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How do healthcare workers protect themselves against COVID-19?

Grey’s Anatomy actress Ellen Pompeo late last week shared an Instagram video explaining to her 7.2 million followers that while many citizens are able to follow government advice to self-isolate to avoid contracting COVID-19, nurses and other healthcare workers don’t have that same privilege.

The video has been viewed 2.9 million times and many of the 12,000 comments posted below it are messages of support from across the globe for those on the healthcare frontline of the coronavirus crisis.

Two Australian academics, writing for The Conversation, echoed Pompeo's points.

Matt Mason, lecturer and program co-ordinator: nursing at the University of the Sunshine Coast, and Peta-Anne Zimmerman from Griffith University said: “Regardless of COVID-19, doctors and other health-care staff often feel some level of expectation to turn up to work even when ill. They’re often worried about placing strain on co-workers and affecting patient care.

“The practice of quarantining healthcare workers who may have been exposed to the virus puts additional pressure on health services and is expected to increase as the outbreak continues.”

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With Love and gratitude ❤️????????.

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The lecturers said as much as possible healthcare workers should follow guidelines issued by their place of work or health department.

On top of the standard health precautions used all year round, Mason and Zimmerman said workers are using two classes of transmission-based precautions: droplet and contact precautions.

“Contact precautions involve putting on gloves and a gown upon entry to the patient care area, to ensure clothing and skin do not make contact with surfaces that have potentially been contaminated with the infectious droplets,” they wrote. “Droplet precautions involve wearing a surgical mask so infectious droplets don’t get in the mouth and nose.”

They added that while normally coronavirus is spread only via droplets, some medical procedures such as inserting a breathing tube can aerosolise the virus, meaning it can stay in the air longer.

“Healthcare workers may take additional airborne precautions when they’re undertaking aerosol generating procedures such as intubating a critically unwell patient. These precautions include wearing a properly fitting P2/N95 respirator and caring for the patient in a special isolation room.”

Researchers from Hong Kong found that health systems can protect healthcare workers during the COVID-19 outbreak when best practices for infection control are “diligently applied”.

The researchers, from Queen Mary Hospital in Hong Kong, reported that zero healthcare workers contracted COVID-19 and no hospital-acquired infections were identified after the first six weeks of the outbreak, even as the health system tested 1,275 suspected cases and treated 42 active confirmed cases of COVID-19.

"Appropriate hospital infection control measures can prevent healthcare-associated transmission of the coronavirus," study authors said. "Vigilance in hand-hygiene practice, wearing of surgical masks in the hospital, and appropriate use of personal protective equipment in patient care, especially when performing aerosol-generating procedures, are the key infection control measures to prevent hospital transmission of the virus."

Enhanced infection control measures were put in place in each Hong Kong hospital shortly after the reports of the disease surfaced, including training on the use of personal protective equipment, staff forums on infection control, face-to-face education sessions, and regular hand-hygiene compliance assessments.

Mason and Zimmerman said while international studies have shown additional measures do protect healthcare workers from contracting infectious diseases, there’s often a gap between the recommended practices and their application in healthcare settings.

“Studies have indicated reasons for this include staff attitudes, insufficient knowledge of procedures, inadequate supplies, time pressures and staffing levels," they said.

“Education and training around these procedures must be routine so that in the face of an outbreak like coronavirus, health-care workers are supported and prepared to implement these critical protocols."

The duo added that it’s critical that healthcare workers can access the appropriate supplies so they can follow the proper infection prevention and control protocols.

“We also need consistent messaging for the public and healthcare workers on when to contact a healthcare professional, how that should be done and what to do to minimise coronavirus risk.”

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