SHARON: Hi, everyone and welcome to another Q&A session with Dr Jan Fizzell. I'm Sharon Gudu, the Executive Director of Quality Assurance and Regulatory Services for the Early Childhood Education Sector at the Department of Education. Dr Jan is here with us today to help answer some of your questions about COVID-19 that we've been receiving over the past few months. As you know, Dr Jan is a public health physician and an international expert in infectious diseases. She has been a medical advisor in New South Wales Health for the past 11 years. Before we begin, I'd like to acknowledge the traditional custodians of the land on which we meet today, the Wangal people of the Darug Nation and I pay my respects to the Elders past, present and emerging and to all Aboriginal colleagues who are watching this video with us. I'd also just like to acknowledge as well the amazing work that ECE educators have done over the last six months. This virus hasn't been easy for any of us, but it's clear that we've seen how tough and resilient early childhood educators are throughout these uncertain times. The last time we caught up with you was a few months ago. So, it'll be good to go over some of the latest to help advice and how services can continue to support children in this new phase. So, is this virus the same as the flu or cold? Or is it a little more serious, Dr Jan?

DR JAN: So, COVID-19 can cause a wide spectrum of illness. So, we see very, very mild illness right through to people who require intensive care therapy, and in some rare cases, it can be fatal. The key thing is it can spread the same way as a cold or flu virus. And it can also have the same symptoms as a cold or flu virus. So, those usual symptoms that we've talked about a lot about a stuffy nose that's new for you. A change in taste or smell, so coffee might not smell right, you might not taste things correctly. The throat gets described as sore or scratches tight, just not quite right at the back of the throat, or developing a new cough. So, these are all things that we will mostly experience every winter for some of us. But this winter, the important thing is that we're particularly aware that they could be symptoms of COVID-19.

SHARON: Thanks Dr Jan. And how are the cases from March different to the cases now? And tell us more about community transmission.

DR JAN: Sure. So in March, what we had was we had people arriving from overseas, sometimes from countries where we didn't even know there was an outbreak yet. And when those people came, they accidentally go to their family and then their family went to work or into the community. And so, we've had some community transmission in New South Wales. We've managed through the significant physical distancing restrictions that we've put on people, limiting our numbers of social gatherings, all of those things, helps us get the level of community transmission down low again, what's happened this time is we've had an introduction from another state who had a large amount of community transmission. But again, we're working really hard through encouraging people to get tested early, and to stay home once they're sick. We seem to be getting on top of it at the moment. So, the key thing is, the thing that's really helped us here in New South Wales is community responsiveness. When we've asked people to go out and get tested, they've gone out and get tested. We've asked people to stay home, they've stayed home. And I know not everyone does the right thing. And that can be really concerning to members of the community. But generally speaking, enough people doing the right thing help us keep this under control.

SHARON: That's a really good point. Our services are really keen to do the right thing. Can you tell us more about strategies that services can adopt to protect children, staff and parents or guardians of children?

