Vulnerable healthcare workers

There are healthcare workers providing direct patient care who are at risk of severe illness from COVID-19.

Evidence from around the world suggests those most at risk of severe illness are:

  • Aboriginal and Torres Strait Islander people 50 years and older with one or more chronic medical conditions;
  • People 65 years and older with chronic medical conditions;
  • People 70 years and older;
  • People with compromised immune systems.

Healthcare workers with compromised immune systems

There is an increased risk of severe disease in healthcare workers with compromised immune systems. This could be linked to conditions or treatments including:

  • current or recent immunosuppressive therapy (chemotherapy or radiotherapy, corticosteroid treatment)
  • all biologics and most disease-modifying anti-rheumatic drugs (DMARDs)
  • neoplastic conditions (leukaemias, lymphomas, myelodysplastic syndromes
  • absent or dysfunctional spleen
  • being post-transplant: solid organ (on immunosuppressive therapy), haematopoietic stem cell transplant (within 24 months)
  • being immunocompromised due to primary or acquired (HIV/AIDS) immunodeficiency
  • severe neutropenia (absolute neutrophil count <0.5 × 109 per L)
  • cancer immuno-oncology therapies (checkpoint inhibitors)
  • other significantly immunocompromising conditions.

Older people

There is an increased risk of severe disease as people get older, especially for those over the age of 70 years.

Aboriginal and Torres Strait Islander people

Aboriginal and Torres Strait Islander people are anticipated to be at increased risk of severe COVID-19 disease, especially those aged over 50 years.

People with serious chronic medical conditions

There is increased risk of severe disease in healthcare workers who have serious chronic medical conditions, including

  • heart disease and hypertension;
  • lung disease including asthma, chronic obstructive pulmonary disease and cystic fibrosis;
  • diabetes;
  • cancer;
  • renal failure;
  • chronic liver disease.

Other considerations

There are some population groups in which there is limited evidence of increased risk of severe illness. This includes pregnant women and people who are obese.

What should vulnerable healthcare workers do

If you think you are a vulnerable healthcare worker, discuss your situation with your manager to determine your level of risk and the best working arrangements for you considering your level of risk, skills and expertise, and the requirements of the organisation. You may be asked to seek further advice from your healthcare worker (GP or relevant specialist). Having a safe working environment is a priority.

There are a range of roles throughout the health system that may be offered to staff who are at higher risk of severe illness, to reduce their risk of exposure to COVID-19.

What should healthcare workers who are caring for or living with a person who is at increased risk of severe COVID-19 disease do

If you are worried because you live with or care for someone at increased risk of severe COVID-19 illness, discuss options with your manager.

What should managers do

Managers should work with healthcare workers identified as being at risk of severe COVID-19 illness, to provide safe working environments.

Consider:

  • areas of the health service where there is low risk of exposure to COVID-19
  • roles within the health service that have low risk of exposure to COVID-19, eg staff education
  • other health services where there is low risk of exposure to COVID-19
  • the option of providing health services remotely, for example through telehealth or telephone services, and assisting with calls to the Public Health Hotline.

If necessary, request further advice from the staff member’s GP or relevant specialist.