxStream and attached information sheet is approved by the DPH, the Deputy DPH, or their delegated Senior Medical Advisor before distribution. PHEOC subsequently seeks approval from the ECC to upload FaxStreams to the www.coronavirus.tas.gov.au website.

3.4 Communication with key health stakeholders

Throughout the response, the DoH undertook regular communication with key health stakeholders, including employee representatives, to provide advice on measures being taken in response to the pandemic, including potential impacts on any DoH and THS employees such as any requirements for self-isolation, leave arrangements, training and PPE availability.

Communication was initially ad hoc, however from 15 March 2020, the State Health Commander chaired a weekly teleconference hosted by the Minister for Health with key health stakeholders. These teleconferences included the Australian Medical Association, Royal Australian College of General Practitioners, Pharmacy Guild of Australia, Rural Doctors Association of Tasmania, Australian Nursing and Midwifery Federation, Health and Community Services Union, Community and Public Sector Union, Primary Health Tasmania, Australian Antarctic Division, and relevant DoH and THS representatives. From early May once the outbreak had been contained, the teleconferences became fortnightly and are currently ongoing, with the most recent held on 31 August 2020.

3.5 Communication with parliamentarians

The DoH has also provided a range of briefings to parliamentarians throughout the pandemic and North West outbreak, in order to advise on response measures and to support effective decision making.

The DoH gave an initial COVID-19 briefing to all parliamentarians on 5 February 2020. Following the first confirmed case of COVID-19 in Tasmania on 2 March, a similar briefing was again offered to all parliamentarians. In addition, from 22 April through until the end of June, regular health briefings have also been provided to the Tasmanian Labor Party and the Tasmanian Greens, facilitated through the Office of the Minister for Health.