COVID-19 and Healthcare workers
This week’s expert:
Prof Raina MacIntyre, NHMRC Principal Research Fellow and Head of the Biosecurity Program, Kirby Institute, University of NSW
Drawn from Dr David Lim’s interview with Professor Raina MacIntyre on the Healthed Podcast, ‘Going Viral’.
• It has become very apparent in this pandemic that healthcare workers are particularly vulnerable to becoming infected with COVID-19
• The virus can be aerosolised and can accumulate over time, especially in closed environments. So while the quantity of virus expelled in a normal breath is far less than that that expelled in a cough or sneeze, the greater number of breaths taken over time means the virus can accumulate to infective levels.
• Many hospitals are older and have not been designed to reduce airborne infections
• While PPE should theoretically be the last line of defence for healthcare workers in ensuring they don’t catch the infection, it is often the only protection afforded these workers
• Unlike other industries where occupational health and safety would work towards reducing the exposure to the risk, in health – the patient is the at-risk exposure – you cannot eliminate the hazard.
• Healthcare workers deserve to have optimal protection – it is a work health and safety issue. The fact that, in Australia over 3000 healthcare workers have become infected with COVID-19, strongly suggests our current protective measures aren’t working.
• We learned from the first SARS outbreak in 2003 that adequate protection is vital for healthcare workers. In Canada, authorities in Toronto believed that SARS was spread through droplets only, and respirators were not necessary for healthcare workers. Toronto had a major outbreak among healthcare workers including three deaths, compared with Vancouver where respirators were given to all health staff and no such outbreak occurred.
• In Victoria a number of hospitals with COVID-19 patients are giving staff respirators, but not all.
• The two key public health measures that are vital in fighting a pandemic are identifying the active cases (so test, test, test) and contact tracing.
• Contact tracing needs to be done as a matter of urgency (within 24 hours) as most people have between 10-20 contacts per day, so delays increase the number of potential patients exponentially. According to current estimates, a patient with COVID-19 will infect about 25% of close contacts.
• In Victoria, which has the most impoverished health system in the country, there simply were not the resources to effectively and quickly do the necessary contact tracing when the state was recording more than 700 cases a day.
• Once new case numbers get too high for contact tracing resources to manage, digital tracing needs to be done. If this is not possible then lockdown of the community is required.
• Digital tracing in the form of the COVIDSafe app has, to date, not been effective. This is partly due some technical issues (mainly on iphones) but also because of the app’s poor uptake.