Tasmanian Government response

Tasmanian Whole-of-Government Submission

Independent Review of the Response to the North-West Tasmania COVID-19 Outbreak

1. INTRODUCTION

Tasmania welcomes the opportunity to provide a submission to the Independent Review of the Response to the North-West Tasmania COVID-19 Outbreak.

The protection of the community was the highest priority across all State Service agencies in dealing with the COVID-19 outbreak in the North-West of Tasmania. The outbreak commenced on 3 April 2020 with the first confirmed case, which occurred in the early stages of the Government’s response to COVID-19. Immediate actions were taken by the North-West health system to manage the outbreak, and by government agencies to assist and protect the community. It was crucial that this outbreak was contained quickly to limit the spread of COVID-19 amongst staff, patients and the broader Tasmanian community.

The closure of the North-West Regional Hospital and the North-West Regional Private as well as the quarantining of all staff and their families was a critical factor in assisting to contain the outbreak. The decisiveness in closing both hospitals and other response measures were key to being able to contain the outbreak in a short period. The work of health professionals in the North-West, and from other areas of the State, to close and recommission both sites while ensuring the continuity of emergency care and other critical services was an extraordinary effort.

Measures already in place across the State to manage the impacts of COVID-19 made Tasmania well-placed to take additional specific actions to respond to the North-West outbreak. For instance, alongside the health response, tougher restrictions on the North-West were introduced. This included the closure of more businesses and non-essential services as well as increasing the enforcement of ‘stay at home’ requirements. On the advice of Public Health Services, the additional restrictions continued for three weeks, from 13 April 2020 to 4 May 2020.

In late April 2020, the Tasmanian Government received the Department of Health’s COVID-19 North-West Regional Hospital Outbreak Interim Report (the Interim Report) which provided 17 recommendations. The Interim Report provided crucial early epidemiological findings, which has enabled immediate issues to be addressed, consistent with best practice in outbreak management. The recommendations were accepted by the Tasmanian Government, and are being implemented across the health system.

Following the release the Interim Report, the Premier, the Hon Peter Gutwein MP, announced that an Independent Review into the North-West outbreak would be undertaken. The Tasmanian Government acknowledges that there are lessons to learn from the North-West outbreak to mitigate the occurrence of similar outbreaks in the future. This Independent Review will build on the findings of the Interim Report.

This Submission responds to the Terms of Reference by outlining how Tasmanian Government agencies managed the broader response to COVID-19 in Tasmania as well as the specific restrictions and measures delivered for the North-West, outside of the health system response. The Department of Health’s Submission outlines information about the health response to manage the North-West outbreak.

2. TASMANIAN GOVERNMENT RESPONSE to COVID-19

The Tasmanian Government acted quickly to contain the spread of the virus and implemented tough restrictions to contain its spread. This included sustained border restrictions as well as limits on gatherings, business and community activities. These actions have had consequences on the Tasmanian economy and have altered the way of life for all Tasmanians. In addition to the health response, it was important that the Tasmanian Government provide economic and social support through this challenging time. This section outlines those measures.

Restrictions

On 19 March 2020 the Premier declared a State of Emergency under section 42 of the Emergency Management Act 2006 for the first time. On 11 June 2020, the Premier extended the declaration for a period of four weeks. This declaration was extended on 8 July 2020 until 31 August 2020, and again on 28 August 2020 until 26 October 2020.The restrictions and response measures are enforced through Directions issued under the Public Health Act 1997 and the Emergency Management Act. This includes Directions related to border restrictions, quarantine requirements and ‘stay at home’ requirements. Directions have been reviewed and strengthened to respond to changing conditions and based on public health advice. Directions and other guidance materials continue to be published on the Tasmanian Government’s Coronavirus website at www.coronavirus.tas.gov.au.

Economic and social support measures

The Tasmanian Government introduced two social and economic support packages in response to COVID-19. The two packages, totalling approximately $1 billion, encompass initiatives across the health sector, businesses and jobs, households and individuals, industry and the community.

On 17 March 2020, the first package, totalling approximately $420 million, was announced. This coincided with the declaration of a public health emergency in Tasmania, under the PublicHealth Act. The first package focused on providing immediate relief and assistance to individuals, households and businesses including assistance for people required to isolate.

