COVID-19

Links to COVID-19 information and resources are on this web page, informed by our regular contact with Government agencies including the Ministry of Health, ACC and Physiotherapy Board of New Zealand. For the most current and accurate information please refer to Government websites. All PNZ member emails on COVID-19 are available here.

Please note this is a summary of current guidance as we understand it and not a substitute for legal advice. Please seek advice from a lawyer should you wish to understand how the rules apply to your specific circumstances.


Updated 19 January 2022

COVID-19 Protection Framework (Traffic Lights)

All of New Zealand is in the COVID-19 Protection Framework also known as the traffic light system. Please visit covid.govt.nz for regional traffic light settings and review dates. A public health order regarding the protection framework is available at legislation.govt.nz, with the Ministry of Health (MoH) providing a guidance statement and flowchart for allied health professionals operating in the framework.

Operating through the COVID-19 Protection Framework

Physiotherapists can operate through the protection framework at all traffic light settings. The MoH guidance statement notes that physiotherapy is exempt from the heath order and “exempt health services can continue to operate and are still required to meet certain requirements, including requirements to display QR codes, maintain contact tracing records. In addition to the requirements specified in the Order, infection prevention control precautions remain the primary mechanism to protect yourself and the people you see.”

Requiring vaccination certificates

The MoH guidance statement also identifies “to ensure that New Zealanders can access essential health services, a more limited subset of health services are prohibited from requiring vaccination certificates or vaccination. These health services must not deny access to premises or provision of goods and services on vaccination grounds. The health services that are subject to this prohibition are health services that are partly or wholly funded by certain government entities” and include ACC.

Members are advised to be familiar with the MoH flowchart to determine how to operate through the framework regarding requiring vaccine certificates from patients. We understand this means you cannot now ask vaccination status. You can screen for COVID symptoms and risk.

Practices co-located in premises requiring a Vaccine Pass

Clause 33 of the Health Order specifies that people need to have access to health services without being asked their vaccination status. Following ongoing advocacy from PNZ and Exercise New Zealand, MoH has provided a letter clarifying clause 33 of the COVID-19 Protection Framework. This identifies that clause 33 would “allow access to a designated premise through somewhere that is otherwise requiring CVCs to operate”, noting that “there should be reasonable systems and processes in place to ensure that it is only the designated premise being accessed”. Exercise New Zealand have also published guidance for exercise facilities operating in the traffic light system.

We’ve been working with local government on clarity for access to physiotherapy practices based in fitness facilities including Council gyms and pools. A message has gone to all local government Councils confirming that access to physiotherapy practices must be provided to all people without requiring a vaccine pass as part of the Council responsibilities. Please check with your local Council for further guidance on this.

Risk Assessment and Personal Protective Equipment (PPE)

An MoH risk assessment and categorisation matrix of healthcare workers exposed to COVID-19 at work is available here, providing a framework to help identify the potential risk of COVID-19 exposure, factors that contribute to this and steps to mitigate or manage these risks.

MoH also has guidance on Infection Prevention and Control (IPC) practices and PPE in health and disability care settings for COVID-19 available at health.govt.nz. This includes advice on patient COVID-19 IPC risk assessment and a risk assessment table on PPE selection to protect primary and community health and disability care workers.

The Royal New Zealand College of General Practitioners (RNZCGP) have guidance on streaming patients with symptoms suggestive of respiratory infection and principles of care for unvaccinated patients. While RNZCGP have written this information for general practitioners it may be helpful to members.

COVID-19 Vaccine Booster

With the COVID-19 Health Order regarding vaccinations being amended in January 2022, we are working to confirm the details of this amendment including when physiotherapists and other health workers covered by the Order will be required to have COVID-19 booster shots. We will keep members updated as more information becomes available.

Further detail

This Order means that physiotherapy premises can operate regardless of the traffic light setting in your region. Because all practitioners and staff at the physiotherapy service are vaccinated the risk of COVID transmission is considered low regardless of vaccination status for patients.

