States Must Learn from Victorian Healthcare Worker COVID-19 Transmissions

Reflecting the downward trend of coronavirus transmission in the broader Victorian population, the number of COVID-19 cases in Victorian healthcare workers has decreased over the past few weeks, according to figures from the Victorian Government.

The most recent figures show that the total number of COVID-19 cases in healthcare workers is 3408, and of those where the transmission source is known, more than 72 per cent acquired the virus in their workplace.

Figures are not available on the number of patient transmissions these infected workers have inadvertently passed on to vulnerable people, but AIHS CEO David Clarke said today “it’s clear that healthcare workers have not been simply catching COVID-19 from patients.

“It goes both ways, so when we consider the impact of extensive workplace health and safety failures, we also need to look at the death and disability caused by those transmissions as well.”

The latest figures indicate that, of the total infections, 206 (6 per cent) are medical practitioners, 1303 (38.2 per cent) are nurses or midwives, 1524 (44.7 per cent) are patient-facing aged care or disability workers and 74 (2.2 per cent) are other healthcare workers.

The Victorian Government’s infection control advisors recently came under a barrage of criticism from the AIHS and a coalition of organisations before revealing the extent to which healthcare workers were contracting COVID-19 at their workplaces.

In response, the government announced a healthcare worker taskforce, and now have health and safety professional input to the taskforce.

Under the taskforce every health service in Victoria is being checked to make sure it is COVIDSafe, ‘PPE spotters’ will be introduced, potential aerosol hot spots will be studied and fit testing will be trialled for staff at highest risk.

A detailed analysis of recent healthcare infections found that the leading causes of infection included cases being ‘cohorted’ in the same clinical space, contact between health workers in areas like tea and break rooms, gaps in putting on and taking off PPE, movement of staff between facilities and older ventilation systems being less effective at ensuring good airflow.

“These are good examples of where we find very basic weaknesses in health and safety systems, processes and practices – especially in hospitals,” said Clarke.

“Most people think the standard of OHS in hospitals is high, but there are fundamental differences in the way disease control people deal with biological hazards.”

Clarke said every other state was under threat of the same problems occurring in the event of outbreaks in those regions.

“Unfortunately, our engagement with the infection control groups has been demonstrating that they generally don’t understand prevention-based workplace risk management, and it shows in all of the advice coming from them.

“To make matters worse, they are refusing offers of expertise from coalitions of agencies in our sector, and remain content to quote and recommend standards which have been demonstrated to fail.”

The Victorian Government announced workers will have greater access to P2/N95 masks in emergency departments, intensive care units, aged care facilities and COVID-19 wards but they will not be fit tested other than through a pilot.

Clarke described this as simply irresponsible. “These decisions are being made by panels which do not understand the available science on the use of P2/N95 masks,” he said.

“It’s only half the job done. Fit testing is not a nice thing to try.

“There doesn’t need to be a pilot, there is existing research that shows P2/N95 masks will only have limited success unless properly fit-tested for each person. Fit-testing more than doubles the effectiveness of these masks.”

The AIHS also called on WorkSafe Victoria to take a stronger leadership role, to be on the ground to fulfil its full role in hospitals and aged care.

“We are concerned that significant numbers of healthcare services have been in breach of health and safety legislation, and little or nothing appears to be being done about it.

“Our question is whether our safe work regulators are ceding their responsibilities to health departments which have a blind spot for worker health and safety,” Clarke said.

“The workplace – especially health and aged care – are where the highest level of risk to workers and our community lies in COVID-19 outbreaks, and the least we can do is ensure that’s where the best WHS strategies, plans and controls are.”

Article originally published by the Australian Institute of Health and Safety.