Update on 11.08.2020

Information regarding face masks for general consulting in non-COVID suspicious patients has been conflicting, confusing and changes frequently. Following is some of the most recent information to be used as a guide for you to make decisions in your practice. Depending on your practice location, your operating state and your personal circumstances this should be considered on a case-by-case basis. For the most up to date Australian information look at the Department of Health website.

As the health and welfare of our members remains paramount to Optometry Australia we recommend practitioners (and preferably patients as well) wear masks in areas where there is community transmission of SARS-CoV-2.  

Mask wear supplements, but is not a substitute for other infection control measures such as hand hygiene, physical distancing and triage questions to limit interactions with potentially infected patients.

Important update for NSW members

On Friday 24 July 2020 the Secretary of NSW Health, Elizabeth Koff released a statement to advise all health workers in New South Wales to wear surgical masks if they are within 1.5m of a patient.  Patients are also required to wear a mask where possible, although children 12 years and under do not need to wear a mask. NSW Health has clarified that while this advice applies to all optometrists, at this stage it is not a legally enforceable directive for members in the private sector.

They have also advised that if a surgical mask is able to be worn without pulling it down or removing it, it can be worn for up to four hours, (but should be replaced earlier if it becomes damp). As cloth masks vary in quality and effectiveness (and are typically not fluid resistant), these are not advised for practitioners in a healthcare setting. Further guidance on use of masks in NSW is available here.

 NSW Health has determined that given the current context of community transmission, they have escalated advice to cover ‘moderate risk’ of transmission according to the COVID-19 Infection Prevention and Control Response and Escalation Framework and poster.

Important Update for Victorian members

Victoria entered a state of Disaster from 6pm on Sunday 2nd of August. Melbourne has moved to Stage 4 restrictions; with strict restrictions on travel, leaving the home and curfews. Regional Victoria has moved to Stage 3 restrictions. From 11:59pm on Sunday the 2nd of August all Victorians are required to wear a face mask when leaving the home. For up to date information see the Victorian State Government Health and Human Services Page.

The Department of Health and Human Services Victorian website on 11.08.2020 updated their clinical information to advise that all healthcare workers should be wearing a surgical mask and eye protection. All healthcare interactions in the state of Victoria are now considered “Tier 1”: requiring hand hygiene, Level 1 surgical mask and eye protection. P2/N95 respirators and gowns are not required unless there is a suspected or confirmed case of coronavirus.

Any patients with upper respiratory tract symptoms, a known COVID-19 contact or whom is suspected or diagnosed with COVID-19 should be immediately referred to a testing centre/the nearest hospital for assessment and emergency eye care when applicable.

At this stage, health professionals must wear a Level 1 surgical mask and not  reusable cloth masks.

For those in Victoria; Patients are only required to wear a face covering that covers both their nose and mouth. Practitioners should however make a COVID risk assessment on patients who are symptomatic and refer to a COVID testing site/hospital. See the Department of Health and Human Resources for more information on what is an appropriate face covering

Unless damp or soiled, you can wear your mask and goggles/face shield for up to four hours. Remove and dispose of all items before going on a break and resume before returning to work.

Patients should also wear face masks in these same environments.”

The DHSS has clarified that “From the perspective of public health services, this guidance is ‘role agnostic’ and applied to all staff (clinical and non-clinical) as appropriate to their potential exposure and patient interactions.  If it is deemed that these staff should be wearing a mask, under the guidance this is specified as a ‘level 1 or type 1 disposable surgical mask’”. They also included on 11.08.2020 that unless they are directly involved in treating patients, eye protection for ancillary staff is not required.

In their “Guide to the conventional use of PPE” updated 06.08.2020.

For Metropolitan Melbourne and Mitchell Shire, updated 21/07/2020

“When leaving home for one of the four reasons, people 12 years and older must wear a face covering”

People in Victoria outside of metropolitan Melbourne and Mitchell Shire

“You are encouraged to wear a face covering when leaving home and if you are not able to keep 1.5m from others”

For practices within the area under restrictions, it would be useful when a patient makes an appointment to ask them to wear a mask for this visit or consider providing a mask for the patient on their arrival at the practice.

