NCTS Case Investigation Checklist
Document One
Guidelines
This checklist can be used to ensure that key steps and information in the Case Investigation
process have been completed. It is not intended for use as a how to. Additional support and
training resources are located in Knowledge.
Case Inform
• Inform Q&A completed
• Case advised of positive test result
• Case informed of isolation obligations
1982
• Case’s symptoms and underlying health checked
• Symptom onset date and infectious period identified
Act
• Scoping note (template in Knowledge) added as a Note
• Place of employment identified (likely to be an Exposure Event)
• Support identified and manaaki referral (in Knowledge) completed
• Compliance, health or wellbeing, high risk work places discussed with clinician
• Fields to check:
• Case Interview Date/Time
• Person Has Been Informed
Information
• Symptom Onset Date and Symptoms identified OR Case Asymptomatic
• Isolation Start Date
• Case Advanced to Follow up
• Case emailed a fact sheet/follow up advice (in Knowledge)
Official
Case Investigation
• Household members identified and
the added through Manage Household
• Contact Locations imported and additional ones manually created
• Exposure Events identified from Contact Locations with clinician
• Exposure Events created and named according to naming conventions
under
• Include description of event’s environment and case’s interactions
• Add Files (emails, visitor registers, screenshots)
• Add Notes (correspondence, decision making re: categorization and/or
delegation, changes or updates to details)
• Businesses identified as Exposure Events contacted and . . .
• Informed of cleaning protocols?
Released
• Requested QR code or name location’s QR code is registered under
• Requested staff list and/or visitor log
• Disease Contacts identified, linked to Person Profile (NHI), added to Exposure Events with
correct Exposure Type (Rainbow chart in Knowledge) and Exposure Start/End Date / Time
• Exposure Events and Disease Contacts delegated by changing the Managed By
(Responsible) field (as required)
1
NCTS Case Investigation Checklist
Document One
• Disease Contacts delegated by changing the Managed
Need more support?
Please email [email address]
1982
Act
Information
Official
the
under
Released
2
Document Two
Section 1
Introduction
INTERVIEW DETAILS
1982
(Complete as much as possible before beginning the call) Act
Interviewer name:
Date:
Time:
Case Ful Name:
NCTS Case No:
EpiSurv No:
Date of Birth:
NHI:
Name of person interviewed (if not the Case):
Relationship to Case:
Reason:
Information
Kia ora/Hello, my name is
[first name only] and I work for the Ministry of Health, National Investigation and Tracing Centre. May I please speak with
____________________ (full name).
It is important that I am speaking to the right person. May I please ask for your date of birth? _______________________
Thank you for confirming this information.
Official
Can you please confirm that I have the correct spelling for your name? _______________________________
⇒
[NOTE TO CALLER: If the person is under 16 (born after today’s date, 2005), ask to speak with a parent or legal guardian. If they are not with their
the
guardian, get a parent/guardian’s name and phone number.
⇒
Record in NCTS the name of person interviewed if not the Close Contact.]
Is this a good time to talk? Where are you currently located?
under
⇒
[NOTE TO CALLER: If they are in a public setting with lots people, politely and calmly ask them to return home. They may need to further advice, including
to wear a mask or have someone pick them up. Find out how long it wil take them to get home and advise you wil call them back one they arrive.
⇒
Record in NCTS as logged call and write a note of your actions. Make a note to your work plan to call them back on your shift.]
Released
Document Two
What language do you feel most comfortable speaking? _____________________________
.
[If not English] Would you prefer to have this call completed in
_______________________ (use language just identified}
⇒
[NOTE TO CALLER: If yes, an interpreter is needed. Fol ow SOP for linking in with Interpreter Services.] I will arrange to call you back with an interpreter.
Preferred Language:
Interpreter Required:
☐ Yes
1982 ☐ No
(If yes, arrange before proceeding)
[NOTE TO CALLER: If Interpreter is needed but declined, continue the call but make a note and discuss with the Supervisor after completing the call.]
Act
Do you have any hearing impairment or other communication requirements?
☐
None
☐
Visual Impairment
☐
Hearing Impairment
☐
Functional Impairment
☐
Psychological function
☐
Communication difficulties
☐
Other:
If Yes: Do you use any equipment to support you with communication? Please Specify:
⇒
[NOTE TO CALLER: Ask if there is a Primary Caregiver that we can speak with to rely the conversat
Information
ion, this call may require a referral back
to the PHU for localised and individualised plan, fol ow SOP.]
Official
the
under
Released
Document Two
Communicating Test Results, Confidentiality &
Section 2
Privacy Assurance, Explain Interview Process
1982
• I understand you were recently tested for COVID-19?
•
If no, politely end the call and speak to your Supervisor.
Act
If yes, ask:
• Have you already been informed of the results of your test?
⇒
[NOTE TO CALLER: If already informed]: I understand that that receiving a positive COVID-19 test result might have come as a bit of a
shock.
⇒
[NOTE TO CALLER: If not informed] I am cal ing to inform you that you have tested positive for COVID-19. This means that you are infected
Information
with COVID-19. I understand that this news might come as a bit of a shock.
Pause __________to let diagnosis sink in. You may need to
reiterate where you are calling from and your name. If upset, acknowledge this and offer to call them back in 10-15 minutes. Only once
they are ready to move on ……..]
Official
• My role today is to provide you with information and support you with the next steps. The Ministry of Health are working to prevent
and reduce the spread of COVID-19. I wil be talking to you about COVID-19, checking how you are feeling today, finding out who you
the
may have been in contact with, providing self-isolation advice, and discussing ways of protecting both you and the people around you. I
will also provide you with information on how to access support services.
• Before we continue, I am required to tel you that this cal is being recorded for quality assurance purposes.
under
• I also want to reassure you that this call is confidential, and your information will be kept private. We may need to share some
information with other health providers, including your doctor to ensure that you have access to necessary support.
• To prevent the spread of COVID-19, we wil need to provide your contacts with self-isolation and testing advice. In rare situations, this
information may include your name and the locations you visited while infectious. This information will only be shared if necessary, to
prevent or lessen a serious threat to public health.
Released
Document Two
⇒
[NOTE TO CALLER: If they ask what happens to the information:] Your information will be entered into the National Contact Tracing
Solution which is a secure database.
⇒
If they have further concerns, you can say: The Health Information Privacy Code protects your privacy. Health information can be shared,
if necessary, under the Health Act 1956 (Subpart 5) and the Health Information Privacy Code 2020. You can read about the code at
1982
www.privacy.org.nz
Act
• I will also be taking notes and filling in forms as we speak. You may notice me pause as I record your information. I will try to let you
know when I am doing this. If I talk too fast, please tel me to slow down.
[NOTE TO CALLER: If you have an accent, ask them if they can
understand your accent.]
• This call may take us around 60 minutes and I might need to ring you again to ask for more information.
• Please feel free to ask questions as we go along. I will do my best to answer them. It is important that you understand that I cannot
provide you with any medical or clinical advice; however, I can refer you to get the right people for further information and support if
Information
needed.
• Is there someone else at home that you would like have sitting with you during this cal ? If so, you may like to put the call on speaker. If
you do this, please be sure to maintain at least 2 metres distance.
• Do you have any questions about what we have discussed so far?
[NOTE TO CALLER: Pause to al ow for this].
Official
the
under
Released
Document Two
Section 3
Personal Details
I would now like to take a moment to confirm some of your personal details.
1982
⇒
[NOTE TO CALLER: Cross reference these details on NCTS or complete missing details.]
Address:
Act
Usual country of residence:
Nationality:
Phone:
(m)
(h)
Email:
Which gender do you most identify with? ☐Male ☐Female
☐Non-Binary
☐Other
Information
Which ethnicity do you most identify with? Please let me know if you identify with more than one ethnicity.
☐
NZ European
☐
Māori
☐
Samoan
☐
Cook Island Māori
☐
Tongan
☐
Niuean
☐
Chinese
☐
Indian
☐
Other (Please Specify):
Official
the
⇒
[NOTE TO CALLER: This is an equity question. If the Case is from Māori or Pasifika communities and identifies that they would like to be
supported for their health and welfare needs (e.g. food, transport or welfare) is needed, confirm that we can share their contact details so
that an appropriate provider can be in touch. Complete call as per script and discuss referral process with Case Supervisor.]
under
Do you have an Iwi Affiliation?