A PNZ hosted webinar on delivering physiotherapy under the COVID-19 Protection Framework with law firm Duncan Cotterill and insurance partners BMS is available here, with further guidance in our COVID-19 member emails.


COVID-19 Vaccination

Please read details of the Government COVID-19 vaccine strategy, the COVID-19 Public Health Response (Vaccinations) Amendment Order and PNZ Position Statement on COVID-19 Vaccination for Physiotherapists. Further resources and guidance from the Ministry of Health (MoH) on COVID-19 vaccines are below.

Research Review have also published an article on vaccine misinformation discussing how this can undermine vaccine confidence and evidence-based strategies for countering vaccine hesitancy.

Do physiotherapy employees need to be vaccinated for their work?

A COVID-19 Public Health Response (Vaccinations) Amendment Order came into effect on 25 October 2021 requiring health, education and corrections staff to be vaccinated for COVID-19. MoH have collated a guidance document for Persons Conducting a Business or Undertaking (PCBUs) and workers about the Order, including the process for reviewing vaccination status and guidance for managing staff who are unvaccinated.

How is a vaccination an exemption granted?

A suitably qualified medical practitioner or nurse practitioner (the applicant) may apply on behalf of a person that the Order applies to and who is not vaccinated. The application may only be on the grounds that the person meets the specified exemption criteria. That application is submitted to the temporary medical exemptions panel run by the Ministry of Health. Read more here and for questions please contact healthorders@health.govt.nz.

Can physiotherapists administer COVID-19 vaccinations?

General Practitioners, nurses and pharmacists are the first vaccinators. If there is a greater need than this then recently retired GPs, nurses and pharmacists will be Tier 2. Physiotherapists may be called in as part of a surge workforce if additional capacity is required. Physiotherapists who take up this training would expected to be those who are already competent in injections, within current scope.

MoH have paid and volunteer opportunities available in various locations as part of the COVID-19 vaccination workforce, including administration, vaccination, and support and liaison roles. Applicants can specify how far they’re willing to travel for work, and the days and hours they're available, by registering at health.govt.nz.

The Physiotherapy Board has noted that being a vaccinator is within the General Scope of Practice. Therefore, you must be registered, hold a current APC and have completed the vaccinator training. There is also a position statement on New Zealand registered physiotherapists practising in a defined field outlining when a physiotherapist is deemed to be competent in an area of practice.

The vaccine rollout is being run through DHBs and Public Health Units. Our experience to date is there is much regional variation in this interpretation and we are continuing to advocate for certainty in this space. The path to become vaccinators is also delegated to DHBs and therefore variable around the country. Please check your DHB website for more information.

Will the current BMS insurance cover this modality?

BMS have confirmed that COVID vaccination is included the PNZ scope of practice, list of modalities, on the basis the physiotherapist has evidence of completing the approved COVID vaccinator training. If your employer requires evidence of you having personal indemnity insurance prior to working as a vaccinator please contact BMS on 0800 999 267 or email pnz@bmsgroup.com.

Will District Health Boards provide insurance cover for vaccinators?

If a physiotherapist is taking on a vaccinator role for the MoH or a DHB, MoH has advised that the determination of personal indemnity insurance cover will be on a DHB by DHB basis. Physiotherapy vaccinators should check with their DHB as to whether the DHB is carrying the insurance to cover vaccination staff. If your DHB does not provide indemnity insurance cover and you are required to show evidence of personal indemnity insurance prior to delivering vaccinations please contact BMS.


Business Support

The latest Government information for businesses is available at business.govt.nz including a summary of financial support. A COVID-19 Business Helpline, 0800 500 362 (North Island) or 0800 505 096 (South Island), is also available to provide support and advice.