For those outside of Victoria

The Australian Department of Health updated their website as of 28.07.2020;

“You do not always have to use PPE when providing treatment or care.

Use PPE if you:

  • care for someone suspected or confirmed to have COVID-19
  • assess or collect specimens from people who have suspected or confirmed COVID-19
  • have significant contact with people who have fever or respiratory symptoms that suggest COVID- 19

Give surgical masks to patients to wear straight away if they:

  • are under quarantine or investigation for COVID-19
  • are suspected or confirmed to have COVID-19
  • have fever or respiratory symptoms

If you do not have the appropriate PPE to assess patients or collect specimens, refer the person to a collection centre, a GP respiratory clinic or emergency department.”

The Department of Health, in their document titled “Distribution of face masks through PHNs Tranche 4 released 13.05.2020 stated

“There is no need for the general public or health care workers to wear masks unless they are dealing with symptomatic patients.” Allied health professionals are now eligible for limited access to the supply for the use of their staff when there is no available commercial supply and they are working in higher-risk clinical areas and with higher risk vulnerable patients.” However they also caution There remains an assumption that allied health professions will, where possible, not see patients with respiratory symptoms or at a higher risk of COVID-19 unless required to as part of their core business (for example: an optometrist can defer seeing a patient with respiratory symptoms until that person is well).”

Go to this website: https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHN-Locator for information on how to access masks.

The updated advice from organisations in the eye sector specifically, seems to be that whilst the use of masks in non-suspicious patients has no specific evidence, optometric practitioners may wish to use one given the close proximity to patients especially considering the current rate of community transmission in their area of practice. The following is a collection of the most recent information for you to use to make a decision in your clinical practice.

New evidence on the effectiveness of masks has been published in the Lancet Journal on the 1st of June 2020 available here. New information includes;

“Evidence of moderate certainty that current policies of at least 1 m physical distancing are probably associated with a large reduction in infection, and that distances of 2 m might be more effective, as implemented in some countries.”

And

“The use of face masks was protective for both healthcare workers and people in the community exposed to infection, with both the frequentist and Bayesian analyses lending support to face mask use irrespective of setting.”

Finally

“Our unadjusted analyses might, at first impression, suggest use of face masks in the community setting to be less effective than in the health-care setting, but after accounting for differential N95 respirator use between health-care and non-health-care settings, we did not detect any striking differences in effectiveness of face mask use between settings”

The Centre for Disease Control and Protection (CDC) in America updated their guidance as of July 9, 2020 to say;

“Universal use of eye protection (in addition to a facemask) for HCP working in facilities located in communities with moderate to sustained SARS-CoV-2 transmission is intended to ensure HCP eyes, nose and mouth are all protected during patient encounters.”
And also “HCP should wear a facemask at all times when they are in the healthcare facility, including in breakrooms or other spaces where they might encounter co-workers.”

The World Health Organisation on the 29th of June in a document “Infection prevention and control during health care when coronavirus disease (COVID-19) is suspected or confirmed” suggested;

“in areas with COVID-19 community transmission, health workers and caregivers working in clinical areas should continuously wear a medical mask during all routine activities throughout the entire shift”

and on the 5th of June 2020 in their document Advice on the use of masks in the context of COVID-19

“Health workers, including community health workers and caregivers, who work in clinical areas should continuously wear a medical mask during their routine activities throughout the entire shift; apart from when eating and drinking and changing their medical mask after caring for a patient who requires droplet/contact precautions for other reasons.“

Note; this advice is for countries “In the context of locations/areas with known or suspected community transmission or intense outbreaks of COVID-19”

They have also included new advice, that in areas of intense outbreak of COVID-19;

“The general public should wear non-medical masks where there is widespread transmission and when physical distancing is difficult, such as on public transport, in shops or in other confined or crowded environments

And

“Members of the general public aged 60 and older and those with underlying conditions should wear a medical mask in situations where physical distancing is not possible”

A good summary is available here.