The second package, totalling approximately $565 million, was announced on 26 March 2020. At that stage, a State of Emergency was declared under the Emergency Management Act. The second package included economic and social support measures targeted at the health system, businesses and jobs, households and individuals, and community organisations.

The Tasmanian Social and Economic Support Measures Update (refer toAttachment A) provides more information about the support measures announced through the two packages and a progress update on the implementation of these measures, where data are available.

The two support packages complement the Australian Government’s stimulus measures of over $320 billion, including the JobKeeper Payment program. Additional funding from the Australian Government was also provided to the Tasmanian Government through the National Partnership on COVID-19 Domestic and Family Violence Responses, the Project Agreement for COVID-19 Legal Assistance Funding and the Project Agreement for the National Infection Control Training Fund.

Supporting the health response

Ensuring that Tasmania’s health system has the capacity to respond to COVID-19 was crucial to stop the spread of the disease in the community and protecting Tasmanians. To prepare for and respond to demand, additional expenditure was outlaid across the health system and existing resources were redirected (where appropriate). This reflects the importance of the health system’s ability to maintain critical healthcare services in this period.

As part of the second stimulus package, $150 million was allocated to meet increasing health costs associated with managing COVID-19 including the purchase of essential equipment and supplies and providing additional staff. Increased funding has also been provided for primary healthcare and mental health support to meet increasing demand, and to adapt to alternate methods of delivery.

The Tasmanian Government signed the National Partnership on COVID-19 Response, which establishes a 50-50 shared funding arrangement between the Australian and state and territory governments to meet the costs incurred by state health services. Through this Agreement, Tasmania received an advance payment of $2.1 million (of $100 million nationally) to prepare the health system. Following this payment, costs incurred by the Tasmanian Government as part of the health response to COVID-19 will be offset by a 50 per cent contribution from the Australian Government. For 2019-20, the Tasmanian Government expects to receive reimbursement of $38.2 million from the Australian Government through this Agreement. This includes costs incurred as part of the health system response to the North-West outbreak.

In addition to financial assistance, Tasmanian Government agencies and funded community organisations have implemented operational measures (e.g. online service delivery) to ensure continuity of services and support despite the implementation of necessary restrictions.

3. TARGETED RESPONSE

In addition to broader response measures implemented across the State, targeted action to protect the residents of the North-West and to limit further outbreak was necessary. Along with the health response, additional actions included enhanced restrictions, increased testing, and financial assistance to residents. This section outlines further measures, outside of the specific health response, that were put in place to respond specifically to the North-West outbreak.

Legislative directions

Directions were issued under the Public Health Act and the Emergency Management Act to aid the North-West health system response and to give effect to the enhanced restrictions.

On 12 April 2020, the Director of Public Health issued a Direction under the Public Health Act to contain the spread of COVID-19 on the North-West. Measures included the requirement for any staff and patients who attended the two hospitals on or after 27 March 2020 and anyone who lived with these staff or patients to undertake two weeks quarantine. Accommodation was provided for those who were unable to undertake quarantine at home.

Additional restrictions were introduced in the North-West region to help protect the community and to reduce the risk of further spread. These measures applied to businesses and the community with the aim of reducing social interactions where possible. Directions were reviewed and strengthened as necessary to respond to changing conditions.

Strict restrictions were introduced to limit visitation to aged care facilities and hospitals, with limitations on hospital visitors remaining following the reopening of the two hospitals.

Increased testing

Increased testing was crucial to understanding the scale of COVID-19 among hospital staff and the broader community. During the outbreak, the Tasmanian Government, with the support of the Australian Government, enhanced its testing capability over and above what was previously available on the North-West. Testing was strongly encouraged in the North-West over this period and the testing criteria were expanded to enable all residents to readily access testing.

Business restrictions

Additional restrictions were placed on businesses and non-essential services in the North-West region between 13 April 2020 and 3 May 2020, via Directions under the Public Health Act. The restrictions were first announced by the Premier on 12 April 2020 to apply for 14 days, however the restrictions were subsequently extended for another seven days. These measures aimed to reduce customer-facing interactions wherever possible.

Under these restrictions, most retail businesses and non-essential services, such as big box retailers, clothing and white goods stores and hairdressers, were not permitted to operate.

Essential services such as medical services, pharmacies, supermarkets, green grocers, food take-away, service/petrol stations, bakeries, laundromats and dry cleaners, newsagents, rural services and general stores, bottle shops, IT repairs, car repairs (new and used car sales were closed), veterinary services, animal and pet food supplies and banks were exempt from the restrictions. Local Government essential services continued to operate as determined by local councils.