DR JAN: So, the good news about COVID-19 is unlike colds and flu, small children and even primary school aged children don't seem to be as severely affected by the disease, but also they don't seem to pass it on to each other particularly well. So, our focus has to be around interactions between adults. Adults are really good at giving it to each other, particularly in social situations. And that's because it spreads by the tiny little droplets where we breathe out. And these tiny little droplets contain the virus, and those tiny droplets can be breathed in by the next person, and that's the major way this disease is spreading. Can also happen when I breathe out, I've got a surface, and if that surface gets contaminated with viruses, then touch the surface, then touch my mouth, my nose or my eyes, I can give myself COVID-19. And that's why hand washing and hand sanitizer is important. So, the things we can do is, the first thing is to limit the close interaction of adults. So, whether that's staff members, maintaining meetings outdoors, where you can have a bit of space around, I know it's cold at the moment in winter, but trying to make sure that people remain physically distanced in the workplace as much as possible when we're interacting with adults from outside. So, parents dropping children at the service or carers dropping children really important to try and encourage them to physically distance. If there's usually a peak drop off time, trying to message to parents who could come 15 minutes early or five minutes later, so that we don't have everyone turning up on the door, say at 8:00 in the morning. Really important also, though, to make sure that signing books, for example, think about virtual signing books, thinking about other ways of doing things. I know a lot of people have got great innovations in the centre as to how to make things more virtually accessible. Even, you know, daily reports about how your child's been, you know, what's their behaviour been like in the centre, going online with those, you know, appropriately security protected is another way of doing these things. So, I think there's been a lot of innovation in reducing the interaction between adults, but it's really important that we don't let our guard down because I think a lot of us are getting a lot more relaxed, a lot more comfortable. And what the current reintroductions have shown is what we've expected all along is that COVID-19, because it can mimic a very mild virus, it's very hard to control. And so, we will see this little burbling under the surface. And it's when it sort of manages to find a good place to start spreading, that's when it will go. So, it's really important that we maintain those behaviours that we had in place. Even though we all wish this was over. But unfortunately, that doesn't make it over.

SHARON: Thanks, Dr Jan. So, some really clear messages there about maintaining that social distance and hand washing all of the things that we've heard before. Yes, yeah. And so, tell us about what a service should do if a staff member or a child is ill.

DR JAN: So, the first thing for everyone is to be constantly messaging. If you're ill, you shouldn't be at work. If your child is ill, they should not be brought to the workplace. If however, which happens to some of us, anytime we start feeling ill during the day, do not soldier on it's time to leave. It's really important that people don't stay at work once they start feeling unwell. And also if you notice a child becomes unwell, do make sure that you isolate them until their parents could come or carers could come pick them up. And then that child needs to leave the service as soon as possible. It should be a clear expectation with parents and carers that anyone who is ill this winter is going to leave. It should be a clear expectation with staff that if you're unwell to you do not come to work. And that if you are unwell, you tell people and that it's easy for you to leave. So, I know that can put a lot of strain on staffing levels, but it is really important that people are not in a place where they're sick. We know that early childhood by the nature of the service, because people can wind up in a smaller room together to say change nappies or whatever else. It is so important that if you are sick, you do not come to work because it is a difficult environment, sometimes to physically distance in, but really easy because people do need to work together to spread COVID.

SHARON: OK. Thank you. I think that's very clear advice -stay at home if you're not well.

JAN: Absolutely.

SHARON: We've recently seen Victoria implement the mandatory use of face masks, for people outside their homes. Do we need these in ECE services?

DR JAN: So, face masks help us stop giving the illness to somebody else. And so, if you're in a situation, like we are in some places in the world, where community transmission is high, and we don't know if we might have caught it from somebody, whether we're on the train or on the tram, or, you know, just out in the community, a mask helps us stop the spread by limiting those little droplets that we've talked about, being able to leave our face and get to other people. So, the reason we wear a mask is to protect other people. So, if you're in a situation where physical distancing isn't possible, where anyone who is unwell has gone home, if you're unwell, a mask is not a substitute for staying at home, if you're unwell, you need to stay at home, where the hand washing is happening well, but there are still circumstances where you can't physically distance. If there is an outbreak in your community, then it is reasonable to choose to wear a mask. At the moment, we would not mandate it because we do not have that level of community transmission. It's really important though, that if people understand that the mask is to protect other people, it will not protect you necessarily if you're not careful with it. The other thing is if people choose to wear a mask, it needs to be done safely because they can become, you know, if you think about what I talked about with those fomites on tables, there's little droplets accumulating, and masks catch them really, really well. So, if you're constantly playing with your mask, you'll be able to transfer those viral particles from the outside of your mask into your eyes and then all over your hands and then you touch things. If your mask is wet or moist, it's time to change it. And again, it's really important that when you are doing anything with a mask, wash your hands first, take it off by the ear loops, either dispose of it, if it's disposable, or put it into a ziplock plastic bag if it's a washable mask, then wash your hands again. It's really important that you do it safely. If you're mask wearing means that you're doing a lot of this pulling up and down that we sometimes see news reporters do, it's probably a situation where you shouldn't be using a mask because if you're doing that a lot, you're actually, you know, contaminating your hands and then you'll contaminate surfaces. So, you're not doing as much with that mask to protect other people, then perhaps by not wearing the mask and being really vigilant about keeping your distance. So, it's so important that you keep your distance and you maintain that vigilance because it is not a suit of armour, it is not magic. It can get through a mask. So, if it's a medical mask that you've been asked to wear for a particular purpose that's got a little bit more protection in it and that will sometimes protect the wearer as well. But it's really important though, that when people are wearing a mask, they do it safely.

