Story courtesy of ABC News national medical reporter Sophie Scott and the Specialist Reporting Team’s Mary Lloyd

A young Melbourne Nurse requested an N95 respirator mask while she was caring for COVID-19 patients but was told “it was unnecessary and that there wasn’t the science to back it up.” She pleaded for better personal protective equipment from hospital management because she feared contracting COVID-19. Instead she was given a surgical mask and a plastic face shield and now her worst fears have come true.

Sadly, the nurse contracted COVID-19 and has since been in isolation, not being able to see her one-year-old daughter since being diagnosed.

“I don’t know when I am going to see my baby again,” she said.

To date, over 1,100 Victorian healthcare workers have contracted COVID-19, with several ending up in intensive care.

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Currently, there is conflicting advice from federal and state health authorities about what type of face masks healthcare workers should wear when treating confirmed and suspected COVID-19 patients.

Victoria’s Department of Health and Human Services recently updated its advice for healthcare workers with a recommendation they wear N95 respirators when treating patients known to have the disease or suspected of having the virus.

At a federal level, Australia’s Deputy Chief Medical Officer Nick Coatsworth said the expert panel advising governments had “a consistent position for some time now that the routine care of COVID-positive patients can be performed with a surgical mask, and not an N95”.

He said increasing numbers of Australian healthcare workers contracting COVID-19 was “of concern” and the medical expert panel was discussing whether recommendations needed to be upgraded.

Doctor calls for national policy on PPE

Infectious diseases physician Michelle Ananda-Rajah wants one national policy to protect healthcare workers and offer them certainty. “There is a lot of stress, a lot of anxiety among healthcare workers all around the country — nurses, doctors, allied health [and] aged care workers — because they feel like they can’t speak up against these guidelines and they don’t feel adequately protected,” she said.

As medical experts learn more about how the virus spreads, there is growing disquiet healthcare workers are not being adequately protected with the personal protective equipment they are being offered. Dr Ananda-Rajah said the advice offered by the expert panel was based on an outdated understanding that COVID-19 was only spread through droplets, despite compelling evidence it could also spread through fine particles that floated in the air and got around a surgical mask.

“When you actually wear one of these [surgical] masks, you get a lot of gaps around your face … and essentially that then allows air to flow preferentially through those gaps and into the wearer and potentially infect the wearer,” she said.

COVID warning for healthcare workers in other states

Doctors across Australia do not want to see what happened to Victorian healthcare workers replicated in other states. Australian Medical Association NSW president Danielle McMullen said having Victorian healthcare workers make up one in 10 infections was unacceptable.

“What has been happening in Victoria with personal protective equipment has been inadequate,” she said. “We need a clear set of advice in NSW on how personal protective equipment guideline use can be escalated and we do not want to see healthcare worker deaths.”

Ben Veness, who works as a psychiatry registrar, said governments should act with an abundance of caution when offering advice on how to best protect people working in healthcare. “I think the Government at the federal and state level has a moral imperative … to recognise that there’s sufficient evidence to suggest that aerosol spread of COVID-19 is likely, and therefore provide the appropriate protection for aerosol spread,” he said.

He was one of a number of concerned doctors who recently sent an open letter to Health Minister Greg Hunt, saying the best available evidence found that N95 respirators offered significantly better protection (96 per cent effective) than surgical masks (67 per cent effective) against infection from viruses.

Healthcare staff want a breakdown of what kind of healthcare workers have been infected, where they contracted the virus and how many are in intensive care.

Dr Ananda-Rajah said transparent reporting of coronavirus infection among healthcare workers should be a national priority. “If you have national reporting of healthcare worker infections you can capture things like gender, age, ethnicity, roles, specialty,” she said.

“Then you can start to kind of understand what the risk is.”