Hardware supply stores remained open to trade customers and businesses only. Retailers could continue to operate through online and home delivery methods only.

These business restrictions applied to the following local government areas: Burnie, Central Coast, Circular Head, Devonport, Kentish, Latrobe, Waratah-Wynyard and West Coast.

Following the easing of these restrictions on 3 May 2020, affected businesses were able to reopen.

Restrictions on business are now consistent across Tasmania, including maintaining social distancing requirements. The full list of business restrictions in Tasmania can be found on the Tasmanian Government’s Coronavirus website.

Schools and childcare related services

All Department of Education schools, libraries as well as Child and Family Centres in the North-West region closed with the exemption of appointments with Child Health and Parenting Nurses.

The extension of restrictions to 3 May 2020 meant that schools in the North-West did not resume for the first four days of Term 2. For Government School students, this effectively extended the school holiday period by four days, though teachers continue to prepare for Term 2 learning from home. Noting that Years 11 and 12 are critical years of study, learning support was put in place for these students during the four day school holiday extension and their teachers made contact with them during this time to work through this process. For all other Department of Education students, the Learning at Home website provided resources and ideas for learning at home, should any parent or carer want their children to continue with learning in some form before the Term resumed on 4 May.

On 4 May 2020, schools sites reopened for students who could not be supervised or supported to learn from home, for example due to parents’ or carers’ work commitments. For other students, Tasmanian Government messaging, based on health advice, was that where possible, students should continue to stay at home and engage in home learning. During this period, teachers provided learning activities and tasks for students.

Early Childhood Education and Care centres in the North-West limited access to their services, including only accepting children of essential workers.

Support for the Aged Care Sector

In relation to aged care facilities, the Australian Government had an Aged Care Surge Team on standby to respond to a possible outbreak in three aged care sites on the North-West. Increased testing for residents and employees at these facilities occurred following the confirmation of one resident and one employee having contracted the disease.

The Department of Premier and Cabinet (DPAC), led engagement with the aged care sector in Tasmania during this time and was a key contact point for the three residential aged care facilities on the North-West Coast and offered assistance from Tasmanian Government agencies should these facilities require it. Tasmania also maintained contact with the Australian Government’s Department of Health, given the role of the Australian Government in regulating the aged care sector.

As noted above, tight restrictions were also placed on visitors to residential aged care facilities, to protect them from the risk of COVID-19. From 7 April, the only visits aged care residents were able to receive were for end of life support and essential visits by doctors and medical staff. Further, residents were not permitted to leave an aged care facility unless it was for essential medical requirements as arranged by facility management.

‘Stay at home’ requirements and increased enforcement

Consistent with advice to all Tasmanians, residents of the North-West were required to stay home unless there was an essential reason to go out. Residents were also asked to limit their movement within and outside of the region.

The ‘stay at home’ requirements were enforced on 14 April 2020 via a Direction under the Public Health Act. The Direction required people to remain at home except for shopping, exercise, medical treatment, social support/care, attending school or work, volunteering, performing essential maintenance. The introduction of the ‘stay at home’ requirements aligned with the timing of the enhanced business restrictions on the North-West.

For State Servants, the ‘stay at home’ message was reinforced through an email from the Head of the State Service to all employees on 12 April 2020, which advised State Servants living or working in the local government areas impacted by the North-West restrictions to work from home for the two week period up until 26 April 2020 unless because of particular work requirements their Head of Agency required them to be in the work place. When these restrictions were extended, an additional email from the Head of the State Service was circulated to staff on 24 April 2020, providing further information about the extension to the North-West restrictions, the implications for schools and businesses and reinforcing the direction for State Servants to continue working from home until 3 May 2020. The email also provided additional details around increasing testing in the North-West including for State Servants and advice for North-West health care workers leaving quarantine.

Tasmania Police was involved in monitoring compliance with quarantine requirements and ‘stay at home’ requirements across Tasmania. During the North-West outbreak, there was a heightened police presence to monitor compliance with the ‘stay at home’ requirements including the movement of people outside of that region (ie. traffic checkpoints). To support this, 20 officers from Northern and Southern Districts were deployed to the North-West.

