We use cookies to improve your experience on our site and to show you personalised advertising. To find out more, read our privacy policy and cookie policy

Skip to Content
University of Wollongong Australia. Logo. University of Wollongong Australia. Logo. University of Wollongong Australia. Logo.
  • Search
  • Give
  • Library
  • Current Students
  • Staff
  • UOW Global
    • Our global presence
    • UOW in Dubai
    • UOW in Hong Kong
    • UOW in Malaysia
  • Menu
  • Study at UOW

    • Courses
    • Apply
    • Scholarships & grants
    • Accommodation
    • High-school students
    • Non-school leavers
    • Postgraduate students
    • International students
    • Moving to Wollongong
    • Study abroad & exchange
    • Global sport programs
    • Campuses
    Study at UOW
  • Engage

    • Future student
    • Alumni
    • Visit UOW
    • Woolyungah Indigenous Centre
    • Volunteer
    • The Stand Magazine
    • Community Members
    • Grants and funding
    • Give to UOW
    • Visit the Library
    • Key contacts
    • Educators & school teachers
    Engage with us
  • About UOW

    • Welcome
    • Our people
    • Services
    • Contacts
    • What's on
    • Global presence
    • Media Centre
    • Faculties & schools
    • Our vision & strategy
    • Our Aboriginal & Torres Strait Islander Strategy
    • Our reputation & experience
    • Locations, campuses & partners
    See more about UOW
  • Research

    • Our research
    • Researcher support
    • Research impact
    • Partnership & collaboration
    • Graduate Research School
    • Commercial research
    • Global Challenges
    • Media, news & events
    • Find an expert
    • Our people
    See more about research
  • Industry

    • Generator Lab
    • Advantage SME
    • Success stories
    • Industry research engagement
    • Equipment & Labs
    • Funding opportunities
    • Intellectual property
    • Collaboration for business
    • Collaboration for researchers
    • Careers and employability
    See more about Industry
  • Alumni

    • Benefits
    • Outlook Magazine
    • Events & webinars
    • Volunteer
    • Awards
    • Honorary alumni
    • Testamurs & transcripts
    • Update your details
    • Your career journey
    • Contact us & FAQ
    See more about alumni
  • Quick links

    • Contact directory
    • Staff Intranet
    • Campus maps
    • Transport & parking
    • Key dates
    • Events
    • Password management
    • Jobs
    • Accommodation
    • Policy directory
  • Library
You are here More Pages
  • Home
  • About UOW
  • Media Centre
  • 2020
  • PPE unmasked: why health-care workers in Australia are inadequately protected against coronavirus

Media Quick Links

  • Contact UOW Media
  • Visiting campus
  • Image library
  • UOW key facts
  • Find an expert
  • News Corp subscription
  • Sign up for the latest news from UOW Media

August 4, 2020


  • Story By
  • Jane L Whitelaw (UOW), Alicia Dennis (Uni. Melbourne)
Share
Type
Opinion Pieces
Category
Health and Medicine
Tags
ResearchScience

UOW in the News

PPE unmasked: why health-care workers in Australia are inadequately protected against coronavirus

The need for advanced-level PPE is becoming increasingly crucial to protect front line health care workers fighting COVID-19


 

In Victoria, more than 1,100 health-care workers have now been infected with SARS-CoV-2, the coronavirus that causes COVID-19. Some 11% of active cases are workers in the health-care sector.

Health-care workers are reported to be among those fighting for life in Victorian intensive care units.

Sign up to The Conversation

While we don’t know what proportion of the Victorian health-care workers currently infected with COVID-19 acquired it at work rather than in the community, it’s almost certain a portion of these infections were contracted in the workplace.

 

Early experience from China found the proportion of health-care workers who contract COVID-19 can be up to 29% in settings with inadequate personal protective equipment, or PPE.

Lessons from China also show workplace transmission of SARS-CoV-2 can be reduced to negligible numbers with sufficient supply, and correct use of, airborne precaution PPE.

Right now, Australia is sitting somewhere in the middle. National guidance needs to be urgently updated to reflect safest practice and acknowledge what we’re learning about the airborne spread of the virus.


Read more: Supplies needed for coronavirus healthcare workers: 89 million masks, 30 million gowns, 2.9 million litres of hand sanitiser. A month.


What is PPE?

PPE is a crucial part of controlling exposure to hazards in all workplaces.

It includes items such as masks, respirators, face shields, gowns and gloves.

PPE is categorised into three tiers, corresponding to the type of hazard.

Level 1: standard and contact precaution PPE

This PPE limits exposure to standard contact hazards. Examples include face coverings and administrative controls such as hand hygiene, cough etiquette and physical distancing.

Level 2: droplet precaution PPE

This PPE prevents exposure to contact and droplet hazards. Examples include surgical masks, eye shields or goggles, long-sleeved gowns, and gloves.

Level 3: airborne precaution PPE

This PPE aims to prevent exposure to contact, droplet and airborne hazards. It includes N95/P2 respirators or powered air-purifying respirators with a P2 filter, eye shields or goggles, fluid-resistant gowns, double gloves, disposable head and neck wear, and protective footwear.

Construction worker wears fluorescent vest, mask and hat.
We’ve heard a lot about PPE in the context of coronavirus. But PPE isn’t just for health-care settings. Shutterstock

Current Australian guidelines

The national guidance on the use of PPE in hospitals during the COVID-19 outbreak has been written by the Infection Control Expert Group and endorsed by the Australian Health Protection Principal Committee.