Previous advice from the 6th of April does include from The World Health Organisation in their document;

Advice on the use of masks in the community during home care and in healthcare settings in the context of the novel coronavirus”; 

“Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including COVID-19. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted. Whether or not masks are used, maximum compliance with hand hygiene and other IPC measures is critical to prevent human-to-human transmission of COVID-19”

The World Health Organisation, in a document entitled “Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19)” Published 19.03.2020 gave a table intended for use in areas without community transmission;

 

The Royal Australian and New Zealand College of Ophthalmologists (RANZCO) updated their clinical advice on July 10th to say;

“Surgical masks are currently recommended for ophthalmologists seeing asymptomatic routine patients in the following countries: USA, UK, China, Italy, South Korea and Singapore. They are recommended in some, but not all Local Health Districts in Australia for health care workers caring for patients in a vicinity closer than 1.5m.”

When face-to-face consultations are required, ophthalmologists are advised to use their own judgement regarding use of PPE in asymptomatic, routine patients. They should be able to assess infection risk on a case-by-case basis, taking into consideration RANZCO guidance about how to assess patients, and be permitted to wear their own PPE, if they feel this is clinically justified. Any decision should acknowledge the need to preserve critically low supplies of PPE in Australia and New Zealand.”

Their website also has specific precautions for paediatric consulting

And previously have said;

“If you do decide to wear one, it would be sensible to keep it on the whole clinic rather than taking it on and off which could transfer virus to hands.” Read more. – 27th March 2020

“For patients who are symptomatic or who are otherwise considered to be at high risk having COVID-19 infection, there is a likely benefit in both the patient (more important) and practitioner on wearing a mask as well as the practitioner wearing other PPE. Therefore, routine wearing of mask by the practitioner is unlikely to be of practical benefit in asymptomatic cases.” – 27th March 2020.

Further, the Royal College of Ophthalmologists UK released a statement titled “Protecting patients, protecting staff during COVID-19 pandemic”, which was subsequently supported and repeated by the College of Optometrists UK. It outlined that for patients with no respiratory symptoms and no COVID-19 risk factors:

“Clinicians may wish to wear standard surgical masks, whilst recognising that they are of uncertain benefit. Gowns and gloves are not recommended” – 25th March 2020

Finally, the American Academy of Ophthalmology also released a statement on the 28th March 2020, outlining that for:

  • Urgent ophthalmology appointment for a patient with no respiratory illness symptoms, no fever, and no COVID-19 risk factors, take:
  • “Standard precautions only.
  • Added precaution of not speaking during slit-lamp biomicroscopic examinations is appropriate.In the setting of adequate PPE supplies, use of surgical mask and eye protection for the clinician as well as surgical mask for the patient may reduce asymptomatic and presymptomatic transmission. 
  • Currently, there are worldwide shortages of personal protective equipment (PPE), which also warrant consideration. Excessive use of PPE may deplete the supply of critical equipment required for patients with COVID-19 as the epidemic expands. Use of PPE should be considered on an institutional and case-by-case basis; universal usage for all patient encounters is appropriate in regions with particularly high COVID-19 prevalence.”

Further information

On the use of PPE for suspect and confirmed COVID-19 cases, the Australian Department of Health advises in “Revised advice on non-inpatient care of people with suspected or confirmed COVID-19, including use of personal protective equipment” updated 7th of April 2020:

“If a person, who fulfils epidemiological criteria and is in quarantine or under investigation, needs medical attention for any reason (e.g. symptoms compatible with COVID-19 or other illness/injury) they are requested:
• to telephone their doctor or hospital emergency department (ED) before presenting
• if they experience severe symptoms, to call 000 and advise the operator that they are in self-quarantine because of COVID-19 risk.