Redeployment of staff

To aid the health response, staff from Tasmanian Government agencies were made available to work on the North-West (as required). For example, as noted above additional police officers were redeployed from the Northern and Southern Districts to assist with the monitoring of compliance with ‘stay at home’ requirements.

During the closure of the two North-West hospitals, staff capacity at the Mersey Community Hospital was expanded to retain as much hospital capacity as possible. This allowed existing patients from the North West Regional Hospital and the North West Private Hospital to be transferred to the Mersey Community Hospital if their clinical condition required it. Additional support was also provided for urgent care and unexpected emergencies, by increasing ambulance capacity in the North-West to ensure patients who needed care could get it, and the health system worked closely with local GPs to deliver more primary care capacity wherever possible.

Department of Primary Industries, Parks, Water and Environment staff facilitated the deep clean of the two hospital sites and worked with an AUSMAT (Australian Medical Assistance) team and members of the Australian Defence Force to ensure emergency services at the North West Regional Hospital could come back online as soon as possible following a deep clean of the area.

Public communications

Targeted public communications occurred during the North-West outbreak to ensure that the community was informed about the additional restrictions and available support measures.

The Tasmanian Government’s Coronavirus website provided a central source of information for the public. It averaged 16,000 visitors a day in its first month, with use peaking at 61,500 visitors in a three-hour period when extra restrictions were first introduced on the North-West. The website has also been used by the COVID-19 Response Unit Contact Centre, which is another important source of information for all Tasmanians.

During the North-West outbreak, the Public Information Unit in the State Control Centre worked closely with the North-West Regional Emergency Coordination Committee and councils to identify the information required by communities and the appropriate channels to disseminate this through, as well as responding to feedback and requests. A range of public information channels was used in the North-West during this period including online formats, television, radio, newspapers and message boards.

Advice, including talking points, was provided to local government and other community leaders which strongly focused on the messages relevant to the North-West.

The Emergency Alert SMS service was used twice to specifically reach North-West residents by delivering messages direct to their mobile phones. The first alert was to advise North-West residents of the changes to restrictions in the region. The second alert was to encourage testing at mobile locations on the North-West.

During the height of the restrictions, an information sheet highlighting the restrictions and the support available to residents was produced specifically for the North-West and letterbox drops to homes in all affected municipalities to ensure those without access to internet were also informed.

Additional support measures for the North-West

Broader support measures in place across Tasmania proved sufficient to facilitate immediate assistance to residents of the North-West during the period of additional restrictions. During the North-West outbreak, these support measures were reviewed and amended slightly where necessary to facilitate increased access to support for residents and respond to emerging local issues.

Impacted businesses could continue to access advice and support through Business Tasmania during the period of additional restrictions. Business Tasmania reported an uptake in enquiries from North-West businesses seeking clarification and advice about the restrictions.

DPAC provided additional support for Government Business Enterprises (GBEs) and State-Owned Corporations (SOCs), by regularly meeting with CEOs of these organisations and facilitating relevant speakers (such as the Director of Public Health, Secretary of the Department of Treasury and Finance and the State Policy Advisor) who could provide the CEOs with more information on key topics to keep their workforces and infrastructure running. During the North-West outbreak, additional specific support provided to GBEs and SOCs included:

• Support to receive key policy advice from the State Control Centre;
• Liaison with the Public Information Unit and COVID Call Centre on testing parameters for employees of GBEs and SOCs;
• Support on clarity and consistency of the employee identification required to ensure essential workers (and contractors if and when appropriate) could still service key infrastructure at the peak of the North-West restrictions; and
• Sharing of all key messages being provided to State Servants from the Head of the State Service to support consistency of advice.

For individuals and families, the Pandemic Isolation Assistance Grant was a key source of immediate financial assistance. The grant is up to $250 per adult, $125 per dependent child (under 18 years) and a maximum of $1,000 for any one family. Prior to the outbreak, the eligibility criteria for the Grant was restricted to holders of a Centrelink Health Care Card or a Pensioner Concession Card who were required to self-isolate. During the outbreak, the eligibility criteria were expanded to include people required to self-isolate on the North-West which enabled individuals and families affected by the North-West outbreak to seek immediate financial assistance.

