Pressure leads to stronger guidelines over PPE
Campaigning and lobbying by nurses and midwives has led to more clarity over the importance of PPE and higher levels of protection.
Since the early days of the COVID-19 pandemic, Association members have pressured NSW Health to provide access to P2/N95 respirators in any areas with suspected or confirmed COVID-19 cases.
NSW Health has now finally adopted new infection prevention and control guides for health workers.
“From the first days of the pandemic, when the public health advice was focused on surface transmission and close contact transmission, the Association argued that it wasn’t possible to rule out airborne transmission of the virus,” says NSWNMA General Secretary Brett Holmes.
“We said precautionary principles should apply, and health workers should be given the highest level of protection.
“We cited the growing body of evidence pointing to airborne transmission in a variety of settings, not just during aerosol-generating procedures.
We are pleased to see the guidelines have been updated, but it is now important that the changes are communicated and implemented throughout the health system.”
Airborne particles, which are usually less than 100 microns in diameter and can accumulate indoors, are now known to be an inhalation risk and source of transmission.
In an article for The Conversation, Professor Raina MacIntyre and Dr Michelle Ananda-Rajah, two of Australia’s foremost experts in COVID-19 transmission, note that while more than 4000 Australian health workers were infected by COVID-19 during the Victorian second wave, health authorities “denied the importance of airborne transmission and blamed clinical staff for ‘poor habits’ and ‘apathy’.”
Access to PPE needed across Public Health System
Victorian health workers felt abandoned, and Brett notes a similar sense of abandonment occurred in NSW.
“During the early days of the pandemic, while the general public was told to wear masks indoors during periods of outbreak, nurses were told they couldn’t wear a mask unless they were caring for someone with suspected or confirmed COVID-19.
“When our members were caring for COVID-19 patients, they were initially provided with surgical masks, not airtight masks. When members were given P2/N95 respirators without proper fit testing, members were taping them to their faces.
“We engaged in long discussions with NSW Health, and last year we finally got to the position where they committed to fit testing P2/N95 masks,” he said.
NSW Health has purchased 20 machines to conduct the fit testing, but Brett says the Association remains concerned about the slow rate of fit testing, and the shortened process to fit test masks to health workers.
“The recent exposures at Royal North Shore, Fairfield, Liver-pool, Westmead, Bankstown and Campbelltown Hospitals sent hundreds of staff into isolation.
They have also prompted the movement of vaccinated workers out of high-risk areas and unvaccinated workers into high-risk areas, highlighting the urgent need for access to PPE across the system,” he says.
“We have also found that fit testing rates are still moving too slowly to protect members as the areas of exposure move within the system.”