The Ministry suggests that those District Health Boards and Primary Health Organisations in possession of portacount machines from the Ministry consider and prioritise fit testing programmes within communities based on the following guidance: 1. Healthcare workers operating in high risk environments such Emergency Departments, Urgent Care, COVID-19 BCP wards, Respiratory Wards, Intensive Care Units and COVID-19 Care in the Community alternative accommodation facilities 2. Healthcare workers providing in-person care to COVID-19 positive people isolating at home as part of COVID-19 Care in the Community 3. Identified staff in an aged residential care facility who will mobilise as part of the ARC BCP response and identified home care, disability support workers and mental health & addiction staff who will provide direct care for COVID-19 positive patients where care cannot be deferred during the isolation period 4. Healthcare workers who will undertaking COVID-19 swabbing with symptomatic people 5. Other healthcare workers and non healthcare workers providing in-person support as part of COVID-19 Care in the Community (e.g. MSD providers, Oranga Tamariki and others). Please also note, healthcare workers should only be fit tested to a 9320A+ particulate respirator if they do not fit test to any other model of particulate respirator, noting that this would only occur in a small number of instances. The preferred model for fit testing is the 1870+ before trying other alternatives. The 1870+ is a ‘paired fit’ with the 9320A+ and the 1870+ has a superior level of fluid resistance. Manufacturing of the 9320A+ has significantly reduced. As such, a transition to the 1870+ is advised and supplies are limited to those who have already fit tested to an 9320A+ and those who only fit test to the 9320A+. It is important that we ensure that those who only fit test to a 9320A+ can continue to be protected in the work that they do. Models of P2/N95 particulate respirators for people who have not been fit-tested The Ministry will supply 1870+ particulate respirators for those people who require a P2/N95 particulate respirator and who have not been fit tested. This model of N95 fits 80-90%+ of the workforce. Workers should perform a fit check (also called a seal check) before engaging with confirmed COVID-19 positive cases, or people considered high-risk based on the IPC risk assessment. If the mask does not fit properly, they should not engage with the patient and look at other options e.g. another staff member conducting the engagement. The Ministry receives limited supplies of alternative models (e.g. smaller sizes) of P2/N95 particulate respirators. Supplies are prioritised for those who have been fit tested to these models and those working in settings where they are likely to require P2/N95 particulate respirators based on the IPC guidance. We are in continuous conversations with suppliers around accessing appropriate smaller sized models of P2/N95 particulate respirators. The Ministry will consider case by case circumstances for supplying alternative models of P2/N95 particulate respirators for community settings, however in most instances we expect organisations to utilise the 1870+.
General Practice and Urgent Care sector update 4