SHARON: OK. And what about thermometers, should they be used as a proactive measure within a service? And what if parents are insisting that services use temperature checks?

DR JAN: So, unfortunately, COVID isn't nice to us. If everyone who got COVID ran a temperature first before they could infect anyone else, thermometer checking would be fabulous, it would work really well. Unfortunately, what we've learned is that a large group of people with COVID-19 actually do not run a fever. A large people group of people with COVID-19, if all we do is temperature screening, will walk through that temperature screen and still be able to spread COVID-19. The other thing with temperature checks is that it can also cause queues. And one of the things that we've just talked about is one of the things that will really help us prevent COVID spreading, is by maintaining physical distancing. So, any procedure that we put in place that can increase the amount of time adults spend together needs to be thought through very, very carefully. We have suggested temperature checking in some situations where we're looking after very vulnerable people. So, that's particularly older people, and particularly coming into our healthcare facilities. Now, that's because an outbreak amongst older people and an outbreak... you know, medically vulnerable group is devastating. But generally speaking, for most people providing care to well people in the community, or people in the community going about their regular business- keeping your eye on physical distancing and hand hygiene is a much more effective use of resources than temperature checking. But if temperature checking comes in, all it will do is just help you do what most early childhood services already do. I mean, I don't know, but I got calls about my child whenever he ran a fever, because he looked out of sorts and grisly, and they knew my child because my child was with them all the time. And so, I didn't need them to tell me his temperature was 38 degrees for them to be able to tell me, "Please take your child home." They're not right today. So, it's really important that the services don't just have to rely on a temperature to be able to send a child home. It's important that the overall picture of a child "Look, we've noticed that they've got a really runny nose, they're really not themselves today, we're really worried, could you please take your child to home and get them tested?" It's a much easier message than your child has a temperature. Your child has a temperature as part of that global picture. And so, you should feel free to exclude children who are not well because you know the kids, not just because of a fever.

SHARON: Thanks, Dr Jan. That's a really good point that educators actually do know these children and they know how to see if a child isn't feeling well.

DR JAN: And I think as parents and carers, we also have to respect the professionalism of early childhood educators. And if you are sure that this child is not how they usually are, 'cause you look after two or five, or how many days a week you look after this young person, you know that child. And so, you are able to actually say, "This is not right. I really think that, you know," and particularly with very young children, it could be the early signs of not just COVID, but lots of other interesting diseases that young children get. And so, exclusion and getting the child checked is not necessarily a bad policy.

SHARON: Ok. And is there anything else that parents should think about when they are taking their child to a service to ensure that the service is a COVID safe space? What should they be looking for?