    Employee Travel

    Employers should consider how they will handle international travel for staff when there is the potential for COVID-19 travel restrictions to occur. To help with this MoH has COVID-19 advice for international travellers.


    Further Guidance for Physiotherapists

    Many thanks to the Cardio-Respiratory Special Interest Group (CRSIG) who have worked to develop Respiratory Physiotherapy Guidelines for Managing Patients with COVID-19 Infection. These provide guidance for the use of PPE in aerosol generating procedures during respiratory physiotherapy and rehabilitation of patients with compromised health.

    The PNZ Paediatric Special Interest Group also have guidance for physiotherapists working in schools.

    If you haven’t already please subscribe to the MoH Health Workforce Sector Updates. PNZ has a webpage with COVID-19 Business Information and FAQs that you may find helpful. This includes information on Government financial support.


    Frequently Asked Questions

    Answers to some of our COVID-19 member queries are available at pnz.org.nz. These have been developed with the Physiotherapy Board to cover a range of topics including telehealth, face masks, QR codes and insurance, and are intended to complement Ministry of Health guidance.


    Telehealth

    PNZ guidelines for telehealth treatment through COVID-19 are available here. ACC sent a message to physiotherapists in August 2020 notifying recipients that telehealth provisions remain in place for most services at all COVID-19 alert levels, with more information on their website. Other ACC provider COVID-19 email updates are available here.


    Mental Wellbeing

    The covid19.govt.nz website offers advice for looking after your mental wellbeing,  Te Pou o te Whakaaro Nui have resources to help you cope with COVID-19 and the Mental Health Foundation of New Zealand have a web page on looking after mental health and wellbeing during COVID-19. This includes free call and text numbers to speak with a trained counsellor. Please look after the wellbeing of you and your whānau.


    Events

    If you're hosting events please refer to covid19.govt.nz or contact pnz@physiotherapy.org.nz for current advice.


      NZ COVID Tracer App

      NZ COVID Tracer supports this by creating a digital diary of the places you visit. More about the app is on the MoH website and business.govt.nz has information for businesses.


      Older Adult Super Seven Strength and Balance Exercises

      In response to COVID-19, a team of DHB clinical leaders identified a need for an exercise programme designed to be done safely at home for older adults known to community services. Collated by Liz Binns and Denise Taylor (AUT University), with input from Ricky Bell (Waikato Institute of Technology), John Parsons (The University of Auckland) and a number of DHB colleagues, the Super Seven Strength and Balance Exercises are available here.


      Personal Protective Equipment (PPE) Suppliers

      Please follow the Ministry of Health guidance on the use of PPE. If you are looking to purchase PPE Whiteley Allcare are long-time supporters of PNZ and the physiotherapy profession. Please visit allcare.co.nz or email sales@allcare.co.nz.


      Rehabilitative Interventions in COVID-19 Survivors 

      This document provides an expert-based opinion on Early and Short-Term Rehabilitative Interventions (After the Acute Hospital Setting) in COVID-19 Survivors. Please note that this is a living document published fortnightly. Information is contained in the document about how input from peers can be sent to the group.


      Additional funding available to support the wellbeing of disabled people including people with health and mental health conditions

      PNZ received the following information from Work and Income in April 2020.

      Kia ora

      The Government has made additional funding available to support the wellbeing of disabled people including people with health and mental health conditions by trying to limit the impacts of anxiety and loneliness during the Covid-19 response. This funding is to enable organisations to continue providing support during alert level 4, alert level 3 and any periods of self-isolation.

      How can the funding be used?

      Organisations can use the funding to:

      • employ additional staff to provide regular support to disabled people and their families/whanau. This support can be provided through a variety of channels including face to face (for essential service providers and following Ministry of Health Guidelines) email, Facebook, texts or phone calls
      • develop resources to provide activities for people at home. This can include setting up and managing private Facebook groups, developing YouTube videos, video conferencing, creating and sending hard copy activity packs, sending art supplies and supporting the develop of peer support networks. We’ve pulled together some ideas from MSD funded providers and have attached them to this email.

