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Australia Victorian coronavirus healthcare workers not getting best PPE or more N95 masks amid shortage fears

02:07  20 september  2020
02:07  20 september  2020 Source:   abc.net.au

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Victoria 's Chief Medical Officer, Andrew Wilson, defends the state's personal protective equipment ( PPE ) guidelines for healthcare workers , but says authorities are also "very careful" N 95 masks fit snugly on the face and provide a higher level of protection from coronavirus than surgical masks .

The mask shortage is forcing health workers to disregard basic coronavirus infection control. Washing disposable masks , wearing trash bags His neighbors recently gave him some extra N 95 s, allowing him to cycle between masks . “Who would have ever thought getting 10 masks at your door

a close up of a person wearing a costume: The N95 mask provides a more secure seal around the face than a surgical mask, to reduce the risk of airborne particles reaching the face. (ABC News: Patrick Stone, file photo) © Provided by ABC Health The N95 mask provides a more secure seal around the face than a surgical mask, to reduce the risk of airborne particles reaching the face. (ABC News: Patrick Stone, file photo)

Victorian COVID-19 health workers are still not being provided with the best protective equipment because the numbers required would "burn through the supplies in one week", the state's Chief Medical Officer has said in private meetings leaked to the ABC.

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That especially includes health care workers , who spend more time with sick people than anyone else — which is why they need masks and other PPE And even if you take a totally selfish perspective on this, there are good reasons to want health care workers to get these medical masks first.

Given the current extreme shortages of respirators needed in healthcare , we do not recommend the use of N 95 FFRs in public or household settings. While this is not an exhaustive review of masks and respirators as source control and PPE , we made our best effort to locate and review the most

And despite repeated State Government assurances that personal protective equipment (PPE) supplies were adequate, health experts said "unconscionable" mask shortages and lax guidelines in the critical early stages of Victoria's second wave in June and July contributed to its size and intensity.

'Fit testing' the highest-level N95 masks for doctors and nurses is still being rejected because of shortages, the leaks show, and workers who test or transport COVID-positive patients cannot access them at all.

N95 masks fit snugly on the face and provide a higher level of protection from coronavirus than surgical masks.

Epidemiologist Mary-Louise McLaws, who advises the World Health Organization on preventing healthcare worker infections, said there was no excuse for not having the right PPE during the second wave.

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My Ideology Is Health ”: Dr. Anthony Fauci on the Tactics of Dealing With the Novel Coronavirus . I tried to get preemptive and was laughed at (basically) 6 weeks ago when I approached infection control about getting more encompassing PPE (such as gas masks and full body hazmat suits because we

First of all, most people buying masks are not getting one that stops the virus from reaching their The coronavirus is transmitted through droplets, not through the air. That means you cannot The type of personal protection equipment ( PPE ) that healthcare workers wear when treating someone

"More than 3,000 COVID cases [among Victorian healthcare workers] is astronomical, and it tells me that something's gone wrong, terribly gone wrong," Professor McLaws said.

"It's poor leadership, it's unconscionable and it's unethical not to have a continuous uninterrupted supply for our frontline healthcare workers."

Healthcare worker infections are a significant contributor to Victoria's second wave, accounting for around 20 per cent of new COVID cases between in July and August. About one third are in hospital workers.

It remains unclear how much subsequent community transmission can be traced back to healthcare worker infections.

Infectious disease expert Raina Macintyre said she believed the unavailability of PPE was a major contributor to healthcare workers getting infected.

"There's no doubt that with better PPE, fit testing and a precautionary approach, much of this wave in health workers could have been prevented," Professor Macintyre said.

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Health care workers who wear N 95 masks as part of their jobs are required to undergo a fit test at Vice President Mike Pence seemed to address the shortage during a White House press briefing with “These masks need to be prioritized for health care professionals that as part of their job are

The coronavirus pandemic and the subsequent mask and PPE shortage have exposed America’s lack of If the US was better prepared for pandemics, it could have avoided the shortage of masks and Alameda Health System nurses, doctors, and workers protest the lack of personal protective

Doctors' union concerned supply, not evidence, drove PPE guidelines

Despite public assurances in April that Victoria had enough PPE, through May and June, as the second wave swelled in Melbourne, there weren't enough surgical masks and N95 masks, leaked meeting notes show.

