Current guidelines for respiratory protection of Australian health care workers against COVID-19 are not adequate and national reporting of health worker infections is required

C Raina MacIntyre, Michelle Ananda-Rajah, Mark Nicholls and Ashley L Quigley
Med J Aust
Published online: 14 July 2020

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Abstract

The guidelines for protection of health care workers (HCWs) in Australia state that a medical mask is indicated for routine care of COVID-19 patients, and a respirator only for aerosol-generating procedures. These guidelines are not aligned with the growing body of scientific evidence around transmission and prevention of SARS-CoV-2 infection. The initial proclamation that SARS-CoV-2 is spread by droplets and contact was not based on strong evidence, and there is no data quantifying the different modes of potential transmission. We outline the evidence of airborne transmission, and the implications for the occupational health and safety of Australian health workers.  There have been over 500 health worker infections in Australia by July 2020, but no national reporting on health worker infections, and lack of transparency in attribution of source of infection when health workers become infected.  We suggest that all health workers treating COVID-19 patients be provided airborne precautions, that the lessons of SARS are heeded and the precautionary principle be applied to health worker protection. We also require transparent national reporting of health worker infections. This is particularly urgent as numerous health worker infections have been reported in hospitals in Victoria during Australia’s resurgence of COVID-19.