Guidelines for COVID-19 alert level 2 - PROVISIONAL high-level principles

As you will be aware New Zealand is currently at alert level 3 lockdown with a review by Cabinet due on 11 May 2020.

Understandably, practitioners are seeking urgent information about the guidelines that will apply under alert level 2 as soon as possible.

At alert level 2 – Reduce, the disease is contained, but the risk of community transmission remains.

At this stage, the Ministry has indicated that “community health services will mainly operate as normal” under level 2 (refer to the Ministry website). Although the Ministry indicates that there will be further changes to New Zealanders’ access to health and disability services under level 2, specific details are not yet available.

Progress to date with alert level 2 guidelines

We have shared the alert level 2 draft guidelines with key associations and educational institutions for their feedback by Monday, 4th May 9am.

We are unable to consult with every practitioner in the time available so if you have any particular concerns with the principles outlined below, please raise these directly with your professional association for them to consider in the feedback they provide on the draft guidelines. 

IMPORTANT: Please keep in mind that the draft guidelines have not been finalised and may change. This includes the PPE and room requirements at level 2. A finalised Level 2 guidelines will require Ministry and Council approval.

Council has consulted the Ministry on these draft guidelines for oral health services under alert level 2. These draft guidelines contain the following PROVISIONAL high-level principles:

  • At alert level 2 routine care can be provided for patients who are not confirmed or suspected to have COVID-19.
  • When delivering care to patients who are not confirmed or suspected to have COVID-19, normal PPE and room requirements, same as before COVID-19, apply as described in the Council‘s Infection Prevention and Control practice standard.
  • The PPE and room requirements that apply for confirmed or suspected COVID-19 patients are similar to those outlined in the guidelines for alert level 3.
  • Stronger staff and patient management provisions will be required under alert level 2. Some of these include:
    • If you or your team member is unwell, stay at home.
    • Ongoing screening of patient health when making appointments to appropriately treat COVID-19 suspected or positive patients in the correct environments
    • Scheduling and managing patients to limit the time they will spend in a common area and unnecessary contact with others - particularly vulnerable groups such as patients over 70 years of age and those considered high risk for severe COVID-19 infection because of a pre-existing health condition.
    • When performing aerosol generating procedures for all patients:
      • Use measures aimed at reducing the extent and contamination of aerosol and splatter wherever possible. For example, high volume evacuation systems, use of rubber dam, and pre-procedural mouth rinses.
      • If the room has a door, close it.
    • Record contact information for everyone entering your practice for easy contact tracing, if required.

Process for finalising guidelines

After feedback has been received from the associations and educational institutions:

  • Council will consider consultation feedback received and revise the draft guidelines, and seek Ministry approval of these as interim guidelines.
  • The interim guidelines will then be published on our website for all practitioners to access.
  • Once the Ministry has finalised its parameters for health services under level 2, any refinements can be made and the guidelines submitted for final sign-off; and the final guidelines published once approved by Council and the Ministry.

Understandably, the multiple processes take time, and final approval after the Cabinet’s decision on alert level 2 can take a few days. We aim to share the final guidelines with you as soon as practically possible. 

We are working to support you all in planning for a return to practice. In the interim, it is hoped that the preliminary information shared with you will signal what the practising environment for oral health services could look like under alert level 2, but please remember these decisions have not been finalised and the draft guidelines are still subject to change.

Look after yourself

We are aware that many practitioners are currently facing severe impacts on your businesses, livelihoods and personal wellbeing. We encourage you to seek help and support from those close to you, your own doctor, and other organisations able to assist.

Andrew Gray & Marie Warner

Chair & Chief Executive