Dear member / clinic owner,
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Updated advice on N95 use
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Some good news KXand below from the Ministry on N95 mask use in primary care.
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We are now to have fit testing and use N95s when:
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“1. There is widespread community transmission
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2. An Alert Level change to 3 or 4
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3. A patient meets the HIS criteria.”
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The advice does not state if all three criteria must be met, but it would seem reasonable to use a fit tested N95 if any of the criteria are met – eg treating an HIS patient regardless of alert level.
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Our Pandemic Response Subcommittee has been pushing for full Ministry recognition of airborne spread and changes to its policies and public health messaging since the middle of last year.
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We see the latest N95 announcement as tacit recognition of airborne spread. Additionally, N95s were recently put to greater use in MIQFs, and the Director General of Health has repeatedly stated over the past month that airborne transmission is increasingly recognised as important, and is a more important means of spread than fomite transmission.
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We have a largely unvaccinated population, a highly transmissible variant predominating, and are approaching the flu season. The risk of a serious outbreak remains.
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We will continue to press for changes in the Ministry’s advice and policies around airborne spread, for healthcare workers and the general public, such as ventilation (opening doors and windows), avoiding the use of fans that recirculate air, meeting outdoors if possible, and avoiding crowded indoor spaces.
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David Gollogly, Jasmine Mackay, Richard Chen, Kelvin Ward
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Pandemic Response Subcommittee
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As you may be aware, last year the Ministry of Health centralised the purchasing of PPE for the New Zealand Health and Disability System as part of the response to COVID-19 heightened Alert Levels. This was done to ensure we could buy and manage PPE for the whole country so that no one missed out and that PPE was where it needed to be. This centralised model has worked well and we continue to directly supply district health boards, general practice, aged residential care and some other providers, relative to each Alert Level. We work closely with Infection Prevention and Control teams and our Science and Technical Advisory Group to ensure the model reflects best practice use of PPE.
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Use of N95/P2 particulate respirators for General Practice and Urgent Medical Care facilities within specific settings
Effective immediately, general practice and urgent medical care (i.e. general practitioners, nurse practitioners, nurses or midwives) staff interacting with a patient in a closed confined space such as an examination or procedure room where:
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- There is widespread community transmission
- An Alert Level change to 3 or 4
- A patient meets the HIS criteria.
can utilise and access N95/P2 particulate respirators once they have been fit tested.
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Updated knowledge about the modes of COVID-19 transmission suggest that it may be more airborne than previously considered and this is a precautionary step that can be taken to help mitigate any potential impacts particularly in light of recent confirmation of community transmission of COVID-19 and the subsequent Alert Level change. The National PPE Supply Chain has been working to ensure that there are adequate supplies of these particulate respirators. These can be ordered direct from the central supply once fit testing has been completed. Please refer to the attached document ‘Interim Guidance on the use of N95/P2 particulate respirators by general practice or urgent medical health care providers (i.e. general practitioners, nurse practitioners, nurses or midwives) for more information and for guidance.
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Can General Practice and Urgent Medical Care facilities order online?
Most general practice and urgent medical care facilities can login to order PPE from the online central supply. Onelink (for the Northern Region) and Health Care Logistics (HCL) for the rest of the country will pack the PPE you order and send it to you once a week. Onelink and HCL will work with those people you identify as key the reference point to finalise accounts in the portal and support you in the ordering process. Onelink and Healthcare Logistics are ready for you to contact them to set up the direct ordering. We will be prioritising the Auckland region first given the Alert Level status and confirmed community transmission.
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When you make contact with Onelink or HCL you will be issued with an ordering guide, including instructions on how to use the website. A catalogue of pre-approved Ministry of Health funded PPE products will be pre-loaded.
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It is essential that fit testing to a N95/P2 particulate respirator is done. Fit testers are available, but a cost will be incurred by the general practices and urgent medical care facilities. The Ministry of Health will only supply N95/P2 particulates to those practices that have undertaken fit testing. We intend to make this transition as smooth as possible and will be working closely with Onelink and HCL to ensure you have what you need within the settings and principles of supply. We will continue to work with the New Zealand Royal College of General Practitioners and the Royal New Zealand College of Urgent Medical Care as we learn more about COVID-19 variants and PPE requirements to ensure you are protected.
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When will this happen?
The portal will provide access from Tuesday 23 February 2021 with priority given to those in the Auckland region given the current Alert level status.
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Who can we contact to discuss our needs?
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If you need to make contact with Onelink or HCL regarding PPE, the contact details at Onelink, for those located within the Auckland Region, are mohppe@onelink.co.nz or phone 09 815 2612. For afterhours contact Kylie Corsbie on 021335694.
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The contact details at HCL for those located outside the Auckland Region are email:mohppeordering@prnzl.co.nz or phone 0800 657775.
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For more information refer to the attachments accompanying this email:
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- Extended use of N95/P2 particulate respirators
Thank you for your support and importantly thank you for the work you are doing to help keep New Zealand safe.
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