A NSW anaesthetist said staff looking after COVID-19 patients were concerned about not being able to access a P2 respirator mask which, like the N95 mask, offers a higher level of protection than a surgical mask.
“We were asked to wear surgical masks for COVID suspected caesarean patients,” the anaesthetist said. “Patients may cough during the surgery or need urgent airway intervention. Surgical mask is not enough.”
A Victorian nurse said hospitals had “remained reactive not proactive as numbers began to grow” and that staff concerns were dismissed by managers.
“After arranging our own PPE, we were told we were causing hysteria,” the nurse said. “Sadly, these people got it wrong and now over 1000 healthcare workers are infected with COVID.”
A Victorian doctor said PPE guidelines “have been completely inadequate and way too slow.”
“I work where over 100 people are now infected,” the doctor said. “This was completely preventable.”
Healthcare workers from both states complained about an ongoing lack of fit testing of respirator masks, leaving them exposed through leaks in ill-fitting P2 or N95 masks when they were provided.
“Labouring women do not wear a mask – they breathe heavily all over the obstetrician who is between their legs,” said a NSW obstetrician, who reported fighting for months with hospital administrators to get a fit-tested N95 mask for use with suspected COVID-19 patients.
“This is a failure of leadership,” Dr Ananda-Rajah said.
“Our organisational leaders who are directly responsible for our safety have steadfastly adhered to a failing strategy that has resulted in over 3200 healthcare worker infections.”
Australian Medical Association Victorian board member and emergency physician Sarah Whitelaw said an ongoing lack of mask fit testing and slow progress on addressing cramped working spaces risked holding back the state from getting on top of COVID-19.
Victoria still has hundreds of infected healthcare workers across its hospitals and aged care facilities, with many more in isolation.
Dr Whitelaw said NSW, where a hospital cluster is growing, must heed Victoria’s mistakes and “learn from what we’ve been through.”
She warned if Victoria dropped the ball on infection control, “we’re looking at potentially holding up the rest of the community at being able to come out of restrictions.”
“Now is the time to throw absolutely everything at this,” she said.
A group of doctors wrote to NSW Premier Gladys Berejiklian, Health Minister Brad Hazzard and Chief Health Officer Kerry Chant on Friday, urging them to upgrade personal protective equipment guidelines to allow healthcare workers to wear N95 or P2 masks while treating suspected or confirmed COVID-19 cases in areas with community transmission.
Paediatric cardiologist Kate Jardine, who drafted the letter, said she believed the improvement in healthcare workers infections in Victoria had come as “a result of them bringing in N95 masks”, along with improvements such as separating COVID-19 patients.
“The biggest travesty was that they kept saying ‘a surgical mask will be fine’, yet a huge number of doctors wearing surgical masks in Melbourne were infected,” she said.
“There is so much evidence for aerosol transmission now.”
Dr Jardine said she wanted fit testing of P2 and N95 masks to be rolled out across NSW and for “all staff and visitors in NSW hospitals to be wearing surgical masks.”
A NSW Health spokeswoman said the feedback would be considered “in line with our established clinical governance and PPE strategy”.
Victorian health authorities were initially reluctant to provide the higher level masks unless COVID-19 patients were undergoing aerosol-generating procedures such as intubation, waiting until hundreds of healthcare workers had been infected before agreeing to do so.
NSW follows the national guidelines set by the Australian Health Protection Principal Committee’s Infection Control Expert Group, which say a surgical mask is sufficient for most interactions with COVID-19 patients because airborne particles are not a “significant” mode of transmission.
Mr Hunt announced on September 9 that a new panel of frontline staff would be established to work with the national expert body on infection control guidelines, but the panel was yet to be appointed on Saturday.
Victoria went beyond the guidelines to give all healthcare workers in hospitals access to P2 and N95 masks while treating patients in COVID-19 wards from July 31.
Dr Whitelaw said better governance and leadership was needed so that healthcare workers were listened to and PPE guidelines could be quickly upgraded as needed.
On Saturday, one of three new COVID-19 cases recorded in NSW was a healthcare worker who cared for patients while potentially infectious at Concord Hospital. At least 22 cases are now linked to the Liverpool Hospital and Concord Hospital outbreak, including nine staff.
As of Friday, 102 healthcare workers in NSW were believed to have acquired COVID-19 at work. NSW Health did not provide a total number of healthcare worker infections.
In Victoria, 3408 healthcare workers had contracted COVID-19 by September 15, with 2466 infected at work and 261 active cases.
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Dana is health and industrial relations reporter for The Sydney Morning Herald and The Age.