Upon presentation to a healthcare setting (general practice or other community care setting, hospital ED or pathology collection centre), of a person who is under quarantine or investigation or is a suspect case:
• Immediately give the patient a surgical mask and ensure they put it on correctly. 
• Direct them to a single room, whether or not respiratory symptoms are present.  o If a single room is unavailable, an area separate from other patient areas should be designated for assessment of suspected COVID-19 patients. 
If this is the first contact with a healthcare provider, contact the local public health unit or state/territory communicable disease branch for advice if you are uncertain about the need for testing.”

And for assessment of persons with suspected or confirmed COVID-19

“For clinical consultation with clinical examination: perform hand hygiene 
• use gown, gloves, surgical mask and eye protection (safety glasses or face shield).”

RANZCO has released the following guidelines on the 16th of April 2020 “Clinical Eye Care” that suggests triaging for patients with suspected COVID-19 as follows;

How do I manage confirmed, probable or suspected COVID-19 patients?

Ophthalmologists seeing a patient with an emergent or urgent eye problem who is at risk or has symptoms suggestive of COVID-19 will need to use their discretion to triage the relative urgency of each condition. To ensure the appropriate triage of patients during the COVID-19 pandemic, the College has adapted the Moorfields Eye Hospital Guidelines to suit our context. These adapted triage guidelines can be accessed to inform your clinical decision making. See below for guidance on immediate management of non-urgent and emergent/urgent eye conditions:

i.) Non-urgent eye problem should have their eye appointment postponed for 14 days until COVID-19 has been excluded.

ii.) Emergent and Urgent eye problems

a. If the eye condition can wait, the patient should be referred to an appropriate clinical centre for testing

b. If the eye condition cannot wait, the current interim advice from the Australian Government Department of Health should be followed including:

  • Immediately give the patient a N95/P2 (surgical if N95/P2 is not available) mask and ensure they put it on correctly.
  • Direct them to a single room, whether or not respiratory symptoms are present.
  • If this is the first contact with a health care provider, contact the local public health unit or state/territory communicable disease branch for advice if you are uncertain about the need for testing.
  • Standard precautions, including hand hygiene (5 Moments), should be observed for all patients. Patients and staff should observe cough etiquette and respiratory hygiene.
  • Contact and droplet precautions should be used for clinical assessment and collection of specimens from a patient under investigation.
  • Perform hand hygiene before putting on Personal Protective Equipment (PPE): gown, gloves, eye protection (goggles or face shield) and N95/P2 (surgical if N95/P2 is not available) mask. All assistants should do the same.
  • To collect eye swabs, stand slightly to the side of the patient to avoid exposure to respiratory secretions should the patient cough or sneeze.
  • After the consultation, remove PPE and perform hand hygiene.
  • Any contacted/contaminated surfaces should be wiped with detergent/disinfectant by a person wearing gloves, surgical mask and eye protection.
  • Note that for droplet precautions, a negative pressure room is not required and the room does not need to be left empty after sample collection.
  • Any patient with severe symptoms suggestive of pneumonia should be transferred to and managed in hospital. Call 000 and advise the operator that the patient is in self-quarantine because of COVID-19 risk.”

Information for children

The Victorian State Government on their website updated 14.07.2020 recommends;

  • Even in an area under stage 4 restrictions, children under 12 do not need to wear a face mask

The American Academy of Paediatrics has recommendations on their website updated 06.05.2020

  • For children, getting the fit right is important
  • Pleated face coverings with elastic are likely to work best for kids
  • When making cloth coverings, consider making them 5×10 inches or smaller.
  • They also have sensible information about helping children understand wearing masks

The Center for Disease Control and Protection in America recommends;

  • Children over 2 wear a face mask
  • Prioritising when the face mask is worn, as some children may not cope with wearing the mask for extended periods of time. Use when it is difficult to maintain a distance of 6 feet from others.
  • Plastic face shields for newborns and infants are not recommended.

And Finally the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) has recommended on their website updated July 10 2020;

  • Wear gloves and N95 masks as children usually cough and sneeze on you
  • Consider telehealth when appropriate

Q) Do I need to wear a N95/P2 Respirator Mask?

