NCWQ Health Report: July 2020

By Dr Kathryn Mainstone, NCWQ Health Adviser

Wearing Masks

As more has been found out about the SARS-CoV-2 virus over time, our routines outlined by government have changed. Recently, over 200 scientists from all over the world have written to the WHO, emphasizing that SARS-CoV-2 may not simply be spread by large droplets, as had previously been believed, but that it could have been spread by smaller aerosolized particles, which may travel distances greater than the current 1.5 metres deemed to be safe and may be situated within interior spaces for hours after being exhaled. This made wearing masks seem possible as a preventive measure, in addition to social distance and hand hygiene.

An anecdotal but compelling study from Missouri talks about the case of two hairdressers who had COVID-19 and continued to work for some days after becoming infectious. The hairdressers wore masks because it was mandatory in their states to do so, as did their 139 clients, who must have had close contact with the hairdressers. None of their clients caught COVID-19 but they did pass it on to members of their family, with whom masks were not worn.

We currently do not know the risks associated with singing and playing musical instruments but researchers at Bristol University and Imperial College London are doing a scientific study at the moment to try and answer this very question. Inside a research lab, singers wearing medical scrubs sing and play Happy Birthday down a tube over and over again. Everything is being measured to see whether singing and talking are different, whether volume alters output and how much is emitted from simply breathing. Singers and musicians are also weighed to see if larger people may emit more breath vapour. It is hoped that this data will be available sometime after September.

There are three varieties of mask available, each offering a different level of personal protection. The P2/N95 mask is more expensive but given about 95% protection if it is fitted correctly; this is the one used in the areas of highest vulnerability such as intensive care units within hospitals. The cheaper surgical mask option offers about 60% protection. The home-made cloth masks, made from three different layers of material, offer about 40-50% protection. These can be washed at above 60 Celsius and reused.

The most important reason that one wears a mask is to protect those around one, especially if one becomes an asymptomatic sufferer and never develops a reason to be tested. COVID-19 may spread in this manner up to 40% of the time, which makes it very challenging to contain once spread and it has overwhelmed the tracing mechanisms.

The above information was taken from the following sources:

1. https://www.nytimes.com/2020/07/14/health/coronavirus-hair-salon-masks.html

2. https://www.bbc.com/news/entertainment-arts-53446329

3. https://www.dhhs.vic.gov.au/sites/default/files/documents/202007/Design%20and%20preparation%20of%20cloth%20mask_0.pdf

NCWQ Health Report, April 2020

By Dr Kathryn Mainstone, NCWQ Health Adviser

Unease During Coronavirus Over Personal  Protective Equipment

Edith Cowan University in WA has recently released a study, based on their questions asked of 350 health workers –  doctors, nurses and paramedics – during the current coronavirus pandemic. It revealed that half of those who responded did not have access to sufficient PPE ( personal protective equipment )  and that 70% had been asked to ration their use of PPE. Doctors were more likely to report overall a lack of face masks, face shields, gowns and hand sanitiser. Over 20% report being tested for COVID-19 and 17% had undergone periods of self-isolation due to work-based exposure. 80% were concerned about exposing their family and 41% expressed this concern as “extreme”. They report a lack of communication between their employers and themselves regarding the issue.       

There is currently a huge gap between what is seen as “safe” for GPs and what in reality is available in terms of PPE. Dr Bernie Hudson, microbiologist at Royal North Shore Hospital, spoke to GPs recently about the issue. He said that in reality, there has been very little research done on the subject but let us know what they currently know. We know that the wearing of surgical masks seems to reduce the spread of infection from someone who already has the virus but does little to stop someone getting the virus. Given that people may be infectious for up to 48 hours prior to getting any symptoms, it might be an idea to offer a mask to anyone wanting to come into the practice and see a GP. He also said that if we had supplies of P2/N95 masks then GPs should use them, assuming that anyone may have COVID-19. The N95 mask is the mask that has a respirator within it and, if fitted well, prevents spread far better than a simple surgical mask. How long should a health care worker wear a mask and can we reprocess them? This is in fact a science-free zone; we have simply not done the studies necessary to give answers to these questions. What we do know is that dentists, ENT surgeons, anaesthetists and maxillofacial surgeons are at high risk given that they are involved in aerosol generating procedures and should be wearing P2/N95 masks at all times.