☐
Yes
☐
No
If Yes, please specify: _________________________________
Would you like a referral to Māori or Pasifika health provider? ☐
Yes
☐
No
Released
Document Two
Can you please confirm the name of your usual GP or medical practice?
[NOTE TO CALLER: If currently not enrol ed in a GP practice, please provide them with contact details of a local provider in follow-up email.]
Name of GP or Medical practice:
1982
Are you vaccinated against COVID-19? ☐
Yes
☐ No
Act
If Yes: Have you received both doses? ☐
Yes
☐ No
If Yes: Which vaccine did you receive? ________________________________________
Now I need to record some more information to help keep you, your household, and community safe.
Can I please ask what your
primary occupation is?
[NOTE TO CALLER: If student, note details of school.]
Primary Occupation Role:
Information
Primary Employer Firm Name:
Employer Contact Name:
Phone:
Official
Email:
the
Occupation Address:
under
Released
Document Two
Do you have a
secondary occupation?
[NOTE TO CALLER: This can include volunteer work.]
Secondary Occupation Role:
Secondary Employer Firm Name:
1982
Employer Contact Name:
Act
Phone:
Email:
Occupation Address:
Are you considered to be an essential worker?
[NOTE TO CALLER: This can be confirmed at the end of the call using the Essential Worker List.]
Information
Essential Worker?
☐
Yes
☐
No
☐
Unknown
After this call, you will need to tell your employer that you are a confirmed COVID-19 Case. You may be entitled to a wage subsidy while in self-
Official
isolation and your employer will be able to provide support with this. They wil also help with contacting any other staff members that are at
risk of being infected.
the
Do you have any questions?
[NOTE TO CALLER: Pause and provide time to ask questions.]
under
Released
Document Two
1982
Act
Section 4
Underlying Conditions & Risk Assessment
Information
COVID-19 may have an effect on people of all ages with underlying health conditions. We want to provide the best advice and support for you.
Please answer yes if you have any of the fol owing conditions
: [NOTE TO CALLER: Read out all the underlying conditions list. If yes, please
specify. Discuss any underlying conditions with your Supervisor at the end of the call.]
Official
⇒
[NOTE TO CALLER: If Case is female] Are you currently pregnant? If so, how many weeks? It is best to inform your midwife or Lead
Maternity Carer (LMC) that you have tested positive for COVID-19. _________________________________________________
the
Underlying Conditions (tick all that apply and specify the disease/condition)
☐ Heart Disease (Cardiovascular Disease)
☐ Diabetes
under
☐ Cancer – Current or Historical (Malignancy)
☐ Chronic Neurological/Neuromuscular Disease (eg conditions affecting brain or nervous system)
☐ Immunodeficiency (eg HIV or conditions that affect immunity or immune system)
☐ Kidney Disease (eg renal failure, dialysis)
☐ Chronic Lung Condition (conditions that affect lungs or breathing,
including asthma)
Released
☐ Mental Health Conditions (If yes, please specify: _________________________________________________________________)
Document Two
☐
High Blood Pressure (Hypertension)
☐
Liver disease
☐
Smoker
☐
Pregnancy: Trimester 1 2 3
1982
☐
Post-partum (pregnant recently had a baby recent <6 weeks)
☐
Other Underlying Condition or Il ness (please specify ___________________________________________)
Act
Do you take any medications?
[NOTE TO CALLER: If yes, ask them to read off the bottle or box label.]
Medications:
Section 5
Symptom C
Information heck
Firstly, I would like to know how you are feeling today. I have a list of symptoms that I am going to read out and I need you to tel me if you
have any of them now, or have had any in the last three days.
Official
⇒
[NOTE TO CALLER: Read out all the list of symptoms, ticking all that apply. If symptomatic ask the date of onset:].
the
Read through symptoms and tick all that apply:
☐
Fever/chills
☐
Runny nose
☐
Headache
☐
Muscular pain
☐
General weakness
☐
Shortness of breath
☐
Irritability/confusion
☐
Chest pain
☐
Cough
☐
Diarrhoeaunder ☐
Loss of sense of smel
☐
Abdominal pain
☐
Sore throat
☐
Nausea/Vomiting
☐
Joint pain
When did you start developing these symptoms? __________________________________ (
Date of onset)
[NOTE TO CALLER: Infectious period wil start two days before this date]
Highest temperature (oC) if taken:
Do you have any other symptoms that I haven’t mentioned?
Please Specify:
Released
Can you please confirm the date you had your test done? ___________________________________
Document Two
[NOTE TO CALLER: If asymptomatic, infectious period will start two days before this date]
Where did you have your test done? _________________________________________________
Is the Case asymptomatic? ☐
Yes
☐
No
If yes: What led you to get a test?____________________________________________________
Use this space to note the Infectious Period Start Date (two days before symptom onset OR if asymptomatic, two days be
1982
fore test taken):
__________________________________________
[NOTE TO CALLER: You wil need to record this date again below when you begin investigating the Exposure Events]
Act
⇒
[NOTE TO CALLER: If your Case is acutely unwell or you notice any clinical safety risks, assess if it is appropriate to continue the call. If
not, immediately refer to Case Supervisor and fol ow red flag steps below:] Information
⚠
Red Flags- Clinical Risk- Acutely unwel
Listen for severe shortness of breath at rest, difficulty breathing, pain or pressure in chest, cold, clammy, new confusion, becoming difficult to
rouse, blue lips or face, little or no urine output, coughing up blood, neck stiffness, non-blanching rash
Official
⚠
I am concerned about your health and believe you need urgent medical attention. Can you please stay on the line while I call my Case
Supervisor to DIAL 111 and get Emergency Services to you. I wi
the l stay on the line with you until Emergency Services arrive.
[NOTE TO CALLER: You wil need to confirm the Case’s address in order to get the ambulance to them quickly. Document your actions and
escalations in NCTS Case notes.]
under
Released
Document Two
Section 6
Exposure Events
INFECTIOUS PERIOD: Start Date: ____________________ (2 days before onset of symptoms OR date of test)
1982
Exposure/Incubation Period
Infectious Period
(14 days prior to onset of symptoms)
(2 days before onset until symptom free for 72 hours)
→
Act
-14 days
-2 days
Information
Date of symptom onset
OR date of test
Official
Infectious Period Start Date
the
under
Released
Document Two
Start Date of Infectious Period:________________________________
• Based on the information you have provided already, you were most likely infectious from _________________________ (
infectious period start
date). We will be focussing on the period starting from that date through to today.
1982
• Before we begin, I’d like to confirm the details of anyone living in your household with you. This can include family, flatmates, or boarders.
Act
Household Contacts (including family, flatmates, boarders, etc)
Current Health Status
(to the best of the
Full Name
Contact Number
Date of Birth
Relationship to Case
Last Date of Contact
Case’s knowledge)
Test Date?
well/unwell
well/unwell
Information
well/unwell
well/unwell
Official
well/unwell
the
well/unwell
well/unwell
under
well/unwell
Released
Document Two
⇒
[NOTE TO CALLER: Does the Case have any household dependents? If yes, do the dependents have any of the following conditions?]
If yes:
I just need to go through the check list of underlying conditions for your dependent(s). If they have any of these conditions, please let
1982
me know.
Act
Underlying Conditions (tick all that apply and specify the disease/condition)
☐
Heart Disease (Cardiovascular Disease)
☐
Diabetes
☐
Cancer – Current or Historical (Malignancy)
☐
Chronic Neurological/Neuromuscular Disease (eg conditions affecting brain or nervous system)
☐
Immunodeficiency (eg HIV or conditions that affect immunity or immune system)
☐
Kidney Disease (eg renal failure, dialysis)
Information
☐
Chronic Lung Condition (conditions that affect lungs or breathing,
including asthma)
☐
Mental Health Conditions (If yes, please specify: _________________________________________________________________)
☐
High Blood Pressure (Hypertension)
☐
Liver disease
Official
☐
Smoker
☐
Pregnancy: Trimester 1 2 3
the
☐
Post-partum (pregnant recently had a baby recent <6 weeks)
☐
Other Underlying Condition or Il ness (please specify ___________________________________________)
under
⇒
[NOTE TO CALLER: If yes to underlying conditions, fol ow red flag actions below:]
⚠
Red Flags- Clinical Risk: Underlying conditions
Be alert for severe shortness of breath at rest, difficulty breathing, pain or pressure in chest, cold, clammy, new confusion, becoming difficult to
rouse, blue lips or face, little or no urine output, coughing up blood, neck stiffness, non-blanching rash.