      Who is the funding for?

      Priority will be given to funding organisations supporting disabled people including people with health or mental health conditions who:

      • live alone
      • live with family/whanau
      • are in Contract Board
      • live in a flat; or
      • live in rural or isolated areas

      Funding amount

      If your application meets the funding criteria you will receive a one of payment of $18,500. You may receive more if you are supporting a large number of people in the priority groups. The funding will be paid as a lump sum.

      Reporting

      You will be asked to provide a brief report detailing how you have used the funding in early July.

      How to apply

      Complete the application form and send it to participation_inclusion_services@workandincome.govt.nz. We will review your application and get back to you if we need more information.


      Cardio-Respiratory Special Interest Group (CRSIG)

      The PNZ CRSIG issued the following statement in April 2020 relating to a video posted by News Hub/The Herald

      Coronavirus: UK doctor offers breathing technique advice to assist in alleviating COVID-19 symptoms. A clip has been shared worldwide over the last few days of a doctor from the UK demonstrating a breathing technique and claiming that it assists in alleviating COVID -19 symptoms. Unfortunately the technique demonstrated in this clip is scientifically inaccurate and for a large percentage of the population it could in fact worsen their respiratory symptoms. The Association of Chartered Physiotherapists in Respiratory Care (ACRPC) of the UK have tweeted that they “are not in support of this technique for COVID-19 as presentations vary dramatically”.  The Physiotherapy New Zealand Cardio-Respiratory Special Interest Group also does not endorse this video or the techniques demonstrated in it. Read the full statement here.

      CRSIG also provided the following resources for all physiotherapists.

      Kia ora,

      As we wait to see how the COVID-19 pandemic will play out in New Zealand, we have an opportunity to ensure we are ready to help out if needed, should we be willing and able to. Being willing is, of course, determined by all manner of considerations, and is a hugely personal decision.

      Being able requires us to have the necessary skills to be competent in either an acute care or rehabilitation capacity. If you have a respiratory background and/or previous ICU experience and are considering helping out and feel you would benefit from upskilling or refreshing your skills here is a selection of relevant information collated by the Cardio-Respiratory Special Interest Group.

      Nga Mihi

      Cardio-Respiratory Special Interest Group Committee

      Physiotherapy in COVID-19 management guidelines

      Open access online cardio-respiratory physiotherapy courses

      The Coronavirus Disease Programme is a 4 part course hosted by Physiopedia and is free to sign up and access for a month.

      1. Introduction to Coronovirus
      2. Infection prevention and control
      3. The role of physiotherapy in COVID-19 and
      4. Respiratory management of people with COVID-19.

      NSW Physiotherapy Virtual Cardiorespiratory ICU Update with focus on physiotherapy in COVID 19 cases is a 2 day recorded audio with PowerPoint and course resources. The purpose is to provide physiotherapy staff with an update in cardiorespiratory physiotherapy practice for intensive care, and planning for potential roles of physiotherapy in the management of COVID-19 patients in this environment. This two day virtual training course provides a refresher and update for physiotherapy staff working in ICUs with increasing cases of COVID-19 and ventilated patients. This course combines key topics from the APA Cardiorespiratory Physiotherapy Level 2 – ICU course and incorporates COVID19 respiratory management based on The Australian and New Zealand Intensive Care Society (ANZICS) COVID-19 Guidelines and COVID-19: Respiratory Physiotherapy On Call Information and Guidance from NHS. Training is best suited to base-mid grade physiotherapists who have prior skills and experience in Intensive Care Units / High Dependency Unit.

      The Clinical Skills Development Service is committed to healthcare improvement through training, collaboration and innovation. It has a number of free online cardiorespiratory physiotherapy courses (as well as other physiotherapy courses).

