Fit testing is seen as the gold standard in PPE, but in the face of the coronavirus’s virulence it is the defence that nurses require.

On 6 May, the International Council of Nurses (ICN) estimated that the novel coronavirus pandemic had infected at least 90,000 healthcare workers and killed more than 260 nurses worldwide.

The ICN said official statistics undoubtedly underestimated the true nature of the problem.

“The lack of official data on infections and deaths among nurses and other healthcare workers is scandalous,” said ICN chief executive officer Howard Catton.

“Nurses and healthcare workers have been put at greater risk because of the lack of personal protective equipment (PPE) and poor preparedness for this pandemic.”

Australia has faced its own challenges with supply and preparedness.

Prior to the COVID-19 outbreak the vast majority of our PPE was manufactured overseas and fit testing – a stringent standard for the use of P2/N95 respirators – had been applied in a very limited way.

NSW Health commits to fit testing

In the early days of the pandemic NSW Health was reluctant to embrace fit testing.

But following pressure from the NSWNMA and our branches and other health unions, NSW Health now says the evidence around fit testing “remains equivocal” but “in the interests of staff welfare we are supportive of the implementation of fit testing until there is more unequivocal evidence available”.

NSW Health has flagged difficulties with the immediate statewide implementation of fit testing “due to limited supplies and range of types/sizes available”.

It has committed to implementing fit testing across NSW as a “rolling program” learning from the Sydney LHD and Hunter New England LHD, which have focused on limited fit testing with high risk staff in high risk areas, caring for high risk patients.

Sydney LHD was an early adopter of all COVID-19 planning and protection. Early in the outbreak they limited the size of meetings and used Zoom for communication.

Where fit testing has been implemented the feedback from nurses has been positive.

Katina Skylas, NSWNMA Branch President at Concord Hospital, who works in the intensive care unit, says fit testing gives nurses some peace of mind.

“Knowing when you walk into that room that you are safe relieves an immense amount of pressure,” she said.

“We are all going home to families and elderly parents and people who are sick at home; we need to know we are safe for them.

“Fit testing is part of Australian Standards, but a new concept to most workplaces; everyone knows fit checking, but fit testing is a new practice. We are fortunate in the Sydney LHD to have the support of district executive: they have purchased testing devices.”

NSWNMA Secretary Brett Holmes says COVID-19 has highlighted in stark terms the need to protect frontline nurses in the midst of a highly virulent pandemic.

“Everything has to be done to minimise the risk to nurses,” he said.

“The nature of their jobs makes social distancing impossible. It is essential we have the highest standards of PPE to protect them.

“That means broadening what our traditional concept of best practice in PPE is.

“It also means improving local manufacture of equipment so we are not relying on overseas suppliers to meet healthcare supply chain needs.”