DR JAN: So, as a parent or carer, the things that I'd be looking for are how they are managing the entry and exit of people from the service. I'd be looking to see at how the staff interact to try and see whether there are, you know, are they always together, huddling and having chats or are they actually managing that distance, and are they actually checking themselves if they go to go in and have a chat because it's really normal and really human to wanna be up close and personal with people. This is who we are. And particularly, if we're early childhood educators, so many people have got so much compassion for other people, it's really important that we actually have to physically check ourselves from our normal behaviours, and it's really hard. But as a parent or carer, I'd be looking to see, are they actually doing that, are they going together and go, "Oops, hang on, we shouldn't be doing that," and stepping apart. And then I'd also like to see what hand hygiene they're doing. I'd be seeing, you know, is there hand sanitizer available out the reach of children? Or if they are using the hand sanitizer, making sure they take it down from the place outside of reach of children and supervising its use, Because hand sanitizer in and of itself, used through the skin, no problem, but it is a problem if kids drink it. So, I'd be quite worried if I saw, you know, hand sanitizer down at kids level where they could get their hands on it. So generally speaking, are they physically distancing? Are they encouraging hand sanitizer? And do the adults look supported in their workplace where they can stand apart? That would be the things that I'd be really looking for as a parent who care.

SHARON: OK, great. That's very clear. Thank you. Can you tell us more about the testing process in New South Wales at the moment? How long does it take to get a result? And do early childhood workers get priority?

DR JAN: So, what's happening at the moment is we've got testing clinics everywhere. They're up on the nsw.gov.au website. If ever there's an area of concern, we'll usually also put on additional testing clinics in that particular area. It's really important that if people get symptoms, or if public health ask you to get tested, even if you don't have symptoms, that you do, go and get that test done as soon as possible because that limits any possible spread. If you register with Service NSW or the pathology provider's SMS service, you'll usually get a result within 72 hours, and sometimes in as little as 24 hours. Now, do early childhood educators get priority? They get priority when it helps us get the disease under control. Because as you can imagine, if everyone gets priority, no one gets priority. That's the really hard part. But we're certainly prioritising, you know, anything connected to an outbreak anywhere, we're concerned that an outbreak may be occurring. So, if somebody has been identified as a close contact, so that's somebody that, for example, we've, most people will have heard about the Crossroads Hotel. If you've been in the Crossroads Hotel at a particular time and date, there'll be some urgency to getting your specimen processed because you're at much higher risk of having COVID-19 than most people in the community. Most people in the community at the moment who have an illness do not have COVID-19. That's the really good news. Out of every 1,000 tests we do, we're only finding, you know, maybe one case. And so out of, you know, probably 900 people with symptoms of cough or cold, only one person has actually got COVID-19. But it's so important that we find that one person so that we don't wind up with 1,000 people with COVID-19 because that's how it spreads. That finding that one person lets us put that contact tracing where we find out where that person's been and who they may have infected, where we can warn that group of people so that they're particularly vigilant about their symptoms, And then we can stop that from spreading. And that's where everyone coming forward and getting tested is so important. So, I know it's frustrating, particularly sometimes you're feeling a little bit sick, you do the right thing, you go and get tested, you're actually feeling fine the next day, but you're still meant to wait to get your results back. It's so frustrating, but we're trying so hard. Even with the extra testing we've been doing this week, the turnaround time to get a result back to you, has not increased. So, we're putting on extra staff in our labs, we're putting on extra testing people. So hopefully, you will find if you get a test done, most of our facilities you'll get those results back within 72 hours, and possibly within 24.

SHARON: OK. And if the test is negative, but the person's been in a location with a confirmed case, when is it safe for them to return to work?

DR JAN: So, there are two different groups of people who could have been in a location with a confirmed case. On the nsw.gov.au website, we've actually got a list of locations and times and dates when people should be concerned. We've asked those people to self-isolate, and that is because they were in the same location with a person who was infectious for long enough to have a problem. There's another group of people who we've said, "just be particularly aware that you could have a problem". And they're groups of people who are less likely to have come in contact with that confirmed case of COVID-19. But just like we're asking everyone in the community, we're asking them to be super aware if they have any symptoms, and if they do have symptoms to get tested. Now, if we've asked you to self-isolate, because you're a close contact of the case, that somebody who's at a very high risk of contracting COVID because you've been around a person when they're infectious, we ask you to isolate for 14 days from the time you last saw that person or you were last in that place. And that's because that's how long it takes for 99.99% of people to develop symptoms from COVID-19 if they're going to actually become sick with it. For everyone else, you don't need to self-isolate. But if you do get sick, and you're in that group, we do ask you to get tested and self-isolate until those test results come back.