The CDC in a document called “Checklist for Healthcare Facilities: Strategies for Optimizing the Supply of N95 Respirators during the COVID-19 Response

Use surgical N95/P2 respirators only for HCP who need protection from both airborne and fluid hazards (e.g., splashes, sprays). If needed but unavailable, use face shield over standard N95 respirator.

The Australian Department of Health, in a Coronavirus disease (COVID-19) document updated on 7th of April “Interim advice on non-inpatient care of persons with suspected or confirmed Coronavirus disease (COVID19), including use of personal protective equipment (PPE)”

In patients with a confirmed COVID diagnosis;

Standard precautions, including hand hygiene (5 Moments), should be observed for all patients. Patients and staff should observe cough etiquette and respiratory hygiene.
Transmission-based precautions:
• Contact and droplet precautions should be observed for routine care of patients in quarantine or under investigation or with suspected or confirmed COVID-19 infection.
• Contact and airborne precautions should be observed when performing aerosol generating procedures (see Appendix 1), and care of patients with severe respiratory symptoms”

However, if you suspect a patient has a possibility of COVID infection, contact the local public health unit or state/territory communicable disease branch before treating the patient for advice.

Q) If I need to wear a mask, what should I do?

“Medical masks are surgical or procedure masks that are flat or pleated (some are like cups); they are affixed to the head with straps.”

The following information from the World Health Organisation on the 6th of March on correct use of medical masks derives from the practices in health-care settings:

  • “Place the mask carefully, ensuring it covers the mouth and nose, and tie it securely to minimize any gaps between the face and the mask.
  • Avoid touching the mask while wearing it.
  • Remove the mask using the appropriate technique: do not touch the front of the mask but untie it from behind.
  • After removal or whenever a used mask is inadvertently touched, clean hands using an alcohol-based hand rub or soap and water if hands are visibly dirty.
  • Replace masks as soon as they become damp with a new clean, dry mask.
  • Do not re-use single-use masks.
  • Discard single-use masks after each use and dispose of them immediately upon removal.”

 

There is a CDC guide on appropriate facial hair for maintaining a tight seal on NIOSH filtering facepiece respirators. The CDC made a statement on Feb 28th 2020 highlighting that this is not in relation to the general public when wearing face masks, but rather specific advice published 2017 for people who require airborne hazard protection. See the graph here. This may be important if you are actively dealing with diagnosed COVID-19 patients.

Wearing a N95/P2 mask fitting advice from Health NSW’s Procedure for putting on a P2/N95 face mask and conducting a fit check:

  1. Remove glasses and hats. Tie back long hair so it does not become tangled in the straps of the respiratory protection
  2. Put the mask on your face, ensuring the nos​e piece is at the top of the mask
  3. Place the headband or ties over the head and at the base of the neck
  4. Compress the mask against the face to ensure a seal across the bridge of the nose
  5. Compress the mask to ensure a seal across the cheeks and the face; and
  6. Conduct a fit check: check the seal of the mask by gently inhaling. If the mask is not drawn in towards the face, or air leaks around the face seal, readjust the mask and repeat process or check for defects in the mask. If the mask still leaks you may need to try a different size or style of mask.

Note: People with beards should shave before using a P2 mask as a good seal between the mask and the wearer’s face cannot be guaranteed if they have facial hair.”

Video by Alison McMillan, Australia’s Chief Nursing and Midwifery officer, on how allied health professionals should wear PPE (correct procedure to don PPE starts at 4:00 mins).

Q) Can you re-use masks? Can they be sterilised?

The CDC also have released advice on the use of face masks during an epidemic, where stocks are potentially low as a strategy for optimising the supply of facemasks.

“Extended use of facemasks is the practice of wearing the same facemask for repeated close contact encounters with several different patients, without removing the facemask between patient encounters.

  • The facemask should be removed and discarded if soiled, damaged, or hard to breathe through.
  • HCP must take care not to touch their facemask. If they touch or adjust their facemask they must immediately perform hand hygiene.
  • HCP should leave the patient care area if they need to remove the facemask.”