As part of the two support packages, the Tasmanian Government provided additional funding to non-government organisations to provide support services and supplies to those in need. During the North-West outbreak, local organisations were engaged to provide essential supplies to households undertaking quarantine and unable to leave their homes. For example, the Red Cross made calls to those in Government quarantine to check-in on their wellbeing, and essential supplies were provided through Salvation Army Doorway Centres across the North-West

4. SUPPORTING OUR STAFF

The Tasmanian State Service has undertaken extensive response and recovery work in respect of the COVID-19 pandemic. The intensity and duration of the response to the pandemic has been unprecedented and the North-West outbreak required agencies to be highly responsive and agile in order to control the outbreak and mitigate its consequences.

Throughout the whole pandemic, but particularly through the period of the outbreak, it was critical to ensure the needs of the Tasmanian State Service were met, including providing clear and consistent communications as well as taking steps to limit the mental health impacts for employees. This was required from both from a duty of care perspective, and to ensure the State Service was capable, resilient and able to respond as the pandemic continued to unfold.

Under Employment Direction No. 23, Heads of Agencies are required to develop and maintain a workplace health and wellbeing program. The State Service Management Office has also developed guidelines to assist agencies in developing and implementing health and wellbeing programs relevant to their workforces.

As a result, individual agencies and workplaces have a range of existing supports in place for staff that they have been able to use and promote to support staff wellbeing during the COVID-19 pandemic. Examples include employee assistance programs (for both staff and managers), workplace contact officers, intranet pages, factsheets and training modules.

Agencies have also introduced additional initiatives to support staff such as creating targeted resources to address the mental health impacts of COVID-19, running professionally facilitated mental health sessions for staff and having Wellbeing Officers phone staff to check in.

In some cases, Wellbeing Strategies have been implemented to address particular issues raised in specific workplaces. These Strategies contain targeted activities and support to assist staff in dealing with particularly stressful or difficult situations that are likely to pose risks to their mental wellbeing.

In addition to agency specific supports and initiatives, a dedicated information page for Tasmanian State Servants was established at http://www.dpac.tas.gov.au/divisions/ssmo/coronavirus. This site contains key information and resources for staff including (but not limited to) travel arrangements, workforce management, leave, working from home and mental health. The website also contains all correspondence from the Head of the State Service that has been circulated to staff during the COVID-19 pandemic. During and following the outbreak on the North-West, specific emails were distributed to all staff in the State Service to provide information and guidance about the restrictions, implications and other impacts for staff.

5. RECOVERY

Given that Tasmania remains under a State of Emergency declaration (until 26 October 2020) and response activities remain ongoing, the full impact of COVID-19 in Tasmania is unknown.

Early recovery measures have commenced with activities already underway. On 8 May 2020, the Tasmanian Government released Our Plan to Rebuild a Stronger Tasmania which sets out Tasmania’s roadmap to recovery including core safeguards and three stages to easing restrictions. The three stages to easing restrictions align with those agreed by National Cabinet. Economic recovery and social support during recovery are identified as the two distinct areas of recovery.

Restrictions have been eased earlier than projected in the Plan, based on public health advice. This result demonstrates that the actions taken to date, including in response to the North-West outbreak, were necessary to mitigate the spread of COVID-19.

The Tasmanian Government has already made a number of commitments across Tasmania to drive economic recovery and ensure social support in recovery. In the North-West region a range of infrastructure projects will help support jobs and growth in the region. These projects include the North-West Coastal Pathway, the Don Irrigation Scheme, the Devonport High School redevelopment, the Burnie court complex upgrade, and a new Child and Family Learning Centre in Waratah-Wynyard.

Given the response is ongoing, the Tasmanian Government’s recovery plan over the short, medium and long term is yet to be fully determined, and is subject to further advice. The recovery plan will be informed by advice from the Premier’s Economic and Social Recovery Advisory Council (PESRAC) and the latest public health advice. PESRAC has delivered its first report to the Premier with recommendations on immediate actions to inform the 2020-21 State Budget. The Government has accepted all of the report’s 64 recommendations. More information about PESRAC is available at https://www.pesrac.tas.gov.au/home

6. Conclusion

The Tasmanian Government made tough decisions to prevent the spread of COVID-19, particularly in response to the North-West outbreak. As a result of strong existing statewide measures being in place, decisive action and the agility of government agencies, the North-West outbreak was contained quickly.

This Independent Review will be a key source of advice to guide preparedness and future response measures for health and other emergencies. As the State moves into recovery, Tasmania can build on the lessons learnt in response to this emergency, and will continue to explore actions to rebuild Tasmania.

7. Attachment