The guidance doesn’t recommend universal airborne precaution PPE for health-care workers dealing with patients suspected or confirmed to have COVID-19. It only recommends level 3 protection for highly specialised procedures such as intubating a patient.


Read more: Is the airborne route a major source of coronavirus transmission?


A preprint in the Medical Journal of Australia has criticised the current guidance, noting it’s not aligned with increasing scientific evidence regarding airborne transmission of SARS-CoV-2 and is therefore inadequate to protect health-care workers.

Inadequate national guidance has led to an inconsistent and non-standardised approach to airborne precaution PPE across all health-care settings.

In the absence of strong national safety guidance, some hospitals and jurisdictions are making independent improved safety recommendations to their staff.

Why we need level 3

Transmission of SARS-CoV-2 occurs by direct contact with droplets and contaminated surfaces — but emerging data suggests it can also be spread by the airborne route.

An analysis of health-care worker deaths in the United Kingdom found none among wearers of level 3 PPE, suggesting airborne precaution PPE was protective.

A nurse stands in hospital corridor scrolling on her phone. She is wearing scrubs, a surgical mask and a hairnet.
Surgical masks don’t offer as much protection against COVID-19 as respirator masks. Shutterstock

Importantly, surgical masks are primarily designed to protect the environment from the wearer. They’re not designed to protect the wearer from respiratory pathogens.

A recent review found N95 respirators offered significantly better protection against viruses including COVID-19 than surgical face masks, while one study found N95 respirators provided 8-12 times more protection than surgical masks against small viral particles.


Read more: Rising coronavirus cases among Victorian health workers could threaten our pandemic response


In Australia, N95 is synonymous with P2 respiratory protection and refers to the filtration efficiency (so N95 means 95% of particles are filtered). But it’s the total inward leakage — what goes through and around the facemask — that’s the critical factor in determining the level of protection the wearer achieves.

To ensure total inward leakage is minimised, respiratory masks used under level 3 PPE must meet certain standards, including fit testing and the training of wearers in their use.

We need immediate action

SARS-CoV-2 is a highly contagious virus with the potential to cause significant ill health and death. In health-care settings, it should be classified as a lethal biohazard and managed accordingly.

The safest approach is to consider all people with confirmed or suspected COVID-19 in hospital, being transported to hospital or being tested for COVID-19 as being able to spread the virus via the airborne route. As such, the use of airborne precaution PPE with a correctly fitted N95/P2 respirator is essential.


Read more: Health-care workers share our trauma during the coronavirus pandemic – on top of their own


There’s also an urgent need for a national registry of health-care worker infections, containing data about the category of health-care worker, where the infection was acquired, severity of disease, hospitalisation, intensive care and death numbers.

This will give us a better understanding of the scope and specifics of the problem, and inform policy and prevention strategies.

Finally, adequate supply of airborne precaution PPE must be available throughout Australia to protect health-care workers from COVID-19.The Conversation

Alicia Dennis, Associate Professor MBBS, PhD, MPH, PGDipEcho, FANZCA, University of Melbourne and Jane L Whitelaw, Certified Occupational Hygienist, University of Wollongong

This article is republished from The Conversation under a Creative Commons license. Read the original article.

UOW academics exercise academic freedom by providing expert commentary, opinion and analysis on a range of ongoing social issues and current affairs. This expert commentary reflects the views of those individual academics and does not necessarily reflect the views or policy positions of the University of Wollongong.

Media Contacts for this article

UOW Media Office

You may also be interested in

Southern Highlands and Goulburn students get a taste for a career in health care
Inaugural conference to examine acute challenges facing rural health system
UOW ‘nature prescription’ randomised trial for chronic disease management receives $1.5 million
Services & Help
  • Current students
  • Library
  • Information technology
  • Accommodation
  • Security & safety
  • Pool, gym & retail
News, Media & Events
  • Media Centre
  • The Stand
  • Alumni Magazine
  • Research news
  • Events
  • Find an expert
Faculties
  • Arts, Social Sciences & Humanities
  • Business & Law
  • Engineering & Information Sciences
  • Science, Medicine & Health
Administration
  • Graduation
  • Environment
  • Policy directory
  • Learning and teaching
  • Financial Services
  • Access to information
  • Jobs
UOW Entities
  • Innovation Campus
  • UOW College Australia
  • UOW College Hong Kong
  • UOW in Dubai
  • UOW Global Enterprises
  • UOW Malaysia KDU
  • UOW Pulse
Connect with us
  • Facebook
  • Twitter
  • YouTube
  • Instagram
  • LinkedIn
  • Conversation
  • Contact us
  • Feedback
  • Give to UOW

Northfields Ave Wollongong,  NSW 2522  Australia 
Phone: 1300 367 869 
International: +61 2 4221 3218 
Switchboard: +61 2 4221 3555

  • NUW Alliance: Smarter Solutions for NSW
  • University Global Partnership Network (UGPN)
  • Reconciliation Australia
  • AWEI LGBTQ inclusion awards logo

Aboriginal flag Torres Strait Islander flag

On the lands that we study, we walk, and we live, we acknowledge and respect the traditional custodians and cultural knowledge holders of these lands.

Copyright © 2023 University of Wollongong
CRICOS Provider No: 00102E | TEQSA Provider ID: PRV12062 | ABN: 61 060 567 686
Copyright & disclaimer | Privacy & cookie usage | Web Accessibility Statement

Close