⇒ If the Case mentions that someone in the household is acutely unwel :
Released
Document Two
⚠
I am concerned about the symptoms that you have mentioned about your householder, can you please stay on the line while I call my
Case Supervisor to DIAL 111 and get Emergency Services to you. I will stay on the line until Emergency Services arrive.
[NOTE TO CALLER: Document your actions and escalations in NCTS Case notes.]
• I now need to go through your daily movements, starting from ________________________________
(infectious period start date) to work out
1982
where you have been and who you have seen. This will ensure we are able to contact trace anybody at risk of infection.
• Have you been using the NZ COVID Tracer App?
Act
⇒
If using the COVID-19 Tracer app: Follow the SOP to upload digital diary to NCTS and use the Bluetooth function. Remember, app
information is only a guide. You wil stil need to systematically work through each day of the Case’s infectious period.
Infectious Period Timeline
Information
⇒
Systematically work through the infectious period and record details against each event. Do not assume that all activities are recorded
in the app – you wil stil need ask who they were with, what activity were they doing, when were they there, where did they go, how
long were they there, and did they do anything else that day that was not recorded.
⇒
Prompts:
•
Was PPE used by Case or Contacts?
Official
•
How much time was spent at location or with contacts?
•
Was there physical contact with anyone?
the
•
Was there any physical distancing?
•
What kind of payment method was used?
•
Did they touch any surfaces?
•
Did they use shared facilities?
under
•
Did they remain in one spot vs moving around?
•
How did they get there?
⇒
Use physical prompts to improve recal : doctors’ appointments, dentists’ appointments, schools, places of worship, shopping, eating
out, banks, malls, gyms, cinemas, markets, stayed at another household. Use bank statements, receipts, and calendars to jog memory,
these can help with dates and times if they paid by card. Encourage them to access data from any app such as from mapping apps
Released
(Google or Apple Maps).
Document Two
Exposure Events & Activity Timeline:
1982
Start and What Was the Event? (Include any key details Any Additional Relevant Who Else Was There?
Act
End Time of including address, how busy it was, what the Case did Information?
Event
while there, etc)
Day -2
Infectious
period
Date:
Information
Official
VENTS
the
EXPOSURE E
under
Released
Document Two
Day -1
Infectious
period
1982
Date:
Act
Information
Official
the
under
Released
Document Two
Day 0
Symptom
onset/swab
1982
date
Date:
Act
Information
Official
the
under
Released
Document Two
Time of
What Was the Event? (Include any key details
Any Additional Relevant Who Else Was There?
Event
including address, how busy it was, what the Case
Information?
1982
did while there, etc)
Act
Day 1
Date:
Information
Official
the
under
Released
Document Two
Day 2
Date:
1982
Act
Information
Official
the
under
Released
Document Two
Day 3
Date:
1982
Act
Day 4
Date:
Information
Day 5
Official
Date:
the
under
Day 6
Date:
Released
Document Two
Day 7
Date:
1982
Act
•
[NOTE TO CALLER: Once the exposure events and activity timeline is gathered, categorise and complete the contacts into the tables
below.]
Information
Official
the
under
Released
Document Two
Other Close Contacts (including workmates, friends, person sitting next to in a bus, anyone within 2 metres of you for
more than 15 minutes)
⇒ I’d like you to help me with the contact details of the people you have mentioned while we were going over your timeline. [
Complete
the table below.]
1982
⇒ If you remember anyone you have been in contact with who we have missed form our list, please let me know.
Act
All your Contacts will receive a call from us to let them know that they have been in contact with someone who has tested positive for COVID-19
and advice that they are required to self-isolate.
Exposure Events: Close and Casual Contacts – anyone that the Case can provide a name for.
•
[NOTE TO CALLER: Use the names from the timeline you created above. Add any additional names as the Case remembers them
Information
Is this the last time
Contact Number
Contact
Exposure Event (include time and
Full Name of
the Case had contact and/or Email and/or
Category (TBD
date)
Contact
with this person?
Address?
Relationship to Case after interview)
Official
the
under
Released
Document Two
Is this the last time
Contact Number
Contact
Exposure Event (include time and
Full Name of
the Case had contact
and/or Email
and/or
Category (TBD
date)
Contact
with this person?
Address?
Relationship to Case after interview)
1982
Act
Information
Official
the
under
• Thank you for assisting me to collect this information.
Released
Document Two
Section 7
Self Isolation Advice
Now I’d like to talk to you about what self-isolation means and the physical distancing you need to do.
1982
⇒
[NOTE TO CALLER: If already self-isolating to the necessary level, record the start date on NCTS Q&A - complete self-isolation
requirements.]
Act
•
Self-isolation is about physical distancing. This means staying 2-metres (body and two arms lengths is a guide) away from others in your
household bubble and having no more than 15 minutes of face-to-face contact with them.
• As much as possible, you should stay in a room by yourself. It should be wel -ventilated (e.g. open windows) but you should keep the
door closed.
• Even if you have no COVID-19 symptoms now you can still develop symptoms from the virus up to 14 days after exposure.
• If you need to go in a car/van for medical assessment, travel alone or with driver only, sitting at the greatest distance possible from the
Information
driver (back seat opposite side to driver). Clean your hands with hand sanitiser and put on a face mask before you leave home.
• It is okay to go into your backyard if you stay 2m away from those in your household bubble. Avoid others when using shared lifts or
stairs in shared living spaces.
• You will need to arrange for shopping/medicine/food to be delivered and left at your door.
Official
•
If you live with other people you need to:
• Wash your hands
often for 20 seconds (guide - sing two cycles
the of happy birthday) before drying your hands thoroughly.
• Always cough or sneeze into your elbow. If you use tissues throw them into your own lined bin or bag. Then wash and dry your hands
well.
• Sleep in a separate bed/or bedroom from others in your home.
under
• Use your own dishes, eating utensils and glass/cups. Wash these items thoroughly using detergent and hot water or place them in a
dishwasher.
• Do not shake dirty laundry as this can disperse the virus through the air.
• It’s ok to wash your dirty laundry with the rest of your household if you do the washing yourself, but you should only fold and put away
your own items. It is best for someone else to fold and put away clean shared laundry items (such as towels and tea towels) and provide
a supply for you.
Released
• If you do not have a washing machine, wait until 72 hours after your isolation period has ended before taking your laundry to a
laundrette.
Document Two
• Always clean all surfaces you touch (phones, computers, tables, door handles) with cleaning product/ disinfectant.
• Use your own toothpaste, soap and toilet paper.
• If using a shared bathroom: Clean the flush button & toilet seat/shower/bath/sink after use.
• Everyone in your household wil need to stay home. We wil be contacting each member of your household to provide them with testing
and isolation advice.
1982
• If anyone in your household becomes unwel , they should arrange to be tested immediately. They should call their local GP, or call
Healthline for advice on testing sites. If they have access to the internet, they can also look up Healthpoint for testing sites in your local
Act
are
a https://www.healthpoint.co.nz/covid-19/.
⇒
[NOTE TO CALLER: Read this section to al Cases.]
• You cannot leave your house without permission from a health professional.
• Healthline will do a daily phone cal check-in with you on your wel being throughout your isolatio
Information n until at least 10 days from when your
symptoms started. You wil need to be symptom-free for 72 hours before you are released from self-isolation. You wil need to wait for
release from self-isolation by a Health Professional.
• All self-isolation information can be found on the Ministry of Health website. Do you have access to the internet? If not, we can post this
information out to you.
Official
the
under
Released
Document Two
Section 8
Health and Welfare Needs Assesment
1982
• I am now going to work through your needs during your isolation period, to see if there are any areas where we can offer some support.
• Some of this may repeat some of the questions we have touched on previously, but it is important that I ask again to be sure.
Act
• If we identify that you need any extra support, we will provide you with information at the end of this call and may need to refer you back to your
local Public Health Unit.
Te Whare Tapa Whā and Wellbeing: Case/Contact Isolation Needs Assessment
Taha Tinana (Physical Wellbeing)
Information
We will start by reviewing any Self-Care Needs you might have.
Are you able to look after yourself independently?
☐ Yes ☐ No
If living with others
Can the other members of your household assist you if you require extra support?
Official
☐ Yes ☐ No
If living with others
Can you be wel separated from other household members in the house?
☐ Yes ☐ No
the
If yes, confirm separate bedroom and/or bathroom.
