protecting yourself and others from coronavirus · health and travel history requirements travel to...

Day Month Date and time of arrival

Place of entry into Designated Biosecurity Area:

Country(ies), States and Territories visited in the past 14 days (please give dates for each):

If by plane If by boat/ship If by road If by rail

Contact details

Accommodation address for the next 14 days

Driver’s licence number

Email

Day Month Date of birth

Nationality (as shown on passport) Name

Flight number Seat number Vehicle Registration Name of Vessel Train number Seat number

COVID-19 (novel coronavirus) - Entry into Designated Biosecurity Areas (Kimberley, East Pilbara, Ngaanyatjarraku) Failure to comply with the Biosecurity (Human Biosecurity Emergency) (Human Coronavirus with Pandemic Potential) (Emergency Requirements for Remote Communities) Determination 2020, made under the Biosecurity Act 2015 (Cth) is an offence punishable by a fine of up to $63,000 for individuals and/or imprisonment for 5 years.

Details of travel

Time : am/pm

Mobile number

You are engaged in (or transporting people engaged in) an Essential Activity that requires you to be in the area (see Definitions section)

You normally reside in the Designated Biosecurity Area and are returning home

For the last 14 days you have: • been isolated from the general public; • not had any Symptoms of human coronavirus (see

Definitions section for details)

You will be transiting through the Designated Biosecurity Area, using the most direct practicable route, without coming into contact with another person

Give details of the situation you have ticked. You may be asked to give further evidence.

You are escaping an immediate threat to your life

You are not allowed to enter the Designated Biosecurity Area unless you and all of the people you are travelling with meet one of the following criteria and you meet the health and travel history requirements outlined on the next page. Tick which situation(s) applies to you and the people you are travelling with.

Restrictions on entry

You are entering the Designated Biosecurity Area from a Designated Biosecurity Area in the Northern Territory or South Australia

If none of these apply to you and you wish to apply for a Special Permission, please complete the attached form

Entry into Designated Biosecurity AreasProtecting yourself and others from coronavirus

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Health and travel history requirements

Travel to remote communities In addition to the restrictions on entry into the Designated Biosecurity Areas, travel restrictions under the Emergency Management Act 2005 (WA) apply to remote Aboriginal communities in Western Australia.

Failure to comply with these restrictions is an offence punishable by a fine of up to $50,000 for individuals and $250,000 for bodies corporate.

These restrictions can be found at: https://www.wa.gov.au/soedeclarations

Your obligations after entering the Designated Biosecurity Area If you normally reside in the Designated Biosecurity Area and are returning home, you will be required to go into isolation for 14 days unless you are engaged in an Essential Activity.

This means:

• You must stay at your home or other accommodation.

• If you live in a private house, you can go into your garden or courtyard. In an apartment or hotel, you can go into the garden but you should wear a surgical mask and move quickly through any common areas.

• Only people who usually live with you should be in the home. Do not see visitors. If you are in a hotel, avoid contact with other guests or staff.

• Regularly clean surfaces that are frequently touched such as door handles, light switches, kitchen and bathroom areas. Clean with household detergent or disinfectant.

• If you are well, there is no need to wear surgical masks at home.

• Ask others who are not in isolation to get food and necessities for you.

• If you develop Symptoms (see Definitions section) while in isolation, you should arrange to see a doctor for urgent assessment. Telephone the health clinic or hospital before you arrive and tell them your travel history. If you must leave home to seek medical care, wear a surgical mask.

Every person entering the Designated Biosecurity Area must take reasonable steps to minimise the risk of transmitting the human coronavirus to other people.

Declaration

This information is required under the Emergency Management Act 2005 (WA) and the Biosecurity Act 2015 (Cth). The provision of false or misleading information may constitute an offence punishable by a fine or imprisonment.

This information is collected and will be used for the purposes of assisting the State Emergency Coordinator to exercise powers and perform functions under the Emergency Management Act 2005 (WA), and the Chief Human Biosecurity Officer for Western Australia to exercise powers and perform functions under the Biosecurity Act 2015 (Cth), in relation to the novel coronavirus COVID-19.

You are not allowed to enter the Designated Biosecurity Area if any of the following applies to you (unless you are escaping an immediate threat to life). Tick if any of these applies to you or any other people travelling with you who are not completing their own forms. See end page for full definitions.

Been exposed to a person with human coronavirus, without adequate

personal protective precautions

Currently showing Symptoms (see

Definition section) Details:__________________________________________________________________________________________

_______________________________________________________________________________________________

_________________________________________________________________________________________________________

Travelled overseas in the last 14 days

Year Day Month Signature

Government of Western Australia - Entry into Designated Biosecurity Areas Form - WA.gov.au - 270320

WA.gov.au

If you are travelling together with family members, minors or other persons who are unable to complete their own form, please provide the names and contact details of each additional person below:

Additional person details 1





Email (Separate contact details not required if traveller is under 18 and travelling with an adult) Mobile number

Date of birth Day Month

Name



Name



If by plane or rail, seat number Name



Name

Email (Separate contact details not required if traveller is under 18 and travelling with an adult)

Mobile number Date of birth Day Month

Name

Important Information: If there are more than five people travelling, please complete an additional form for the remaining passengers

If by plane or rail, seat number





Additional people travelling information

WA.gov.au

If you do not fall within one of the categories of authorised travel, you may apply for a Special Permission.

To apply, complete the declaration below and the primary entry form, and either:

• email both forms to [email protected]; or

• provide both forms to an officer authorised under the Emergency Management Act 2005 (WA).