The Royal Australian and New Zealand College of Ophthalmology (RANZCO) released a statement saying;

“Standard Surgical masks have not been specifically noted to be helpful for ophthalmologists, ophthalmic assistants or other healthcare workers as there is no evidence of their usefulness against virus transmission to the healthcare worker. However, we would understand that you might want to wear one if you feel it will help you avoid touching your face during clinic. If you do decide to wear one, it would be sensible to keep it on the whole clinic rather than taking it on and off which could transfer virus to hands.” 27th March 2020 – Read more.

The World Health Organisation has also answered this question on disposable face masks; stating on the 31st of March that:

“Disposable medical face masks are intended for a single use only. After use they should be removed using appropriate techniques (i.e. do no touch the front, remove by pulling the elastic ear straps or laces from behind) and disposed of immediately in an infectious waste bin with a lid, followed by hand hygiene.”

Professor Mary-Louise McLaws, a Professor of Epidemiology of Hospital Infection and Infectious Diseases Control at the University of New South Wales and a member of the World Health Organization (WHO) Health Emergencies Program Experts Advisory Panel for infection Prevention and Control Preparedness also answered this issue with the following on the 9th of April 2020;

“During the SARS 2003 outbreak healthcare workers reused their own masks because of the surge in demand for masks associated with the high number of SARS patients and the high number of procedures that required the healthcare worker to wear a mask. They placed their N95 mask into a labelled bag and re-used it the following day until the mask was moist or damp and then they replaced it with a new one. This is not an ideal situation but is an emergency response to severe disruption to the supply chain.

We can’t yet safely reprocess N95 masks because research has reported reprocessing degrades the strands within the mask. The World Health Organization (WHO) is right now working with global experts to identify the safest method of extending the use of masks until a reprocessing method that does not degrade the mask is identified.”

However, there are multiple contradicting sources regarding the re-use of N95 masks:

The National Academies of Sciences, Engineering, and Medicine reports that, in a pandemic situation where masks are in short supply, “use and store the respirator in such a way that the physical integrity and efficacy of the respirator will not be compromised.” You shouldn’t keep it in your pocket, wallet, purse, or handbag.

The Centers for Disease Control and Prevention (CDC) website suggests that you “hang used respirators in a designated storage area or keep them in a clean, breathable container such as a paper bag between uses.” This is for pandemic situations where the supply of N95 masks is significantly compromised.

Q) Where can I get slit lamp shields from?

All optometrists should use slit lamp shields to reduce droplet transmission during close encounter patient examinations.

Some options for commercial slit lamp shields;

Other universal shields:

Q) Can I make my own slit lap shield?

Yes. Qld Member Helen Flohr passed on a helpful tip for creating a temporary breath shield by putting an empty sheet through the laminator and then cutting a hole for the slit lamp eye pieces. It is again larger than many conventional breath shields. Please be aware these may be more difficult to disinfect between patients than commercial shields.

Q) Will optometrists be able to access the government stockpile of masks?

The Australian government has now announced they will be providing allied health professionals with some provision of the government stockpile of mask. Operating under the assumption that Optometrists will triage patients with respiratory symptoms, Optometry has been classified as moderate priority (as opposed to radiographers x-raying COVID-suspect patients whom are high priority).

They have also provided the reminder; “It is important to note that Personal Protective Equipment (PPE), including surgical masks, is a last line of defence in infection control and prevention. PPE does not replace the need for modifications to practise such as telehealth and physical distancing.”

How to apply to receive surgical masks from Victorian and Tasmanian PHNs

Individual PHNs have in place processes for access to PPE. Allied health practices with demonstrated need should first determine which PHN region they belong to. A list of PHNs can be found at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHNLocator and you can search for your PHN by address.

Once you’ve identified your PHN, please refer to the list below. If your PHN is not included in this list, please use the contact details on the Department of Health website to get in touch with your PHN.