☐ Separate bedroom
☐ Separate bathroom
Do you (and your household) know what to do if your il ness worsens?
Confirm Answer: Contact GP or Healthline to discuss next steps. If very unwel ,
under
contact Emergency Services on 111.
☐ Yes ☐ No
Do you (and your household) have access to a face mask and know how to use it? ☐ Yes ☐ No
If No: If you do not have access to masks and need to leave the house for an urgent medical appointment, face
covering such as a bandana or scarf are suitable options.
If living with others
Do you understand what we have discussed about hand hygiene and covering coughs and sneezes?
Confirm Answer: Wash your hands regularly for 20 seconds and ensure you sneeze
Released
into your elbow.
☐ Yes ☐ No
Document Two
Do you (and your household) have access to hygiene and cleaning materials?
☐ Yes ☐ No
If living with others
Do you understand what we have discussed about cleaning the surfaces around you,
including kitchenware, bathroom surfaces, and laundry?
☐ Yes ☐ No
If living with others
Do you and your household know what to do if
they develop symptoms?
1982
Confirm Answer: Contact GP or Healthline to organise a test immediately.
☐ Yes ☐ No
• Are you currently taking any medications?
☐
Yes ☐ No
Act
If Yes: Do you have enough supplies enough supplies for your isolation/
recovery period?
☐
Yes ☐ No
•
[NOTE TO CALLER: If not enough supplies]: I advise that you contact your GP and ask them to send your
prescription to your nearest pharmacy and request a non-contact home delivery
Medical
• If you become unwel , please don’t wait - seek medical support or Emergency Services for help.
Support/Emergency
Remember to call them ahead and explain that you are positive for COVID-19 and you are concerned
Services
about your condition.
Information
• Do you require ongoing medical support for any other health conditions?
☐ Yes ☐ No
• Do you have any upcoming urgent medical appointments?
☐
Yes ☐ No
If yes, specify:
Official
•
If Yes: You wil need to contact your health provider and to discuss your next steps.
[NOTE TO CALLER:
Consider referral to local PHU, or remote support services]
the
Safety
• Do you have any mobility difficulties?
☐
Yes ☐ No
• If Yes: Please Specify: _____________________________
under
• If Yes: Do you use any equipment to support with your mobility? Please Specify:
_______________________________
Financial/Income
• Do you see any concerns/chal enges with income while in self-isolation?
☐ Yes ☐ No
Support
Food & Personal Care
• Do you have enough food and personal care supplies available for the period of isolation/recovery?
Supplies
☐ Yes ☐ No
Released
Document Two
• Do you have access to online shopping? ☐ Yes ☐ No
• Do you have support from outside your home to leave food supplies at
your door if needed?
☐ Yes ☐ No
• Food or other supplies need to be delivered contactless; if you do not have internet or a credit card for
online ordering, consider calling your local shops or food banks or rural delivery servic
1982 es.
[NOTE TO
CALLER: Consider referral to local PHU, Meals on Wheels, hospital food services, Welfare Services]
Act
• Do you need any support with meal preparation?
☐ Yes ☐
No
Accommodation and Living Arrangements I would now like to go over your accommodation. Some of this might touch on information we have discussed previously, but I do need
to re-confirm, just to be sure.
Address where
isolating (if different
Information
to previous records)
Do you see any concerns/chal enges to self-isolation? ☐
Yes
☐
No
If yes, please specify: ______________________________________
Official
Do you live in any of the fol owing settings? Read out loud:
☐ Hostel/Institution
☐ Motel/Hotel
the
Can you please re-confirm how many people live in your home with you?
How many bedrooms do you have in your home?
under
How many bathrooms do you have in your home?
Are there shared common areas (e.g. kitchen/dining room/living room/laundry/elevator)?
Does anyone else stay there from time to time? When was the last time they were there? What are their
names/ages?
Released
Document Two
Taha Wairua (Cultural & Spiritual Wel being) I would now like to check on your Cultural or Spiritual well-being. Cultural and Spiritual needs differ for everyone and can range from
religion through to your own personal self-care habits and routines. You may be able to fulfil these requirements individually, or you may
need community support.
1982
Cultural & Spiritual
• Do you need any support to fulfil your religious, cultural or spiritual needs while in isolation?
Wellbeing
☐ Yes ☐ No
Act
• If yes: Do you have remote access to religious, cultural or spiritual services? ☐ Yes ☐ No
• Do you require Iwi support?
☐ Yes ☐ No
If yes, specify: ______________________________________________________
Taha Whānau (Family Wel being) I am now going to check on how your isolation might impact your family and whānau wel -being.
Family Wellbeing
• Do you provide care anyone, child or adult, either within or outside of your household?
Information
☐ Yes ☐ No
If yes, please specify: _______________________________________________
If yes: Is there someone else who can take on that role while you are in isolation?
☐
Yes ☐ No
Official
• Are there any household members who may be at increased risk of complications from COVID-19 or
have any underlying health conditions?
☐ Yes ☐ No
the
If yes, please specify:__________________________________________________________________
under
• Do you have any pets or animals in your household?
☐
Yes ☐ No
If yes: Do you have enough supplies for them during isolation?
☐
Yes ☐ No
If yes: Do you need support to care for your animals?
☐
Yes ☐ No
• Where there's COVID-19 in a household, we recommend animals remain on the property.
Released
Document Two
Taha Hinegaro (Mental Health & Emotional Wel being) I would just like to advise that the fol owing questions are more sensitive in nature. Your answers wil be treated confidentially. We ask
these questions to ensure that you are safe and have the support you need.
1982
Mental Health &
Do you have:
Emotional Wellbeing
Act
• Any mental health conditions that you feel might make it harder to isolate (e.g. anxiety, depression,
bipolar disorder, schizophrenia or any other concerns)?
☐ Yes ☐ No
• Any alcohol or drug dependencies?
☐ Yes ☐ No
• Do you have any concerns or issues that may affect you isolating safely?
☐ Yes ☐ No
If yes, please specify: _________________________________________
• Have you felt threatened or hurt by someone in your home?
☐ Yes ☐ No
Information
• Do you have internet access to remain social y connected with friends and family
while in isolation?
☐ Yes ☐ No
• It is important that you look after yourself. This can be a stressful time for you and your family/whanau.
If you need to talk to someone, text or call 1737, this is a free 24hr
Mental Health Support Line to talk
Official
with a trained counsellor.
• Please remember that nobody except for Emergency Services or approved Health Professionals can
come to the house while you are is
the olating. Friends, family, and tradespeople wil need to wait until you
have been cleared by a Health Professional before they resume visits. If people are bringing you food or
supplies, they should leave it outside the door. Nobody, aside from those already living with you,
should enter your home while you are isolating.
under
• It’s a really good idea to stay connected with friends and family. I recommend staying regularly
connected via video chat and phone calls.
Do you have any
other needs or
concerns?
Released
Document Two
Notes
1982
Act
Information
Official
the
under
Released
Document Two
Section 9
Summarise and Ending the Cal
1982
⇒
[NOTE TO CALLER: Repeat key messages and check their understanding.]
Act
I think we are nearly finished. Do you have any questions about anything we have talked about today?
Just to go over what we have discussed in our phone cal :
1. Regardless of whether you have any symptoms, please stay home and isolate yourself from others in your household;
2. Please inform your employer that you have tested positive for COVID-19;
3. Remember, Healthline will do a daily phone call check-in with you on your wel being throughout your isolation until at least 10 days
from when your symptoms started. You wil need to be symptom-free for 72 hours before you ar
Information e released from self-isolation.
4. Please follow the advice of the person who will be calling you each day;
5. Monitor your symptoms and ensure you remain in isolation until you are released by a Health Professional;
6. If you become unwel , please don’t wait - seek medical support, or contact Emergency Services on 111.
7. Remember to call ahead before visiting a healthcare provider and explain that you are positive for COVID-19 and you are concerned
Official
about your condition;
8. COVID-19 Healthline can be contacted on
0800 358 5453;
9. If you need any help with the cost of living, food, clothing, bed
the ding or loss of livelihood, please call Ministry of Social Development on
0800 559 009. They wil be able to offer you some more information about any financial support you may be entitled to;
10. Please remember that other people cannot come to the house unless it is an Emergency. If people are bringing you food or supplies,
they should leave it outside the door. They should not enter the home;
under
11. I encourage you to stay connected with friends and family via video chat and phone cal s;
12. It is really important that you look after yourself. This can be a stressful time for you and your family/whanau. If you feel overwhelmed
or just need someone to talk to, please text or cal 1737 the free 24hr
Mental Health Support Line to chat with a trained counsellor;
13. I may need to ring you again for more information;
Released
Document Two
We have discussed a lot of information today. I wil send you all this information by email after this phone call,
[NOTE TO CALLER: Or by post if they do not have internet access.]