You may not enter the Designated Biosecurity Area unless and until you are advised that the Special Permission has been granted. This may take up to three (3) working days.

Declaration

I,_____________________________ (print your name), hereby apply under section 5(4) of the Biosecurity (Human Biosecurity Emergency) (Human Coronavirus with Pandemic Potential) (Emergency Requirements for Remote Communities) Determination 2020, made under the Biosecurity Act 2015 (Cth), for Special Permission to enter the Kimberley / East Pilbara / Ngaanyatjarraku Designated Biosecurity Area (circle the relevant area).

I confirm that I meet all of the following criteria:

• immediately before entering the Designated Biosecurity Area, I do not have any of the signs or symptoms of human coronavirus with pandemic potential (see definition of Symptoms in Definitions section);

• in the 14 days immediately before the entry, I have not been exposed, without adequate personal protective precautions, to human coronavirus with pandemic potential;

• in the 14 days immediately before the entry, I have not been outside Australian territory (as defined in s 12 of the Biosecurity Act 2015);

• I am not entering the area wholly or partly for the purpose of engaging in an activity in the area that is prohibited by or under an Australian law;

• my entry to the area is not otherwise prohibited by or under an Australian law.

These are the reasons why I believe I should be allowed to enter the Designated Biosecurity Area:

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

This information is required under the Emergency Management Act 2005 (WA) and the Biosecurity Act 2015 (Cth). The provision of false or misleading information is an offence punishable by a fine or imprisonment. This information is collected and will be used for the purposes of assisting the Chief Human Biosecurity Officer for Western Australia and/or human biosecurity officer(s) who is employed with the Department of Health of Western Australia to exercise powers and perform functions under the Biosecurity Act 2015, in relation to the novel coronavirus COVID-19.

Year Day Month Signature

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Application for Special Permission

Designated Biosecurity Area

See attached map. Detailed maps are available online at https://www.wa.gov.au/government/publications/biosecurity-act-designated-regions

Essential Activity

Essential Activity in a designated area means any of the following:

(a) providing any of the following for the benefit of one or more persons in the area:

(i) health care;

(ii) education;

(iii) services relating to prevention of, or recovery from, domestic violence;

(iv) services relating to child protection;

(v) policing services;

(vi) emergency services;

(vii) essential services of a kind typically provided by local government, such as rubbish collection;

(viii) services, benefits, programs or facilities that the Chief Executive Centrelink has the function of providing;

(b) providing correctional services in relation to one or more persons in the area;

(c) providing funerary services in the area;

(d) conducting, or taking part in, a sitting of a court or tribunal in the area;

(e) operating, maintaining or repairing:

(i) equipment for providing electricity, gas, water, medical services or telecommunications services; or

(ii) other essential infrastructure in the area;

(f) delivering food, fuel, mail or medical supplies in the area;

(g) obtaining medical care or medical supplies in the area;

(h) continuing the construction in the area of housing or transport infrastructure that was in progress immediately before the commencement of this instrument;

(i) carrying out mining operations (see below), or operations ancillary to mining operations, in the area in a manner that is agreed with a human biosecurity officer so as to minimise the extent to which other persons in the area are exposed to the persons carrying out those operations;

(j) transporting freight to or from a place in the area.

mining operations includes operations for the extraction of oil or gas.

Symptoms includes any one or more of the following:

(a) a fever of 37.5 degrees or above; or

(b) a history of fever (including symptoms of a fever such as night sweats or chills); or

(c) symptoms of acute respiratory infection (including, but without limitation, shortness of breath, a cough, sore throat and/or fatigue).


Definitions

WA.gov.au

Designated Biosecurity Areas - Australia

Economic & Geospatial Analysis SectionPolicy Analysis & Evaluation Branch

NIAA March 2020, Ref:2020/30

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Sydney

Canberra

Broken Hill

Melbourne

Brisbane

Cairns

Townsville

Mount Isa

Longreach

Weipa

Adelaide

Port Augusta

Coober Pedy

Amata (L)

Mimili (L)

Perth (WA)

Albany

Broome

Kununurra

Hobart

Darwin

Alice Springs

Katherine

Nhulunbuy

0 500 1,000250Kilometers


Excluded Pastoral Leases




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Sydney

Canberra

Broken Hill

Melbourne

Brisbane

Cairns

Townsville

Mount Isa

Longreach

Weipa

Adelaide

Port Augusta

Coober Pedy

Amata (L)

Mimili (L)

Perth (WA)

Albany

Broome

Kununurra

Hobart

Darwin

Alice Springs

Katherine

Nhulunbuy







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Sydney

Canberra

Broken Hill

Melbourne

Brisbane

Cairns

Townsville

Mount Isa

Longreach

Weipa

Adelaide

Port Augusta

Coober Pedy

Amata (L)

Mimili (L)

Perth (WA)

Albany

Broome

Kununurra

Hobart

Darwin

Alice Springs

Katherine

Nhulunbuy




WA.gov.au

CO

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-19 | W

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Designated Biosecurity Areas - Western Australia




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Sydney

Canberra

Broken Hill

Melbourne

Brisbane

Cairns

Townsville

Mount Isa

Longreach

Weipa

Adelaide

Port Augusta

Coober Pedy

Amata (L)

Mimili (L)

Perth (WA)

Albany

Broome

Kununurra

Hobart

Darwin

Alice Springs

Katherine

Nhulunbuy





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