Thread by @LazarusLong13

Work in IPC?

Here's a true CoVid story from old Victoria. From catastrophe to redemption.

Victoria, Australia, that is.

"In the second wave, Victoria was by far the hardest-hit state. Its case numbers were dwarfing those in every other state..."

vox.com/2020/12/4/2215…

On August 11, 2020, the government said that max 15% of HCW infections were acquired at work.

Then, on August 25, 2020, the government reported that figure was actually 69%.

Source:
parliament.vic.gov.au/file_uploads/P…

(Backup Found On Web Archive = BFOWA)

By September 2020, it was over 3,000 cases.

Source:
wsws.org/en/articles/20…
(BFOWA)

And man, the government had a brutal message:

But was all hope lost?

No - and a great lesson in double-checking sources.

While that quote was in the original document, a whole lot more was in there, too.
premier.vic.gov.au/protecting-our…
(BFOWA)

✅Identified where most infections were happening like in break rooms and older

ventilation systems.
✅Reviewed the excellent results from the Royal Melbourne Hospital (more on that later).
✅COVID Aerosol Hot Spot Analysis Study
✅Deployed PPE spotters to spot incorrect wearing.
✅Increased N95 availability from 50,000 to 800,000 (16x increase).

And so....

What happened?

Let's ask Andrew Hewat, Assistant Secretary Victorian Allied Health Professionals Association - and the actual reason that I knew about this story.

https://twitter.com/AndrewHewat/status/1362408728759308302?s=20

(BFOWA)

Yes! N95's, spotters, fixing ventilation - these are all the things you need to stop an airborne pandemic.

Or is it?

Of course not! Here are some lessons learned from an in-depth investigation - the Royal Melbourne Hospital
mja.com.au/journal/2021/2…
(BFOWA)

"The Royal Park Campus had the highest number of staff with COVID‐19, making up 40.8% (n = 107) of health care worker infections at the Royal Melbourne Hospital, despite this campus constituting about 10% of the total staff workforce...."

Between July 12-18, they got a lot of

CoVid+. And it got really, really bad.

But then the magic happened (see below).

Now - if you are in IPC, you may not be familiar with one aspect in particular - the de-densification.

By reducing the number of patients, you reduce the number of Aerosols Generating People.

The more people you have in a space, you have more aerosols - even if they are just breathing.

But you and I both know that patients don't just breathe - they talk, yell, sing, cough, sneeze.

All of that generates aerosols that carry SARS-COV-2. And per the Surface/ Stability

studies, we know they can hang around infectiously for hours.

There's more there - I encourage all to read it.

There is one more tip that was not in that report.

You and I both know that the hospital administration does not want to issue N95's, because it costs so much.

Here's where you get to be a hero to both the hospital and your HCW's.

N100 elastomeric respirators.

✅ Cheaper...HUGE money save
✅ Safer. N100 vs N95.
✅ More comfortable - fit is easier.
✅ No HCW wants to go back to N95's afterwards.

Details:

https://twitter.com/LazarusLong13/status/1385649632345165824?s=19

These threads always get one or more additions - so I suggest checking back in a week.

Some more data:

https://twitter.com/DrPieterPeach/status/1336056790920744960?s=20

Here's the voice of the HCW from that time:
bmjleader.bmj.com/content/leader…

Top-level source (I prefer to open PDF's directly, myself:
bmjleader.bmj.com/content/5/1/31…

H/T: @DamianTheAussie for sharing the above resources, and @rajah_mich for sharing the voice of the HCW!

And thank YOU!