There is also a lot of advice about COVID-19 on the Ministry of Health website. This is updated frequently so I would encourage you to check
the website regularly;
1982
If you remember any further details that you think wil help us with contact tracing, tell your daily Healthline Caller who will be checking in on
your health and wellbeing throughout your isolation/recovery time, or reply to the email we send through to you.
Act
Thank you for your time, I wish you al the best with your recovery.
Information
Official
the
under
Released
Document Two
Section 10
Post Interview Actions
1982
Personal Details
Age:
Gender:
Act
Ethnicity:
Language:
Occupation:
Communication Support:
Disease Status
☐
Symptomatic
☐
Asymptomatic
Information
Symptoms:
Symptom Onset Date:
Infectious Period Start Date:
Underlying Conditions:
Official
Exposure Events Checklist
☐
Call Household Contacts (Call 3)
the
☐
Review Exposure Events with Supervisor to identify Close and Casual Contacts
☐
With Supervisor, determine which Exposure Events need to go back to the Public Health Unit (specify below)
Exposure Events to go back to Public Health Unit: under
☐
With Supervisor, determine which Exposure Events require further investigation (specify below)
Exposure Events requiring further investigation:
Released
Document Two
Support and Manaaki Needs
☐
Support with Daily Activities
Specify:
☐
Comprehension and Compliance Specify:
1982
☐
Healthcare
Specify:
☐
Mobility
Specify:
Act
☐
Income
Specify:
☐
Food/Groceries
Specify:
☐
Accommodation
Specify:
☐
Cultural/Spiritual
Specify:
☐
Family/Whānau/Animals
Specify:
☐
Mental Health/Safety
Specify:
☐
Other
Specify:
Information
Other Information
Official
Does the Case need to be referred back to the Public Health Unit?
☐
Yes ☐
No
Does the Case need to be provided with GP information?
☐
Yes ☐
No
the
Does the Case need to be called back for any further information?
☐
Yes ☐
No
Does additional information need to be included in the email to the Case?
☐
Yes ☐
No
If yes, please specify: ______________________________________________________________________
under
Action Plan/Next Steps:
☐
1
☐
2
☐
3
Released
Document Two
☐
4
☐
5
☐
6
1982
Case Interviewer signature:
Name:
Date:
Act
Case Supervisor signature:
Name:
Date:
⚠
Red Flags- [NOTE TO CALLER: Discuss any complex needs with Case Supervisor at the end of the Case Interview]
Information
Official
the
under
Released
Document Two
Section 11
Important Contact Numbers
1982
Who
How
For
COVID-19 Health Line
0800 358 5453 OR
Act
+64 9 358 5453 (for international cal s)
Health advice and information
0800 559 009
Income, Food, Clothing, Living costs,
Ministry of Social Development
www.workandincome.govt.nz/covid-
Financial help, Wage subsidy while in
19/index.html
self-isolation
Mental Health Support Line (Need to Talk)
Call or Text 1737
Mental health, Wellbeing, Counselling
Mental health, Wellbeing, Counselling
Youthline
0800 376 633
www.youthline.co.nz
Information
Alcohol Drug Helpline
0800 787 797 or text 8681, 24 hours a day, 7
days a week
Alcohol and Drug Counselling, Wellbeing
Rural Support Trust
0800 RURAL HELP
Mental health, Wellbeing, Counselling
Consulates for overseas visitors
www.mfat.govt.nz/en/embassies/
Official
Consular advice
Information for all travellers,
student visa holders, migrant
www.immigration.gov
the t.nz/about-us/covid-19 Visa advice
workers.
Official Government websites [if they have internet access]
www.health.govt.nz – you can search for “Caring for yourself and others who have, or may have, COVID-19 at home” to find information
about how you are to self-isolate.
under
Released
Document Three
National Investigation and Tracing Centre
1982
Investigation of a COVID-19
Act
case: Quality Framework
Information
August 2020
Official
the
Ministry of Healt
under h
Released
Document Three
Acknowledgements
The Ministry of Health would like to acknowledge the individuals who have contributed to the
development of this Quality Framework. This document was initially drafted by the New Zealand
Ministry of Health in collaboration with a Public Health Unit Advisory Group, established in May 2020,
as part of the COVID-19 response. This group was facilitated by Toby Regan and Anita Frew at the
Ministry of Health.
Dr Catherine Jackson
Public Health Medicine Specialist/Medical Officer of Health, Northland
Public Health Unit
Julie Ritchie
Charge Nurse, Health Protection Team, Auckland Regional Public Health
Service
Dr Richard Hoskins
Public Health Medicine Specialist/Medical Officer of Health, Waikato
Public Health Unit
Grant King
Health Protection Officer/Drinking Water Assessor, Toi Te Ora Public
1982
Health, Bay of Plenty + Lakes Districts
Stephen Layne
Health Protection Team Leader, Toi Te Ora Public Health, Bay of Plenty
+ Lakes Districts
Act
Maree Rohleder
Team Leader Health Protection, Hauora Taupori Population Health, Te
Puni Tūmatawhānui, Hawkes Bay District Health Board
Dr Sharon Sime
Public Health Medicine Registrar, Regional Public Health
Liz Macdonald
Clinical Nurse Specialist, Disease Control & Well Homes Team, Regional
Public Health
Helen Graham
Team Leader, Protection Team, Community and Public Health,
Canterbury District Health Board
Information
Dr Susan Jack
Public Health Physician, Medical Officer of Health, Clinical Director,
Public Health South
Lou Oldham
Communicable Disease Nurse, Public Health South
Terms and Abbreviations
Official
The following terms and abbreviations are used in this document.
Term
Meaning
the
ARC
Aged Residential Care
DOB
Date of Birth
under
GP
General Practitioner
MOH
Medical Officer of Health
NCCS
National Close Contact Service
NCTS
National Contact Tracing Solution
NGO
Non-Government Organisation
Released
NITC
National Investigation and Tracing Centre
PHMS
Public Health Medicine Specialist
PHU(s)
Public Health Unit(s)
Page 2 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
Contents
Acknowledgements ....... ....... ................................. ....... ............................ ....... ............................. 2
Terms and Abbreviations ........... ....... ............................ ....... ................................. ....... ................ 2
Background . . ............................ ....... ......................... ....... .................................... .... ........................ 4
Case investigation and contact tracing .. ....... ................................. ....... ............................ ....... ........ 4
Provisional COVID-19 disease indicators ............. .............. ....... .................... ....... ............................ 5
About this Quality Framework ...................... ....... ......................... ....... ............. .............. ....... ........ 5
Tools ................... ....... ............................ ....... .................................... .... ............................ ....... ........ 6
Quality Standards for Case Investigation of a COVID-19 Case .. ................................. ....... ................ 7
1.
Planning and partnerships ..... .... ............................ ....... ......................... ....... ............. .......... 7
1982
Standard 1.1 ............... ....... .................... ....... ......................... ....... .................................... .... ... 7
Standard 1.2 ............... ....... .................... ....... ......................... ....... ....................................
Act ....... 7
Standard 1.3 ............... ....... .................... ....... ......................... ....... .................................... .... ... 7
2.
First contact ........................ ....... ............................ ....... ................................. ....... ................ 8
Standard 2.1 ............... ....... .................... ....... ......................... ....... .................................... .... ... 8
3.
Case details/first assessment . .... ....... ............................ ....... ......................... ....... ............. .. 9
Standard 3.1 ............... ....... .................... ....... ......................... ....... .................................... .... ... 9
Information
4.
Identify source events ................. ....... .................... ....... ................................. ....... .............. 10
Standard 4.1 ............... ....... .................... ....... ......................... ....... .................................... .... . 10
5.
Identify spread .................... ....... .................................... ....... ......................... ....... .............. 11
Standard 5.1 ............... ....... .................... ....... ......................... ....... .................................... .... . 11
Official
6.
Contact identification .... .................... ....... .................... ....... ......................... ....... .............. 12
Standard 6.1 ............... ....... .................... ....... ......................... ....... .................................... .... . 12
the
7.
