Today, OzSAGE, a diverse, multi-disciplinary network of Australian experts, releases its advice paper for protecting Australia’s Healthcare Workers- Control of Covid-19 infection transmission in Healthcare Settings and preventing the loss of the Healthcare Workforce.
In opening up of Australia, the strain to our health systems from Covid-19 must be considered. When cases surge, the health system becomes strained. Countries such as Denmark and Singapore have seen surges despite high vaccination rates, and Australia must also be prepared for future surges, as shown in updated modelling released today. Waning of vaccine immunity occurs by six months after the second dose. Despite being double vaccinated, many Australian health workers have become infected.
Established occupational health and safety protocols for preventing transmission of airborne disease to healthcare workers were not employed prior to the aerosol transmission of SARS CoV-2 being recognised. In 2020, healthcare workers were at nearly 3 times the risk of infection than members of the community prior to the Delta variant of SARS Co-V2. Despite this, NSW has flagged the intention remove automatic workers compensation, and to force health workers to prove that they acquired infection at work in order to be eligible for workers compensation. This comes at a time when we face a mass exodus of burnt-out health workers from the health system.
Infections in healthcare workers cause staff shortages and loss of critical staff and can mean loss of a health service to a community. Aside from the potential for deaths and serious illness in healthcare workers themselves, there are also deaths and complications for patients in the health system. We do not have reporting of hospital acquired COVID-19 in Australia, but in the US, nearly 2% of hospitalised patients acquired COVID in hospital. There are examples reported in the media of hospital outbreaks in Australia where patients admitted for other reasons became infected and sometimes died of COVID-19.
OzSAGE recommends improving healthcare systems to protect healthcare workers and their patients through Safe Indoor air and Vaccines Plus :
- Confirm safe air by checking and adjusting ventilation of indoor spaces (including shared rest areas), see Safe Indoor Air (Ventilation). Creating and maintaining safe air involves using Carbon Dioxide monitors and HEPA filtration if required. Individual patient hoods have demonstrated control of cross infection
- Vaccination of all staff with patient interaction, including with a third dose no later than 6 months after second dose
- Fit tested N95 or TGA approved elastomeric respirators or higher for all staff in outbreak area or with potential to receive patients from such areas
- Masking or respirators for patients and visitors
- Creation of green, amber and red zones with specific protocols, and patient allocation with clinical triage and rapid antigen testing for safe transit and care of potentially infectious patients
- National reporting of health care acquired COVID in patients and staff.
- Retain automatic access to workers compensation for infected health workers.
It is important that safe indoor air, PPE for airborne viruses other controls are in place in all health care settings. Education of healthcare workers and their management inside and outside hospitals on controls is important. OzSAGE encourages efforts in this area, such as this chart developed for General Practice.
OzSAGE calls on the NSW Government to retain automatic workers compensation access for infected health workers, and to mandate that the burden of proof should be on the workplace to prove that infection was not acquired at the workplace.
“Healthcare settings are an area where the appropriate use of rapid antigen tests for staff, patients and visitors may help to prevent and control incursions of COVID-19 from the community, providing an additional layer of protection but not as a substitute for Safe Indoor Air and Vaccines Plus.”Dr David Anderson, Virologist
“The healthcare system approach to infection control has historically been heavily focussed on patient safety, but that is only one half of the issue. A focus on protecting healthcare worker safety is critical to prevent COVID-19 transmission in healthcare”Ms Kate Cole, Occupational Hygienist
“For so long advice has focused primarily on hospital settings, we must not forget that the majority of healthcare is delivered in the community. As risk of exposure increases across all healthcare settings it is important that recommendations incorporate General Practice, Community based private specialists and Allied Health providers. The OzSAGE advice provides clear and actionable strategies that both empower and enable healthcare workers and employers to move towards safer workplaces”Dr Kat McLean, General Practitioner
“Our healthcare workers are a critical workforce whose skills and experience cannot be replaced in real time in many cases. It is imperative that their safety concerns for airborne virus transmission are listened to and improved safe indoor air ventilation, third dose vaccination, fitted elastomeric and N95 masks, treatment zones and testing programs are implemented. Making these changes provides ongoing ability to maintain some level of usual care when pandemic disease threatens to overwhelm a health system”Dr Karina Powers, Occupational and Environmental Physician
Our health workers matter. We are facing an exodus of burnt-out health workers from our hospitals and must do everything we can to protect their health, wellbeing and human rights so that we can protect them, the health system, and all enjoy the benefits of high quality care for COVID and non-COVID conditions.Prof Raina Macintyre, Public health physician,