Up to 80% of infected Victorian healthcare workers contracted COVID-19 at work

An average of 33.7 Victorian healthcare workers have been diagnosed with coronavirus each day so far in August.
 
This figure was one of a number of alarming new insights contained in the most detailed analysis of healthcare worker infections released to date by the Victorian Department of Health and Human Services (DHHS).
 
The analysis shows that the second wave of cases has affected healthcare workers at much higher numbers than the initial outbreak; of the 2692 total confirmed cases to date, 91% were diagnosed in July and August.
 
Excluding cases still under investigation, 86% of all second wave infections have likely been acquired at work. By way of comparison, only 22% of healthcare workers infected during the first wave are believed to have caught coronavirus in the workplace.

Only 6% of healthcare worker infections during the second wave are confirmed to have occurred in the community.
 
In response to the findings, the Victorian Government has announced ‘a big program of work’ to drive down coronavirus infections among healthcare workers.
 
Every health service in Victoria will be checked to make sure it is COVIDSafe, while ‘PPE [personal protective equipment] spotters’ will be introduced and fit testing of masks will be trialled for staff at highest risk.
 
‘Our health heroes take care of us – and we need to take care of them,’ Victorian Premier Daniel Andrews said.
 
‘This work further demonstrates the wildy infectious nature of this virus and the need to do everything we can to stop its spread.
 
‘My message to every healthcare worker is, if you get coronavirus at work, put in a WorkCover claim straightaway. It’ll be fast-tracked and we’ll get you the support you need.’
 
More than 40% (955) of second wave healthcare worker cases so far have been those in aged care, while 32% (729) work in hospitals. Only 1.5% (36) have been linked to staff at general practices.
 
GPs comprise the largest portion of these infections (19), but only 27% are likely to have occurred in the workplace, compared with 55% of nurse infections. It is not known how many of the cases linked to GP clinics are still under investigation.
 
Healthcare workers in Victoria’s emergency departments, intensive care units, aged care facilities and COVID-19 wards will also have greater access to N95 masks under the Victorian Government plan, but this access does not yet extend to those working in general practice.
 
‘Guidance on using N95 respirators has been expanded to be the broadest in Australia, increasing their usage from 50,000 to 800,000 per week,’ the release from the Premier’s office states.
 
‘Further work will be undertaken on the use of N95 respirators and updated across non-hospital workforces.’
 
The updated respirator advice comes after dismissals of airborne transmission from the Infection Control Expert Group (ICEG), which contrast against a recent BMJ editorial that urges governments to ‘acknowledge the evidence’ and accept ‘the importance of airborne transmission’.
 
However, while a growing number of healthcare workers have pointed the finger at inadequate PPE, Victorian Chief Medical Officer Associate Professor Andrew Wilson said poor infection practice has ‘probably’ been the main driver of new cases.
 
‘In hospitals, about 70% of people who are infected are nursing staff, with a much smaller number who are medical staff and other healthcare workers,’ he said.
 
‘We’ve definitely learnt a lot about how these have been happening, that there’s outbreaks that occur in wards – particularly where groups of patients are kept together. So what we would describe as cohorting of patients together.
 
‘In that environment, the infections have spread throughout groups of people, and that’s been something that’s been understood for several weeks and we’ve already been able to work with hospitals on that.’
 
Shared spaces, including contact in tea and break rooms, substandard PPE use, and ageing ventilation systems were identified as other leading causes of workplace infection.
 
Victorian Health Minister Jenny Mikakos said more action will likely be taken to slow the spread in health settings.
 
‘If the tea room, for example, is just too small for people to be able to have a meal safely, then we will be establishing marquees and other facilities with appropriate heating to make sure healthcare workers can have access to those basic amenities,’ she said.
 
To help investigate the impact of fit testing on healthcare worker infection rates, a trial will commence at Northern Health and be overseen by the newly formed Healthcare Worker Infection Prevention and Wellbeing Taskforce. The taskforce will review the trial and provide recommendations on any further expansions.
 
Another step recommended by the taskforce includes ‘a recognition of new and emerging evidence regarding aerosol spread’, and a ‘COVID Aerosol Hot Spot Analysis Study’ designed to identify potential risk areas in clinical spaces caused by aerosols.
 
The study will model aerosol behaviour, tracking particles as they are carried via airstreams and onto surfaces.
 
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