Isolation/quarantine requirements ......... ....... ............................ ....... ................................. . 13
Standard 7.1 ............... ....... .................... ....... ......................... ....... .................................... .... . 13
8.
Health and welfare advice ..... .......... ................. .... .................... ....... ............................ ...... 14
under
Standard 8.1 ............... ....... .................... ....... ......................... ....... .................................... .... . 14
9.
Close out interview and explain next steps .................................. ....... ................................. . 15
Standard 9.1 ............... ....... .................... ....... ......................... ....... .................................... .... . 15
10.
Actions following interview .... .................... ....... ............................ ....... ........................... 16
Standard 10.1 ............. ....... ............................ .... .................................... ....... ........................... 16
Released
11.
Quality assurance and audit . ................. .... ............................ ....... ................................... 17
Standard 11.1 ............. ....... ............................ .... .................................... ....... ........................... 17
Standard 11.2 ............. ....... ............................ .... .................................... ....... ........................... 17
Appendix 1: Case investigation in the disease pathway . .......... .............. ....... .................... ....... ...... 18
Appendix 2: Detailed components of a case investigation .. .................... ....... .................... ....... ...... 19
Page 3 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
Introduction
Background
The four key pillars of Aotearoa New Zealand’s overall public health strategy for responding to COVID-
19 are border control, robust case detection and surveillance, effective case investigation and contact
tracing, and strong community health measures. Case investigation and contact tracing, along with
other health measures including isolation and quarantine, are evidence-based measures shown to
reduce morbidity and mortality associated with COVID-19.
It was recognised early during the COVID-19 pandemic that Public Health Units (PHUs) would need to
increase capacity for case investigation and close contact tracing, often at very short notice. To provide
contact tracing support for the PHUs, the National Close Contact Service (NCCS) was established by
the Ministry of Health (the Ministry) in March 2020. To manage large numbers of case investigations,
1982
PHUs will need the ability to handover or delegate some case investigation work to either other PHUs
or the Ministry if they become stretched beyond local capacity. The Ministry has since extended the
Act
scope of the support available to PHUs to include case investigation as well as centralised close contact
communication and follow-up services as required through the National Investigation and Tracing
Centre (NITC).
It is fundamental that all services involved in case investigation for COVID-19, complete the process
to the same standard and in a consistent manner to allow for a seamless handover between the
providers involved. To support the delivery of a high-quality process across all elements of case
investigation, the need for a quality framework was identified. This framework and quality standards
are designed to guide the development of regional policies and procedures which suit the different
Information
PHUs and their communities but still allow for work to be shared between different providers.
Quality is not a static concept. Rather, providers should continuously work to generate and maintain
a high-quality service and the organisational culture should reflect this. This Quality Framework is
intended to lead to a greater consistency of practice for the case investigation process. While the
Official
framework is focused on COVID-19, it is envisaged that in the future it may be widened to include
other communicable diseases.
These quality standards should be adhered
the to at all times except if, during an COVID-19 outbreak,
the Director of Public Health or the Director-General of Health issue a directive that overrides one
or more of these standards. In such situations, specific directions by the Director-General of Health
take precedence over these standards.
under
Case investigation and contact tracing
Case investigation and contact tracing are fundamental components in the response to eliminating
COVID-19 within Aotearoa New Zealand. Case investigation, contact tracing and other public health
measures (eg, quarantine, isolation, physical distancing and the wearing of face masks) are evidence-
based strategies which are shown to reduce the morbidity and mortality associated with the virus.
The aim of case investigation and contact tracing is to prevent potential onward transmission, raise
Released
awareness about the disease and its symptoms, and support early detection of suspected cases. Case
investigation contact tracing and ongoing management are existing practices traditionally performed
by PHUs to manage infectious notifiable diseases.
The high-level steps in these processes are:
1. Case investigation and management
informing a case of their diagnosis, directing them to isolate/quarantine and providing
them with health and welfare advice
determining where a case got their infection from (source)
Page 4 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
identifying who else a case could have potentially exposed (contacts)
following up daily with a case until they are released from isolation/quarantine
(management)
2. Contact tracing
contacting potentially exposed individuals (close contacts), advising them to
isolate/quarantine and providing them with health and welfare advice
communicating daily with close contacts to check if they are developing symptoms. If
close contacts become symptomatic with clinical signs consistent with COVID-19, they
should have a clinical assessment/test to determine if they have become a case.
The identification of contacts is a component of the case investigation process and is therefore
covered by these standards. However, it should be noted that processes that occur prior to case
investigation, as well as the subsequent process of contact tracing and daily management, are
currently outside the scope of these standards.
1982
For a diagram of where case investigation fits in the disease pathway, refer to Appendix 1.
Act
Provisional COVID-19 disease indicators
The Ministry has developed ‘Provisional Covid-19 contact tracing indicators’ which provide an end-to-
end view of Aotearoa New Zealand’s public health response to COVID-19. These indicators are used
for initial reporting and monitoring across the COVID-19 disease pathway, including case investigation.
The expectation is that these indicators will evolve in the short to medium term as more is learnt about
both the virus and the process of case investigation and contact tracing from a monitoring perspective.
Information
Throughout this document there are some references to timeliness (eg, prompt, timely) which do not
have an associated national indicator that defines a specific timeframe for completion of the task. It
is expected that providers will have a local understanding of what is considered an acceptable
timeframe in these situations to ensure that both they and any downstream service(s) are able to
meet any indicators with defined timeframes.
Official
The quicker the response, the lower risk of onward transmission.
the
About this Quality Framework
This Quality Framework is the first step in supporting the delivery of a high-quality case investigation
process to a national standard.
The Quality Framework is based aro
under und 11 agreed quality standards that capture the most important
aspects of a high-quality COVID-19 case investigation. Each standard has several elements that provide
more specificity around what is required to meet that standard. A list of supplementary support tools
is also provided for each standard. The figure below illustrates this relationship.
•Tools
Element
•Related
indicators
Released
•Tools
Standard
Element
•Related
Standard
indicators
•Tools
Element
•Related
indicators
Page 5 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
Where PHUs are mentioned throughout this Quality Framework, it is acknowledged that the standard
or element also applies to the Ministry, should they be needed to carry out case investigations if case
numbers are such that the capacity of PHUs is exceeded.
In addition to the quality standards, PHUs and the Ministry have other obligations, including under Te
Tiriti o Waitangi/Treaty of Waitangi, recognition of and adherence to health legislation, and any
legislation related to the privacy of health information.
Tools
A range of tools have already been developed at different PHUs to assist with the case investigation
process. While specific guidance, forms and documents are noted for each standard and included in
Appendix Two, each PHU should consider their own circumstances to determine what they already
have available, or what they may need to develop, to ensure case investigations are carried out to the
required standard.
1982
The Ministry is not mandating the use of any of these, they are suggestions only and aimed at
streamlining processes wherever possible.
Act
It was originally intended to include a national ‘case investigation form’ as part of this work. However,
due to the need to frequently review and update the form to ensure it remains aligned with the
process, it is not included in this document but will be released as a separate national tool.
The suggested tools listed have been identified as already existing in some or all PHUs around the
country and are mentioned for information only. Except for the National Contact Tracing Solution
(NCTS), additional tools are not being mandated by the Ministry for national use at this stage. Any
existing national tools and/or processes related to the EpiSurv Case report form or database also
remain unchanged by this Framework.
Information
Official
the
under
Released
Page 6 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
Quality Standards for Case Investigation of a COVID-19 Case
1.
Planning and partnerships
Standard 1.1
Partnership approaches with Māori and other communities must be
established. It is essential that these relationships are in place prior to
disease events occurring as speed of response is a critical aspect of
investigations.
Element 1.1.1: Operational relationships with Māori/iwi and Pacific agencies are
in place that can support rapid case investigation and contact tracing.
1982
Element 1.1.2: Operational relationships are in place with a range of local
agencies, NGOs, ARCs, schools, universities and other learning institutions to
Act
support rapid case investigation and contact tracing.
Element 1.1.3: Local DHBs must have agreements in place to ensure alternative
facilities for isolation/quarantine are available to support those that cannot
safely isolate/quarantine at home.
Standard 1.2
Technology must be optimised to support interviews being conducted
remotely (by phone, video or email) as appropriate. Clear communication
must be a priority for al cases, including those with disabilities or when
Information
interpreters are required.