SHARON: OK. And so, just to be clear, self-isolating means don't come to work for 14 days, and if you're a parent, don't bring your kid for 14 days.

DR JAN: Exactly. So, self-isolation is a really difficult concept for most of us. It basically means hanging in your room, which sounds really, unless you've got a house to yourself, which, you know, most of us if we're parents and carers, will not be the case. But the idea is to try and absolutely limit your interaction with other members of your household and absolutely no interaction with the broader community. So, that means that you're basically not going into the same shared living spaces as other members of your household. It means that you're not leaving a house unless there's an emergency or to go and get tested. It means that you are basically staying put. It means that you should be asking someone else from your family to cook, or if someone else from your family can't cook, thinking about having the late meals delivered to your home, which I know is expensive, but still better than you getting out and spreading COVID around your kitchen if you're potentially infectious before you know it. So, try to limit that spread in your household. 'Cause household, if you go out of your room, then wearing a mask in your room, again, to protect the other members of your household from you. So, it's a really hard ask of people. No visitors, no household gatherings, not even if you're shut away in the room, don't, you know, you are shut away. Now the thing is, if only you have been asked to self-isolate, the rest of your family can go around their normal business so they can go to childcare, they can go to work. If you become a case and they become your close contacts because they've been in the household with you, then yes, your whole house will need to isolate together. But if one person is a close contact in a family group, they should self-isolate and keep away from their family so the family can go about their normal business. If the family can't isolate away from you, then probably try and limit your activities to the house.

SHARON: OK. Thank you. So, in terms of getting tested, all of the testing sites are on the NSW Health website?

DR JAN: Yes. Or you can also ring your GP and ask them for their advice about any local services that they might be aware of, or they may also be willing to test you. But otherwise, the clinic sites are across the state. There's private pathology labs, there's NSW Health clinic sites, if there's any charges, and some of the clinics are less likely to take very young children. And that's simply because as I said before, young children can get a febrile illness, an illness where they're running a fever for lots of different reasons. Some of them are quite serious. So, we don't wanna just test someone and send a very young child home and then has an adverse outcome. We really wanna look after people remembering that many children running a fever will not have COVID. So, it's still important that if your child is running a fever, and you're worried about them, call your GP, and if you're very worried, of course, go to the emergency department. The hospitals are safe. That's something I really want to reinforce. Your GP and the hospitals are safe for you to go and get care for your child or for yourself. We are going to extraordinary lengths to protect our healthcare services from COVID-19. So please, if you're worried about your child or worried about yourself, go to hospital, call an ambulance, call your GP. The services are open to look after you.

SHARON: OK. And what about people who don't have access to Medicare? What happens if they have a positive COVID-19 test?

DR JAN: So, NSW Health wants to look after everybody who was COVID-19. So, the fees have been waived for public hospital care for people without Medicare cards. It's free to have a COVID test. You do not need to have a Medicare card to have a COVID test at the clinics run by NSW Health. So please, if you need a COVID test, do not think "I'm gonna get charged a lot of money to have the test", do not think, "Oh my goodness, if I'm sick, I can't go to hospital." You can and you should, we will look after you.

SHARON: OK. That's great to know. How important are COVID-19 policies and procedures for services, including risk assessments?