The briefings between Chief Medical Officer Andrew Wilson, Department of Health and Human Services (DHHS) staff, unions and WorkSafe Victoria have been provided to the ABC. They suggest DHHS had not "modelled" sufficient supplies.

Unions repeatedly called for simple surgical masks for more workers.

But Professor Wilson told them while the requests were not unreasonable, "… on those scales we'd be going through one million masks a week", a source said.

The peak medical body is also concerned the State Government may have changed guidelines about the safest PPE for workers to wear, based on when supplies finally arrived.

Health workers had been crying out for higher level N95 masks since April, but federal and state authorities said the evidence did not warrant it.

The ABC has determined that it was only when Victoria secured its first onshore manufactured supply of the masks in August, and there was relief in the system, that DHHS changed its guidelines and said the evidence now supported more workers having access.

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Coronavirus Home. Your Health . Contingency Capacity Strategies (during expected shortages ). Prioritize the use of N 95 respirators and facemasks by activity type with and without masking symptomatic patients. For more information on CDC's web notification policies, see Website Disclaimers.

With the new COVID-19 outbreaks and shortages of N 95 masks : what are the alternatives for the healthcare workers (doctors, dentists During the screening, surgical masks with PPE (including face shield) should be used and any procedures that might Get high-quality answers from experts.

Australian Medical Association (AMA) board member and emergency physician at the Royal Melbourne Hospital, Sarah Whitelaw, said the Government had not been transparent about why the guidelines changed at that time.

"There's certainly been a concern that our PPE guidelines have not been drawn up necessarily just on what is best practice, but that in fact, they have been drawn up based on what we've had available,'' Dr Whitelaw said.

Chief Medical Officer says all decisions based on 'expert advice and evidence'

In response to questions from the ABC, Professor Wilson rejected suggestions that supply dictated guidelines and said they were changed because of observed risks in some health services where patients with COVID-19 were being cohorted in wards.

"All decisions about PPE use in our health services has been guided by expert advice and evidence, with the best possible protection for staff the primary consideration, and thankfully supply has always met that guidance," he said.

Despite the onshore supply, shortages still plague the Government.

Last month, Premier Daniel Andrews told reporters: "We have substantial reserves of those (N95) masks."

But this month, Professor Wilson told a briefing there were not enough N95 masks for all workers in contact with COVID-19 patients because it would "burn through the supplies in one week," meeting attendees said.

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A source told the ABC that was why the Government had resisted fit testing — a process that involves each worker trying different makes, models and sizes of masks to find the most protective.

The Government still did not have the supplies to provide healthcare workers with the best fits, the source said.

#victoriacaseslookupEMBED

Government commits to fit-testing 'trial' in all COVID-19 wards

While behind closed doors DHHS staff knew about the shortages, the Premier told a press conference on August 12, when almost 2,000 health care workers had been infected, that most were getting coronavirus in the community, not in the workplace.

Health Minister Jenny Mikakos told a parliamentary committee only 10-15 per cent of healthcare worker infections were happening in the workplace — outraging frontline workers.

Two weeks later, a DHHS report conceded at least 69 per cent of workers had acquired the virus at work, for a variety of reasons.

[Tableau graph of HCW infections]

This weekend, after inquiries from the ABC, the Government committed to a fit-testing "trial" in all coronavirus wards.

Professor McLaws said healthcare workers had been taken advantage of.

"You do not want your young healthcare workers, which they usually are, having ill health into their middle age [due to COVID-19] because of a problem with the supply chain," Professor McLaws said.

"The leaders need to think very carefully about what they're expecting. Would they expect this of their family member? I can't imagine they would think that that's okay."

In a statement, Chief Medical Officer Andrew Wilson said Victoria had done an incredible job of securing PPE in the pandemic.

"Victoria's advice on N95 respirators was expanded in August to go above the National Guidelines due to observed risks in some of our health services where patients with COVID-19 were being cohorted in wards," he said.

"Since then a large range of measures have been enacted to further reduce risk and numbers of healthcare worker infections have reduced significantly. Whilst the guidance has naturally led to increased use of respirators, this has been carefully planned for and risks mitigated."

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COVID-19 takes a toll on public transport, speed camera revenue in Qld .
The lockdown in March dragged annual revenue down as people stayed home and avoided public transport.Queensland's public transport network recorded a drop in patronage of almost 20 per cent over the past year, costing more than $71 million in fare revenue.

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