Element 1.2.1: Case interviews must be conducted by phone or video cal or
potentially via email (to be considered on a case by case basis).
Standard 1.3
Internal processes and procedures mu
Official st be established and documented
for case investigations.
the
Element 1.3.1: Standard operating procedures must be readily available for al
staff carrying out case investigations, including what to do if they are unable to
contact a case.
Tools
under
Operational policies
Standard operating procedures
Released
Page 7 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
2.
First contact
Standard 2.1
Trust and rapport must be established with the case, information should
be provided around the role of the staff member and their organisation
and the case’s disease status established.
Element 2.1.1: Every case is contacted in a timely manner by an appropriately
trained staff member who is authorised to perform this task under the Health
Act.
Related indicator: Time from Notification to Case Interview within 24 hours
(≥80%)
1982
Element 2.1.2: Every case has their identification confirmed and accurate
contact information recorded.
Act
Element 2.1.3: Every case is given the opportunity to identify as non-English
speaking or as having a disability to enable the most effective communication.
Element 2.1.4: Every case has the right to use an interpreter.
Element 2.1.5: Every case is given the opportunity to discuss their current
diagnosis, health status and is encouraged to ask questions.
Element 2.1.6: Every case is given information on the disease and how it
spreads.
Information
Element 2.1.7: Every case is given the opportunity to identify as one or more
ethnicity(ies).
Element 2.1.8: Every case must be informed of why their information is being
collected, who has access to it and where
Official it will be stored.
Tools
the
Call scripts
Test results
Case investigation form
EpiSurv form
Case checklists
under
Interpreter services
Released
Page 8 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
3.
Case details/first assessment
Standard 3.1
Every case must have their symptoms, the date of symptom onset and any
pre-existing co-morbidities accurately recorded.
Element 3.1.1: Relevant clinical information must be confirmed or obtained from
the case.
Element 3.1.2: Every case who has, or is at high risk of developing, moderate or
severe disease must be referred for further assessment (nurse, MOH and/or
their GP), if required.
Element 3.1.3: Every case must have a health risk assessment undertaken.
(The U
MinistrN
y con D
sider E
s this R
ele
ment to R
be i E
mport V
ant
I
but, basE
e
W
d on feed
back
1982
received, acknowledge that it requires further consultation and discussion prior
to publication and therefore will be managed outside of this version of the
Act
Quality Framework).
Tools
Call scripts
Comorbidities checklists
EpiSurv form
Escalation processes
Referral forms for GPs
Information
Official
the
under
Released
Page 9 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
4.
Identify source events
Standard 4.1
Details around a likely source of infection (person or possible
premises/event) that may have led to the case contracting the disease
should be established and recorded (source events).
Element 4.1.1: Every case must have a history of activity and contacts recorded
for the 14 days prior to becoming ill (the incubation period) to aid identification
of the likely source of their infection (source events).
Tools
Call scripts
Data records from apps
Activity History forms
1982
Act
Information
Official
the
under
Released
Page 10 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
5.
Identify spread
Standard 5.1
Exposure event(s) where the case may potential y have infected other
people wil be promptly identified and recorded.
Element 5.1.1: Every exposure event in the 2 days prior to developing symptoms
and whilst still infectious must be identified.
Refer to the Ministry’s guidance for the onset date of asymptomatic cases.
Element 5.1.2: Every exposure event is recorded including venue, time, date and
for travel related event the relevant travel information.
Element 5.1.3: Exposure events that have contacts which are unknown to the
case will be further investigated by the investigating agency, except for flights or
1982
intercity buses that have allocated seat numbers who will be referred to the
NITC for identification and follow up.
Act
Tools
Call scripts
Data records from apps
Activity History forms
Information
Official
the
under
Released
Page 11 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
6.
Contact identification
Standard 6.1
People who have been exposed, or potential y exposed, to the case wil be
identified and appropriately evaluated in a timely manner.
Element 6.1.1: Every exposure event must be discussed with a case to identify
potentially exposed people (contacts).
Element 6.1.2: Every known contact must be evaluated and classified by the
case investigator as either close or casual contacts, according to exposure risk.
Element 6.1.3: Names, DOB or estimated age, occupation and contact details of
known close contacts must be accurately recorded in the NCTS.
Element 6.1.4: 80% of close contacts must be entered into NCTS within 2 hours
1982
of the identification of the close contact and either advanced to follow up or
forwarded to NITC for action.
Act
Tools
Call scripts
Close contact record forms
Definitions of contacts
Decision tools close vs. casual contacts
Fact sheets
Email template regarding contacts for cases to complete Information
Official
the
under
Released
Page 12 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
7.
Isolation/quarantine requirements
Standard 7.1
Cases wil receive clear communication on direction to isolate/quarantine.
Element 7.1.1: Every case is clear about the expectation to isolate/quarantine
and is given instructions and resources on how to do so.
Element 7.1.2: Consideration must be given to every case regarding the safety of
their intended isolation/quarantine location. Safety may refer to either their
own personal/physical safety, the safety or health of others around them or
both.
Element 7.1.3: Every case must have an assessment of adequate space for
isolation/quarantine based on the number of people and bedrooms in their1982
household.
Element 7.1.4: A case who cannot safely isolate/quarantine at home must be
Act
offered an alternative facility by the investigating agency in accordance with
local DHB arrangements (the person may be required to isolate/quarantine in a
facility some situations).
Element 7.1.5: Every case is provided with clear advice about caring for self and
protecting others.
Element 7.1.6: Every case must have the criteria for release from
isolation/quarantine explained.
Information
Element 7.1.7: Every case is provided with written advice following the interview
on isolation/quarantine requirements, caring for self and protecting others and
guidance regarding release from isolation/quarantine.
Tools
Official
Fact sheets
Date calculators
the
Follow up emails
Release criteria
under
Released
Page 13 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
8.
Health and welfare advice
Standard 8.1
Additional support requirements must be identified and provided for al
cases who need it while in isolation/quarantine.
Element 8.1.1: Every case will be assessed for any additional health and welfare
support required.
Element 8.1.2: Every case must be given advice about who/how they share their
diagnosis with to mitigate adverse reactions/comments.
Element 8.1.3: Referrals to appropriate services must be made, including Māori
and Pacific providers for relevant populations, if additional needs cannot be
supported by a Case Manager.
1982
Element 8.1.4: Every case is provided with support and culturally appropriate
information in a language of their choice, where possible.
Act
Tools
Welfare forms
Information for employers
Escalation/red flag symptoms
Referral forms for Maori, Pacific or other providers
Interpreter services
Information
Official
the
under
Released
Page 14 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
9.
Close out interview and explain next steps
Standard 9.1
Cases must have al their questions answered, understand what they need
to do and be clear about the next steps before conclusion of the interview.
Element 9.1.1: Every case must be informed they will receive a daily check and
that these may be either physical (visits) or remote (phone, email, app etc).
Element 9.1.2: Every case must be provided with appropriate numbers to call if
they need help or have questions.
Element 9.1.3: Every case must have their understanding checked and
confirmation of their intention to isolate/quarantine should be obtained.
Tools
1982
Release criteria
Phone numbers for support services or questions
Act
Fact sheets
Information
Official
the
under
Released
Page 15 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
10.
Actions fol owing interview
Standard 10.1
Additional post-interview work must be completed thoroughly, in a timely
manner and to a high standard.
Element 10.1.1: Every exposure event(s) must be investigated, and an
assessment made of contacts to establish if they are casual or close.
Element 10.1.2: Every case should be discussed with a supervisor (if deemed
necessary in accordance with local procedures) and/or team to aid identification
of high-risk cases or clusters.
Element 10.1.3: All required notifications and/or referrals to other agencies
(PHUs, Police, the Ministry, GPs) must be made in a timely manner according to
1982
local protocols
Element 10.1.4: Case documentation must be accurate and fully completed
Act
including signatures, dates and times.
Element 10.1.5: Case details must be entered into electronic system(s) in a
timely manner.
Tools
Exposure event records
Decision tools close vs. casual contacts
Definitions of contacts
Information
Follow-up emails/letters/fact sheets
Referral/notification forms for external organisations
Official
the
under
Released
Page 16 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
11.
Quality assurance and audit
Standard 11.1
Documentation requirements must be clear.
Element 11.1.1: Clear guidance around documentation must be established
within organisations: what is needed, what is to be retained and for how long.
Standard 11.2
Processes for regular internal audits of case investigations must be
established.
