By Pat Pepper
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…