A young Melbourne nurse says she pleaded for better personal protective equipment from hospital management because she feared contracting COVID-19. Her worst fears came true.
- A Melbourne nurse who contracted COVID-19 says she tried to access a higher grade of mask
- She is part of a growing number of practitioners who fear they are not protected while at work
- Experts say the advice around the type of mask required is not clear
“I had requested an N95 respirator mask while I was caring for COVID-19 patients but was told it was unnecessary and that there wasn’t the science to back it up,” she said.
Instead, she said, she was given a surgical mask and a plastic face shield.
So far, more than 1,100 Victorian healthcare workers have contracted COVID-19, with several ending up in intensive care.
The nurse, who asked to remain anonymous, developed severe muscle pain, debilitating fevers and bad headaches and immediately sought a COVID-19 test.
“I had a panic attack when I got the positive COVID-19 result. I couldn’t breathe. I couldn’t speak,” she said.
“It was my worst fear.”
She has been in isolation and has not seen her one-year-old daughter since being diagnosed.
“It’s debilitating and very hard mentally.”
The nurse worked on a ward in a Melbourne hospital with COVID-19 patients and she said she repeatedly asked the hospital for an N95 mask.
“I was very fearful that I would get COVID-19 without it,” she said.
“I wanted to help people and comfort COVID-19 patients who are petrified.
“But why did my health need to be compromised?”
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.
And 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.
A warning for 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.”