Element 11.2.1: An internal audit programme must be established local y to
regularly assess the investigating agency’s compliance to these standards and to
enable prompt identification of quality improvements.
1982
Act
Information
Official
the
under
Released
Page 17 of 23
Investigation of a COVID-19 case: Quality Framework
Document Three
Appendix 1: Case investigation in the disease pathway
The diagram below highlights the scope of this document in the disease pathway.
1982
Act
Probable and
Key
confirmed cases
Sick people
isolated/
Sick people
Case
quarantine
monitored
Close
contact
Released from
Finding
International
Symptoms
isolation/
service
arrivals
develop
Information
quarantine
Pre-symptomatic
Symptoms
Test
Positive test
Close contact
Wel people
Well people
(infectious )
develop
undertaken
result returned
PHU notified of case
Case
investigation
reached
isolated/
followed up for
quarantine
14 days
Not a close contact or
Close contact
Official
symptom free and outside
exposure window
resolved
the
under
Released
Document Three
Appendix 2: Detailed components of a case investigation
Component
Tools available
1) Preparation and planning
Operational
policies
Goal: to ensure that partnerships are in place and workable
Standard
solutions available with a wide range of community and
operating
NGO groups to support the rapid case investigation and
procedures
contact tracing functions detailed below. It is essential that
these relationships and solutions are established prior to
disease events occurring as speed of response is frequently
a critical aspect of investigations. This may include but is not
1982
limited to:
Māori, Pacific and other ethnic communities
Act
Aged Residential Care facilities
Local DHBs: particularly Infection Prevention and
Preparation
Control (IPC) and Occupational Health, Māori and
Pacific health managers
Local Ministry of Education contacts, Early Childhood
Council, schools, early childhood facilities, universities
and other learning institutions
Primary Healthcare Organisations
Information
Welfare support agencies
Interpreting services
Isolation/quarantine facilities
Correction facilities
Official
the
under
Released
Document Three
2) First contact
Call scripts
Case
Goal: to develop trust and rapport with case, clarify role of
investigation
the PHU and confirm they are aware of their disease status
form
(positive, probable, under investigation).
Symptom
checklists
Always talk directly to case and not to family members,
unless the case is under 16, or is unable to provide the
information (e.g. too unwell, cognitive impairment) in
which case a family member or health facility staff may
be appropriate
Ascertain if an interpreter is required
Introduce the PHU employee
Confirm that you are talking to the correct person
1982
Inform the case of the reason for the call including what
will be discussed and the role of the PHU
Check whether the case is aware that they have tested
Act
Case interview
positive for COVID-19 and if not inform them of their
results and what this means
Ask after their health (may be asymptomatic)
Provide an opportunity for the case to ask questions
Give brief overview of what will be discussed in the call:
o contact and health record details
o basic information about the disease
o how they may have gotten sick/infected
Information
o why it is important to trace contacts
o who else may have been exposed
o isolation advice and protective measures
o access to welfare support
Official
3) Case details/first assessment
Call scripts
Co-morbidities
Goal: to obtain details of current illness/symptoms
checklists
the
including onset, past medical history, demographic and
Symptom
contact information, and undertake a health risk
checklists
assessment.
EpiSurv forms
Criteria for
under
Establish date/time of onset of first COVID-19 related
escalation to
symptoms. Document all symptoms and any change in
MOH or GP
symptoms or severity over course of illness
Confirm name, address, contact information, ethnicity,
occupation (identify if high risk occupation) and GP
name and contact details
Identify any chronic symptoms, comorbidities,
Case interview
medication, smoking, alcohol and drug use. Highlight
Released conditions that impact risk assessment (e.g.
immunosuppression, cardiac disease) and decision-
making regarding release from isolation (history of
smoking, asthma, hayfever, chronic cough)
Perform risk assessment (consider referral of people at
high risk of moderate to severe disease to primary care).
Identify red flag symptoms that indicate an urgent
clinical review is required.
Document Three
4) Source identification
Use data from
apps
Goal: to identify case’s potential source of infection with
History forms
COVID-19 in the 14 days prior to onset of symptoms.
14/7 prior
Contact
Determine whether case has had contact with anyone
definitions close
with COVID-19 (either close or casual contact)
vs. casual
Obtain details of places visited, events attended, and
NCTS: create
Case interview
people interacted with on each of the 14 days prior to
exposure event
symptom onset
Obtain details of any travel (e.g. planes, trains, taxis
buses, ferries)
5) Exposure events and contact identification
Call scripts1982
Close contact
Goal: to identify all close contacts, who may need to need
record sheets
to be isolated or quarantined. This includes recording
Activity History
Act
details of all venues or situations where other people could
forms
have been infected (exposure events).
Fact sheets
Identify venues, premises and travel e.g. flight
Contact
undertaken by case during their infectious period
definitions close
o International flights: be clear about dates
vs. casual
(departure vs. arrival)
NCTS: create
Systematically work through each of the exposure
exposure event
events to identify individual contacts at each event or
NCTS: create
Information
location; transport where close contacts had al ocated
Case interview
close contact
seating such as aeroplanes and intercity buses should
NCTS: Finders
be forwarded to NITC for identification
Service
Gather enough information to determine the risk to
those contacts (close contact or casual contact)
Official
Collect names, DOB (or an estimate of age) and contact
details, for all close contacts exposed to case during
their infectious period (i.e. 48 hours prior to symptom
the
onset up until the case was isolated)
6) Isolation/quarantine requirements
Call scripts
Fact sheets
Goal: to ensure that t
under he case understands the requirements Date calculators
for isolation/quarantine.
Criteria for
release
Provide details of isolation/quarantine requirements and
how decision will be made about when to release them
Check number of people in household and number of
bedrooms (as a signal of overcrowding and ability to
Case interview
isolate/quarantine at home)
Released
Ascertain whether the case is able to isolate/quarantine
safely in their current location
Confirmation of intention to isolate/quarantine
Document Three
7) Health and welfare needs
Call scripts
Fact sheets
Goal: to determine if any additional health or welfare
Welfare forms
supports are required while in isolation/quarantine.
Ascertain whether case has any welfare needs whilst in
isolation/quarantine (e.g. food, income, social support,
sick leave)
Confirm that their welfare needs are able to be
addressed and if not reassure that referrals will be made
to the appropriate services
Provide health advice – caring for self, protecting others
Case interview
o how to access support for physical and mental
health
1982
o call GP or Healthline for any health needs
o number to call for mental health support
o information about COVID-19 and red flag
Act
symptoms that require urgent clinical review
and advise case to cal ambulance if these
occur.
8) Close out interview and explain next steps
Call script
Call checklist
Goal: to wrap up interview and ensure that the case has all
Fact sheets
questions answered and to advise on the next steps.
Daily check-in
emails/call
Information
Opportunity for questions
scripts
Inform case of daily check-ins
Who and when to call for help
Check understanding regarding isolation/quarantine
Case interview
and when it ends
Official
Outline the next steps in follow up – our contact tracing,
including efforts to maintain privacy whenever able, the
potential need to reconta
the ct case etc.
9) Actions following initial interview
Call checklist
Discuss case with team leader or supervisor, if required
Referral forms
dependent on staff member carrying out interview
GP letter
under
Facilitate urgent clinical review by GP if required based
template
on identification of current red flag symptoms or
Follow-up email
underlying conditions
template
Send a fol ow up email to patient summarising
ing interview
NCTS/EpiSurv
information covered in interview with links to
access
information sources
Complete any referrals needed to address additional
Released health and welfare needs
Actions folow
Complete, sign and date al hard copy documentation
Enter information into IT system(s) in a timely manner,
including EpiSurv.
Document Three
10) Additional investigations following call
Clinical
Definitions of
Goal: to undertake additional investigations to identify
Close and Casual
close contacts that the case could not personally identify.
Contacts
Decision tools
Obtain any additional information that is required to
around
detail exposure events and or close contacts
escalation and
tion
Contact premises and venues to obtain lists of potential
which patients
close contacts
to trace
Obtaining lists of potential close contacts, including
Referral forms
details of flights to forward to NITC for further
for external
investigation; transport where close contacts had
agencies
allocated seating such as aeroplanes and intercity buses
Further investiga
should be forwarded to NITC for identification
1982
Evaluate exposure events and identify any close
contacts vs. casual contacts
Refer in a timely manner as necessary to other
Act
investigators and or agencies if assistance is required
with these investigations.
Information
Official
the
under
Released
Document Outline