Increasing number of Victorian COVID-19 outbreaks linked to healthcare sites
Nearly 400 Victorian healthcare workers have caught the coronavirus since the beginning of the pandemic.
When Victoria reached a new height of 428 new COVID-19 cases on 17 July, Victoria’s Chief Health Officer Brett Sutton said positive cases among aged care and health care workers were driving some of the outbreaks.
Just three days earlier, an article in the Medical Journal of Australia reported that health worker infections represented six per cent of all infections to date.
In mid-July, Victoria’s Department of Health and Human Services announced that 388 Victorian healthcare workers had caught the virus since the pandemic began, and 150 of the cases were still active.
While the department said the “vast majority” of the workers testing positive had been infected outside their workplaces, increasing numbers of Victorian outbreaks have been linked to healthcare sites, including the Northern and Alfred public hospitals, the Brunswick Private Hospital, and the Royal Children’s Hospital. At the time of writing, 27 clusters had been linked to aged care homes in Victoria.
Lisa Fitzpatrick, the Victorian branch secretary of the Australian Nursing and Midwifery Federation, told The Lamp increased community transmission meant that Victorian nurses, midwives and carers are dealing with uncertainty.
However, she said, “It’s important to remember nurses and midwives are well educated in infection control and know how to protect themselves against the risks at work.
“The Victorian health depart-ment’s close-contact tracers are working on understanding the source of infection for each healthcare worker who has tested positive with COVID-19.”
Lisa said that while healthcare workers are contracting the virus in the community and at work, significant numbers are self-isolating and awaiting results of tests. In the meantime, she said Victoria is well prepared in the event a surge workforce is needed.
“There are more than 4000 nurses on the health department’s pandemic surge workforce register, and the federal government has funded critical care education for more than 20,000 nurses, plus refresher education for registered and enrolled nurses who were no longer in clinical practice.”
The importance of PPE
The surge in infections occurred as the Medical Journal of Australia published a paper by University of NSW infectious diseases expert Raina MacIntyre and co-authors, calling for all health workers treating COVID-19 patients to be provided with respirators.
They write that a “growing body of scientific evidence around transmission and prevention of SARS-CoV-2 infection” was challenging beliefs that droplet and airborne transmission were distinct modes of transmission.
“Newer studies show that droplets and aerosol particles exist in a continuum,” they write. “Even a single large droplet may reduce in diameter and become airborne during its trajectory, because of evaporation.”
They propose that “N95 respirators offer significantly better protection (96 per cent) than surgical masks (67 per cent) against SARS, MERS and SARS-CoV-2”.
The authors add: “Our health workers are a precious asset and warrant the highest protection – not simply for their occupational health and safety, but for a functional and resilient health system.”
In mid-July the federal health minister, Greg Hunt, announced five million masks from the national medical stockpile to support Victoria’s response.
Lisa Fitzpatrick says the “state health department has confirmed that delivery of masks and PPE from the national stockpiles to private aged care nurses, carers and other aged care workers will be coordinated through existing Victorian mechanisms once approved for release by the Commonwealth Government”.
“Ninety per cent of deliveries are occurring within 24 hours of being ordered.”
The crucial importance of PPE was highlighted by Victorian nurse Lisa Peters, who wrote about her experience testing residents of the Flemington and North Melbourne public housing towers for the ABC online.
Going into the towers, Lisa writes: “We were assembled in teams of two nurses and two police officers, and each of us had a trolley containing everything we needed.
“When each floor was completed, we went back downstairs to ‘doff’ — remove our PPE in a particular way so as not contaminate ourselves or others.
“Teams of paramedics were on hand to assist with every step. They possibly thought their job was insignificant, but it was just as important as ours.
“One little break in our PPE and we could become the next source of community transmission.”
Lisa wrote that with both her own safety and that of her immediate family weighing on her mind, “she had never felt so anxious about doffing in all my decades of nursing”.