PPE boost to help GPs fight Sydney COVID outbreak

Anastasia Tsirtsakis

13/07/2021 5:07:50 PM

But while the National Medical Stockpile allocation has been welcomed, GPs say extra help is still needed, including clarity around fit-testing.

Surgical and N95 masks.
GPs in Greater Sydney can now request a package of PPE through their local primary health network.

The additional supply for GPs and other healthcare providers was announced on Monday, as NSW recorded 112 new cases of COVID-19 amid its ongoing outbreak.
Eligible GPs can request a package of PPE through the seven local primary health networks (PHNs) affected by the current lockdown, with the initial allocation from the stockpile including up to:

  • 1,000,000 surgical masks
  • 1,000,000 N95 masks
  • 250,000 pairs of gloves
  • 250,000 gowns
  • 250,000 goggles.
Federal Health Minister Greg Hunt said the packages will ensure GPs can ‘safely see their patients’ during the outbreak, in cases where telehealth is not the appropriate option.
Sydney-based GP and Deputy Chair of RACGP Specific Interests Disaster Management, Dr Penny Burns said the allocation is ‘a first step’ in acknowledging the important role GPs are playing in responding to the pandemic.
‘This is great news and very welcome,’ she told newsGP.
‘GPs need good, reliable access to the same level of protection that hospital and other healthcare services are offered during a pandemic.
‘It is essential to keep all our healthcare workers, GPs included, safe.’
Prior to the announcement, general practices have generally been told that National Medical Stockpile (NMS) resources are meant as a ‘fallback’. So, for Dr Tim Senior, who is also based in Sydney, the change is welcome but also ‘a bit late’.
‘I mean, we’re nearly three weeks into lockdown and the numbers are going up and it’s only now where PPE supplies seem to be a problem? It all feels very reactive,’ he told newsGP.
‘I know GPs who are feeling pretty much almost abandoned across western and south-west Sydney. PPE feels like the minimum that can be done.
‘But it needs to be adequate numbers distributed quickly and fairly – and possibly sustained, because who knows how long this lockdown is going to carry on?’
And despite the best efforts being made to appropriately screen and triage symptomatic patients, eight general practices have already been listed by NSW Health as exposure sites.
Dr Senior says many practices fear that they will be next, with significant disruption caused to patients and practice staff. 
‘It’s so easy for patients to come in with relatively minor symptoms and test positive; so easy for staff to be in places where they’re exposed, and it can close a practice down for two weeks,’ he said.
Western Sydney representative of the RACGP’s NSW/ACT Faculty Council, Adjunct Associate Professor Michael Fasher told newsGP the access to PPE will provide GPs with some peace of mind, particularly for those who are not yet fully vaccinated.
‘I myself am not due for my second AstraZeneca for a month, but in light of the Chief Medical Officer’s advice and the amount of COVID around, I’ll look to bring that forward this week if I can,’ he said.
‘But that’s not easily done when practices have a limited allocation of vaccine and have to plan ahead to make sure that no vaccine is wasted.’
Associate Professor Fasher also fears that without adequate PPE, doctors will stop seeing patients face-to-face.
‘I myself, for instance, have new patients aged two weeks and six weeks to see this afternoon and the practice manager’s question to me was “Are you prepared to see them?”,’ he said.
‘Well, the answer is I can’t leave a two-week-old and a six-week-old unexamined or their family context unexplored. And whilst I could partly do that by video consult, it really does need, I think, face-to-face. And I couldn’t ask my young colleagues to do the same without PPE.’
Queensland GP Dr Kat Mclean has been a vocal advocate for aerosol protection. She says that while the PPE supply from the Commonwealth is ‘fantastic’, that she has ‘considerable concerns’ over the silence around fit-testing P2/N95 masks.
‘All of these actions seem to be reactive rather than proactive,’ she told newsGP.
‘And although we are potentially having P2 masks distributed, we don’t know what those masks are and we don’t know whether GPs are being fit-tested. My thought would be that they haven’t.
‘GPs are proactively trying to organise fit-testing themselves, but without any idea of the masks that will be distributed or what is available, it really creates a barrier.’
Dr McLean said despite the Infection Control Expert Group (ICEG) having published new mask guidelines in June, she has yet to see a plan around airborne infection control for general practice specifically.
Meanwhile, Dr Burns says she would like to see access to PPE from the NMS extended to all GPs working in the pandemic.
‘Although GPs are using telehealth, they are still contributing significant hours face-to-face, assessing unwell patients in their communities, providing usual healthcare as possible, and are often putting themselves at risk on the frontline in doing so,’ she said.
‘They are seeing undifferentiated presentations coming into their surgeries and this creates a risk, not only in areas of outbreak, but also in areas not yet a hotspot – as you never know when that first local case is going to arrive.’
Dr Senior has similar concerns, and says past experience suggests that it is only a matter of time until another state is at the centre of an outbreak.
‘Every outbreak we have, has stories about people going through regional areas,’ he said.
‘It’s so easy for this to spread [and] the Delta variant feels like it’s so contagious, it’s almost guaranteed that there’s going to be other outbreaks elsewhere.
‘We can predict that that’s going to happen, we’re just not entirely sure exactly where. But that does mean that practices across the country need to be prepared for that – and protected for that.’
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