DR JAN: Super important. So super important. And that just makes sure everyone knows what's expected of them, and how to keep themselves each other and the community safe. It is super important that you have a checklist. Now, early childhood services are fabulous already, because they've already got the Staying Healthy in Childcare volume from the NHMRC that helps you understand what to do with all the different infectious diseases that can affect an early childhood service. So, it's really important that you review your policies and procedures, make sure that it's all bedded down for this winter, make sure that you've got all those policies in place and think about those extra things that we need to do around physical distancing, hand hygiene, increased cleaning of high touch surfaces, so, anywhere where you'd be changing nappies, doors, thinking about the toys that kids put in their mouths, 'cause they just can't help it. And thinking about how do you keep them clean and how do you stop disease spreading from child to child. So, super important that we do review our policies, we look at how we're doing things and keep those policies up to date with what's going on locally. So, for example, if you are in an area where there's outbreaks going on, that you can maintain the messaging to parents, and that you can maintain that messaging to staff about how important it is to do those things that will keep you and the community safe.

SHARON: OK. And, of course, from a regulatory perspective, risk assessments are an important tool to mitigate any potential risks to your service and the children in your care and should inform the development of policies and procedures. We recently held online webinar sessions about risk assessments. And we will put the link to that recording when we upload this video as well. Given some staff or children may be out of the service for up to 14 days, how should this be included in plans?

DR JAN: So, I think it is really important to first centres to think about what's the minimum regulatory requirement for staffing and having a different way of staffing if you need to. The second thing is to think about if you cannot meet that minimum regulatory requirement, what those messages will be with parents and keeping kids safe at the service, who, and then the third thing is also thinking about if there is a smaller number of children, how do you provide care for that small number of children across a different age range? 'Cause I know some people are more comfortable with very young children, some people are more comfortable with older children. So, it's really important that perhaps people are aware of the policies and procedures of a different area to where they normally work. Now, generally speaking, we're asking people to not move around the workplaces more than they need to. But if people do need to move around, make sure that they're properly orientated and that they really know what's going on for that particular setting that they're in.

SHARON: Thank you. You're right. COVID-19 may, of course, impact service staffing arrangements. The Department can support services to apply for a waiver. So, if you've got any questions about waiver eligibility, please contact our Information and Enquiries line about that. Dr Jan, if a child at the service develops COVID-19, am I, as a service, required to inform all the families?

DR JAN: So, there's two different things that you need to be aware of. The first thing will be is if the child for example has been on holidays and hasn't been near the service for many weeks, whilst they've been on holidays and develops COVID-19, then the risk of the service is nil. So, the child and parents haven't had anything to service, the risk to the service is nil. NSW Health will not be contacting that service as a priority, simply because we'll be busy contacting all the places that we do need to be in touch with. So, however, as the service becomes aware, the key thing is to get in touch with the local Public Health Unit and ask them for advice about what we need to tell people to do what. Because what we do see happening is sometimes a place that's actually not being particularly affected eg. that child who's been on holidays, yes, their child does attend that service, but know that child hasn't been there for the last two months. If that service gets into a panic and closes, and sends children everywhere, it can cause a whole lot of work, not just for the service, it can cause a whole lot of family disruption, and it can be completely unnecessary. If however, there is a case that has actually been in attendance for the service, NSW Health will help that service work through what to do with all the different groups. And so that's really important to understand that the local Public Health Unit, the Public Health Unit list is up on the NSW Health website. If you google NSW Public Health Unit, you can check by your postcode, which Public Health Unit will be able to help you. And Public Health Unit will be able to step you through what things if any you need to do. They'll be able to help you with communications to parents. You will be able to help us potentially with our contact tracing to work out who we need to ask to do different things, because it may be that some people are close contacts. And we need people to actually go home and self-isolate for 14 days. There may be other children who are casual contacts and their families just need to be aware to watch for symptoms. Or it may be, again, even though the child does attend the service that actually didn't attend when they were infectious. And, therefore, there's nothing more to do than perhaps just the general community messaging of, "Yes, there has been a child in the service. But no, there's no special precautions. Yes, we're already doing all the cleaning. We're already doing all the other preventive activities and if we all cooperate together, there's nothing more for us to do." So, I think that's the key thing. There is no one set, a child's become positive. But the key, one key thing is to do is to talk to the Public Health Unit if you're concerned.