      Physiotherapy and Critical Care Management is a course run by the Clinical Skills Development Service and is suited to those with a respiratory skill set. PaCCMan contributes to the learning and development of physiotherapists for work in the intensive care environment and expands their knowledge of contemporary, safe clinical practice. It includes practical sessions on assessment and clinical skills, as well as simulated experiences in providing respiratory care and rehabilitation.

      New Zealand Specific COVID-19 resources

      Keep up to date with the latest information from the Ministry of Health and review the information around PPE to familiarise yourself see below.


      World Physiotherapy Resources 

      World Physiotherapy have collated information and resources about COVID-19 for physiotherapists on their website.


      BMS Insurance

      A document from BMS on COVID-19 is available here. Please note the following advice regarding BMS insurance and telehealth services. Telehealth is an acceptable practice provided it’s considered within the scope of your individual practice. Your professional indemnity policy with BMS has a jurisdictional limitation within New Zealand. The policy terms and conditions will still apply in the event of a claim." BMS can be contacted at 0800 999 267 and pnz@bmsgroup.com.


      Online Resources

      The following online resources link to pages from New Zealand and the World Health Organisation. Links are provided to ensure members are directed to the latest information as these pages are updated.

      New Zealand Government

      The Ministry of Health (MoH) – includes advice for health professionals

      The World Health Organisation (WHO)

        ACC

        Information on International Travel

          Translation Service

          • NZTC INTERNATIONAL - The Translation Centre are offering online video and audio interpreting services as an alternative option to face-to-face interpreting. Please contact interpreting@nztcinternational.com.

          Online Courses

          A number of online courses and webinars have become available for physiotherapists at no cost to help the profession through COVID-19. Below are links to a number of these resources. 

          ONGOING COURSES AND WEBINARS

            Physioplus Courses

            Physioplus is providing an online programme of courses on COVID-19 at no cost. The aim of the course is to provide a practicing physiotherapist with the knowledge, practices and skills to allow them to play a proactive role in global and local efforts to reduce the impact of this pandemic. Read more here.

              University of Melbourne PEAK Programme

              In light of the COVID-19 pandemic and the increasing use of telehealth to deliver physiotherapy services, the Centre for Health, Exercise & Sports Medicine at the University of Melbourne has fast-tracked the release of the PEAK (Physiotherapy Exercise and physical Activity for Knee osteoarthritis) programme training modules at no charge. Read more here.

                Cardio-Respiratory Courses

                The Clinical Skills Development Service is committed to healthcare improvement through training, collaboration and innovation. It has a number of online cardio-respiratory physiotherapy courses (as well as other physiotherapy courses). Read more here.

                Physiotherapy and Critical Care Management

                Suited to those with a respiratory skill set, this course contributes to the learning and development of physiotherapists for work in the intensive care environment and expands their knowledge of contemporary, safe clinical practice. It includes practical sessions on assessment and clinical skills, as well as simulated experiences in providing respiratory care and rehabilitation. Read more here.

                RECORDED COURSES AND WEBINARS

                Employer Webinar

                Humankind hosted a webinar for PNZ members on 1 April, outlining employer obligations and options during COVID-19. A recording of the webinar is available here. There are also links to resources discussed in the webinar including COVID-19 considerations for employers, 1737 – free counselling services for New Zealanders and the Mental Health Foundation website.

                Telehealth Webinars

                Dr Angela Cadogan has provided a Telehealth for Physiotherapists webinar for the profession and Dr Mark Fulcher has developed two telehealth consults webinars on Practical Tips to Get You Up and Running and Assessing the Knee. Read more here.

                Physiotherapy Virtual Cardio-Respiratory ICU Update

                This two day recorded audio with PowerPoint and course resources provides physiotherapy staff with an update in cardio-respiratory physiotherapy practice for intensive care, and planning for potential roles of physiotherapy in the management of COVID-19 patients in this environment. Read more here.


                  Page updated 19 January 2022