We have always had pandemics and it comes as no surprise that South Korea and Taiwan have dealt with the current pandemic so well, given that they had to confront SARS in 2003. They knew exactly how to go about dealing with this virus from the outset. It is sad that Australia has found itself so short-supplied with all aspects of personal protective equipment and is still so woefully unprepared. Never again should we rely on overseas countries for the supply of masks, gowns, gloves and test kit reagents. We have mercifully been released from the initial human carnage which has been present in the US and Europe but this is an ongoing story and will require tremendous effort to prevent it from breaking out in spot fire scenarios over the coming months. Hopefully, our current PPE situation will be rectified but that story that is yet to be told…     

Health Adviser Report February 2014

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By Beryl J Spencer

NCWQ Health Adviser

According to the World Health Organisation, “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.” Therefore, when thinking about health and the impacts on women’s lives it is necessary to consider where women live, the work they do, their family and social roles as well as the opportunities they have for relaxation and self care.

It is known that the higher the income someone has the greater is their potential for health. In most countries income is closely linked to education. Societies with the best outcomes on a number of health and social scales are those with the least variation between high and low income earners. One way this can be achieved is with social support systems that keep this difference to a minimum.

Therefore, it is important for the NCWQ to continue its bursary program. These programs assist and enable girls to undertake and complete education and indirectly impact on their health. The NCWQ can also advocate against systems that adversely affect women’s earnings. These can include advocating for equal pay for equivalent work; review of superannuation systems and social support programs that minimize the gap between men and women and between the high and low income earners.

The following are issues that the NCWQ should be aware of because of their impact on women’s health.

Homelessness:

Women’s homelessness is usually linked to their decreased earnings because of their caring and parenting roles. If a woman is homeless she is more vulnerable to violence and exploitation. In Queensland, even though 40% of homeless people are women, there are 10 times more beds for homeless men than women.

Family violence and sexual assault:

Violence is a risk factor for homelessness. An ABS survey in 2005 found that in the previous 12 months 4.7% of all women had experienced physical violence and 1.6% sexual violence. In 2003, 81% of female victims of sexual violence knew their offender while for that year only 47% of male victims did. In that same year, 49% of female victims were killed as a result of a domestic altercation. An Access Economics report for the Office for the Status of Women estimated that the total cost in 2003-04 for domestic violence was $8.1 billion. A report on violence against women for VicHealth in June 2004 found that ‘violence is responsible for more ill-health and premature death among Victorian women under the age of 45 than any other well-known risk factors including high blood pressure, obesity and smoking.’

Chronic disease:

Our current lifestyles put us at risk of a number of chronic diseases including diabetes and heart disease. We don’t get enough physical activity, our diets often include insufficient fruits and vegetables, we smoke, we have risky alcohol intake and are a leading country for obesity. While most women fear developing breast cancer, they are often unaware that heart disease is the no. 1 killer of Australian women and are possibly 3 times more like to die from this than breast cancer.

Sexual and reproductive health:

From menstruation to menopause, women’s sexual and reproductive health impacts on their lives. The rates in Australia of gonorrhea, syphilis and chlamydia especially in young females aged 15-29 and young Aboriginal women aged 15-35 is  increasing.                                                                                                                                                                                                                                                                                                                                                                                                                                                                       While teenage pregnancy rates are falling, Australia still has one of the highest rates of teenage pregnancy compared to other developed countries. Indigenous teenage women are 5 times more likely to give birth as non-Indigenous teenage women.

Indigenous women and women from non-English speaking backgrounds are over represented in maternal death statistics.

Mental and emotional health:

Pregnancy and birth are a key time for women to experience anxiety and depression. The Queensland Maternal and Perinatal Quality Council Report 2011, showed that for 2004-08, suicide was the leading cause of death for women within 1 year of giving birth. A Price Waterhouse Coopers report found that for 2010, the cost of postnatal depression to the Australian economy was $500 million.

According to beyondblue, 1 in 5 Australian women will experience depression and 1 in 3 will experience anxiety in their lifetime. And women experience these at higher rates than men. There is an increasing amount of research into the links between physical ill health (including some chronic diseases) and emotional ill health (such as depression).

Access to services:

A key issue for all women is access to and choice of services. Not all Queensland women have equal access to all services they require. Women living in rural, regional and remote areas often experience poorer health than women living in urban Queensland. To access the services they require, women may need to travel hundreds of kilometres, which increases the cost to them and means they are less likely to seek the care and treatments they require to prevent ill health or to maintain their health.

NCWQ health advisers report feb 14