SHARON: And what about if a staff member is self-isolating or undergoing testing, should a service inform families?

DR JAN: So, this winter, because we're asking everyone all the time, any cold, any cough, get tested. Then I think perhaps just sort of saying, "We know that constantly this winter, we will have children getting tested, we will have staff getting tested. If there is a result of concern, we commit to let you know." I think that's probably the better thing than saying, "You know, this winter it should be, 'Oh, where's Anna?' 'Anna's sick today,'" The assumption would be, if Anna's today, she's also getting tested, if that makes sense. This winter for everybody, if somebody is off work with a cold, the assumption should be "and they're getting tested". And we don't have to alter everything, because if we're doing what we can do, we're doing the physical distancing, hand hygiene, high touch surface cleaning, and all those things that we can do to keep our service safe. We've already got all the controls we've got in place, and like the other 999 people, this test will probably come back negative. So, we could just have a whole lot of messaging nearly every day of the week for any child and any adult who got tested. We just need to assume that this winter, anytime somebody gets sick, they're going to be tested because that's what we really want you to do.

SHARON: OK. Well, that's a good message. And I think there's a clear message in there as well about working with a local Public Health Unit about what the right thing is to do, depending on the services circumstances.

DR JAN: Absolutely. So, the local Public Health Unit doesn't need to know every time somebody got a cold, the local Public Health Unit does need to know if somebody's saying, "oh so and so, had a test positive, you might not be able to tell me but does my service have any concerns and is there anything I need to be telling parents and carers and staff", and they'll be able to help you through that.

SHARON: And I think the point you made before that services can help with contact tracing, that I just want to remind everyone about the importance of record keeping. It's a regulatory requirement, but it is so critical in this time that attendance records are available and up-to-date, and that also staff attendance records are available and up-to-date. So, please make sure all record keeping is in order.

DR JAN: And especially contact phone numbers, and especially email addresses, because sometimes the first thing we'll do when we've got quite a long list of people to contact, the first thing we may do is actually send you a text message to say, "Please isolate, wait for a call." So, it's really important that mobile phone numbers are up to date, that addresses are up to date if possible, and that if there are changes, you're keeping a record of who is there, who isn't there. And even if somebody leaves early, it's helpful for us to know that because it could be that there's been no overlap between a child's presence and a child not being there. And that can be the difference to a parent being able to go to work the next two weeks or not.

SHARON: OK. And if a service is in or near a hotspot, are there extra precautions they should be taking?

DR JAN: So, generally speaking, we should assume at the moment that everywhere is a hotspot. There is no one particular hotspot because at the moment, we may have this low level of COVID burbling under the surface and it could pop up anywhere. So, the really important thing to understand is that, we all need to be careful all the time. If you are in an area though, where there do seem to be a number of outbreaks, particularly if you've got any medically vulnerable children there, so children who may have poor immune systems because they're recovering from leukaemia or transplant, or anything else, then you should talk with that family and work out what the plan is. If the area becomes an area of concern to NSW Health, they'll should have a plan from their doctor and their team. So, you should all work together for that particular medical plan. But generally speaking, I'm not going to say, "Take more care with physical distancing," because I want you to take that care wherever you are. I'm not going to say "Take more care with hand hygiene", 'cause I want you to take that care. So, keep doing the things we've asked you to do. They work with your hotspot or whether you're not a hotspot, it's really important that those things just stay in place.

SHARON: OK. And if a staff member contracts COVID-19, what are the next steps?

