The Infection Control Expert Group (ICEG) and National COVID-19 Clinical Evidence Taskforce have jointly agreed on updated recommendations to protect healthcare workers from COVID-19 infection. This includes advice on when to use face (surgical) masks, P2/N95 respirators and eye protection.
The updated recommendations are the result of a significant body of work and reflect a balanced risk approach to protecting healthcare workers from COVID-19.
The advice represents a broad consensus among experts across a diverse range of fields, including:
- infection prevention and control
- infectious disease
- primary care
- occupational hygiene
- care of older people
- women’s health
- paediatric and adolescent health
- operative/perioperative care
- emergency care
- critical care
- nursing care
- occupational and environmental medicine, and
- clinical engineering.
Throughout the pandemic, the Department of Health, ICEG and the Australian Health Protection Principal Committee have constantly reviewed the medical evidence and regularly updated their advice which has been adopted by governments.
In this context, experts from across a diverse range of fields have worked very closely together to continually update guidelines relating to the use of personal protective equipment (PPE) – including surgical face masks, respirators and eye protection.
Their recommendations are based on the combined experience and expertise of the members involved – and relates to healthcare workers in all settings, including hotel quarantine. They build on ICEG’s previous recommendations, with risk assessment to remain central when considering the use of PPE.
ICEG has followed the emerging evidence and recognises the potential for transmission of SARS-CoV-2 via aerosols in specific circumstances.
ICEG advice recommending the use of particulate filter respirators for aerosol-generating procedures performed on COVID-19 cases was first published on 5 March 2020.
ICEG has also recognised broader circumstances in which there may be potential for aerosol transmission in clinical care. This includes in the context of certain behaviour, such as shouting. Guidance relating to this was published on 30 July 2020.
ICEG acknowledges the potential for aerosol transmission in these settings and notes the risk may be higher under certain conditions, such as poorly ventilated indoor crowded environments.
Given the varied nature of healthcare settings, decisions around the use of PPE may need to be flexible, guided by evidence, context, and consideration of healthcare worker preferences. The recommendations are not exhaustive, but instead aim to supplement more detailed guidance available at a state, territory and institutional level.
PPE is a critical part of infection prevention and control. However, organisations should consider it as the last line of defence within a broader ‘Hierarchy of Controls’ framework. Such a framework should include implementing measures to minimise the risk of the virus spreading, for instance isolating cases and ensuring workplace practices are COVID-safe.
As with all ICEG advice, these recommendations will be revised as new evidence emerges.