DR JAN: So, the first thing is, we'll probably be talking to that staff member to find out where have they been, have they been at work, or if they've been out in the community so we can work out where the areas of risk are that we need to focus. If we then find out that that staff member has been at work, when they were infectious, we'll work with their employer, not necessarily naming the staff member, but we possibly will have to name someone if we're really trying to get down to tintacks, but generally speaking, we try to protect the person's identity as much as possible. And, therefore, we work with that service to try and work out when they may have been there when they were infectious. Remembering that people can be infectious before they get symptoms. So, somebody isn't necessarily doing anything wrong by being at work while they're infectious. They can be infectious and not know it yet. And so, talking to that service about where that staff member has been, who they interacted with, who they're on duty with, and so on, working out who those close contacts are, that we'll need to ask to self-isolate if there are any, working out which children may have been close contacts, so we can ask them to self-isolate if required, and working out who casual contacts are, so the people who don't need to self-isolate, but we just asked to be particularly aware of their symptoms. So, we'll work through that with the service. And it may be that we find that the staff member has never been on duty while infectious and so, there's no further action to be taken in the service. Or if there have been on duty whilst infectious, we then work it through. But that's where the Public Health Unit comes to the fore. They really work hard with each particular employer to try and make sure that we keep people safe.

SHARON: OK. And what about deep cleaning? When is that done? And what is it?

DR JAN: So, early childhood services have always had really good information. If I can reassure you, most of our deep cleaning information comes from what you already do when you've had a child with norovirus, or when you've had a child with anything else. So, you know how to do this. It's the same cleaning as you do. If you've had any other infectious disease in the centre. It's about that two-step cleaning, that manual planning where you've got the detergent, and then you've got the disinfectant. And it's those surfaces most used by a child or by an adult, where they've been, do the same thing you'd normally do is if there was another infectious disease in the centre. You don't need to fog it. You don't need to do anything more than manual labour. So, those guidelines are all up on the website. But, again, if you use the usual cleaning guidelines that you use for your service if you've had an infectious disease there, you're doing great.

SHARON: OK. Thank you. And what about excursions? Should services be taking kids on excursions at the moment?

DR JAN: So, I think that's very much going to be a local risk assessment about what's going on in your community, what the level of comfort is amongst parents and staff and considering what is happening. So, there are some areas of New South Wales where we've had very little COVID, where you haven't had many travellers from Victoria recently, for example, and where things are very quiet and you want to go to the local park. Well, if you can go to the local park, and that's OK with the parents and you can manage all those things through your usual risk assessments. It's probably OK. However, if it's a big excursion involving public transport and extravaganza with lots of people everywhere, that's probably not still the best idea. As far as people coming into service, again, it's thinking about "what's going on in my local community". If I'm an area where I'm hearing about lots of cases occurring locally, probably you don't want more people coming into your centre than you absolutely need. If however, again, you're in a different area, there's some sort of screening of the person to make sure that they haven't come from a hotspot, that they aren't sick, all of those things and you're comfortable with that person coming in, to do the thing that they're doing, that's OK too. But they need to make sure that they follow your rules of physical distancing, hand hygiene and everything else.

SHARON: OK. And that's a good reminder about excursion risk assessments that are required under the National Law and Regulations. And I know that all services are familiar with those, so they're really important in this context as well. OK. That's been fantastic, Dr Jan. Do you have any final words of advice about where to get ongoing, updated advice about COVID-19?

DR JAN: So, the nsw.gov.au website has all the latest information. I understand the NSW Department of Education website also will have appropriate information for early childhood educators. And if you're part of a group of services together, your group will also have particular information. And again, if you've got particular concerns about whether there's been a case or anything else, your local Public Health Unit are the group to work with. Most of you will know them well from other unfortunate incidences over the years, but they're the group to work with.

SHARON: Thank you. That's right. And the Department of Education is keeping our website up-to-date with frequently asked questions, so please do visit our website. And also don't hesitate to contact our Information and Enquiries phone line, if you have any questions about any of things that we've talked about today, and we'll try to get you the answers. Thank you so much, Dr Jan, for giving us your time today to answer some of these questions. We really appreciate it.

DR JAN: You're so welcome, and we're so thankful to the early childhood educators who have been on our frontline right through this and have worked with us with this. They are such an important part of our community and we really value all the great work you're doing. Thank you.

SHARON: Thank you