PHNGeneral websiteMask ordering process – Allied Health
Eastern Melbourne PHN PHN COVID website
Online ordering process
Gippsland PHN PHN COVID websiteTo request a supply, or if you have any questions, please contact Gippsland PHN:

Phone: 03 5175 5444
Email: info@gphn.org.au
North Western Melbourne PHN COVID websiteOnline ordering process
Murray PHN PHN COVID websiteOnline ordering process
Primary Health Tasmania PHN COVID websiteVisit the PHN COVID website, navigate to ‘surgical masks’ and follow the instructions.
South Eastern Melbourne PHN PHN COVID websiteOnline ordering process
Western Victoria PHN COVID websiteOnline ordering process
Tasmania PHNPHN COVID websiteVisit the PHN COVID website, navigate to ‘surgical masks’ and follow the instructions.

How to apply to receive surgical masks from NSW and ACT PHNs

Individual PHNs have in place processes for access to PPE. Allied health practices with demonstrated need should first determine which PHN region they belong to.

A list of PHNs can be found at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHN-Locator and you can search for your PHN by address.

Once you’ve identified your PHN, please refer to the list below. If your PHN is not included in this list, please use the contact details on the Department of Health website to get in touch with your PHN.

PHNGeneral websiteMask ordering process – Allied Health
ACT (Capital Health) PHN website Online ordering process
Central & Eastern Sydney PHN COVID website See the information regarding masks for allied health
Online ordering process

Hunter New England Central Coast PHN website Online ordering process
MurrumbidgeePHN website Online ordering process
Nepean Blue Mountains PHN PHN COVID website Online ordering process
North Coast NSW PHN PHN COVID website Look at the information regarding surgical masks and follow the process for ordering (currently being updated)
Northern Sydney PHN PHN COVID website Online ordering process
SENSW PHN (Coordinare) PHN COVID website Online ordering process
South Western Sydney PHN COVID website See information about surgical masks and follow the process for ordering. Email enquiries to: enquiries@swsphn.com.au
Western Sydney PHN COVID website Online ordering process
Western NSW PHN COVID website Online ordering process

How to apply to receive surgical masks from South Australian PHNs

Individual PHNs have in place processes for access to PPE. Allied health practices with demonstrated need should first determine which PHN region they belong to.

A list of PHNs can be found at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHNLocator and you can search for your PHN by address.

Once you’ve identified your PHN, please refer to the list below for specific information on how to apply for the surgical masks.

PHNGeneral websiteMask ordering process – Allied Health
Country SA PHN COVID website Online ordering process
Adelaide PHN COVID website See the informationon surgical masks and complete the 'Pharmacy, Aboriginal Controlled Health Service and Eligible Allied Health Surgical Mask EOI' and return to covid19@adelaidephn.com.au

How to apply to receive surgical masks from QLD PHNs

Individual PHNs have in place processes for access to PPE. Allied health practices with demonstrated need should first determine which PHN region they belong to.

A list of PHNs can be found at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/PHNLocator and you can search for your PHN by address.

Once you’ve identified your PHN, please refer to the list below. If your PHN is not included in this list, please use the contact details on the Department of Health website to get in touch with your PHN.

PHNGeneral websiteMask ordering process – Allied Health
Central Queensland, Wide Bay, Sunshine CoastPHN COVID websiteOnline ordering process
Gold CoastPHN COVID websiteOnline ordering process
Western QueenslandPHN COVID websiteNo designated application process for allied health yet. Contact the PHN to request surgical masks.

Darling Downs and West MoretonPHN COVID websiteNo designated ordering process for masks. To order masks, contact the Primary Care Liaison team: practicesupport@ddwmphn.com.au
Northern QueenslandPHN COVID websiteOnline ordering process
Brisbane NorthPHN COVID websiteOnline ordering process
Brisbane SouthPHN COVID websiteOnline ordering process

How to apply to receive surgical masks from WA PHNs

For mask requests, practices in Western Australia are asked to complete the COVID19 Request Form.

Practices should also familiarise themselves with the appropriate use of surgical masks.

In general, the allocation will be one box (50 surgical masks) per practice, re-orders will be permitted, however re-orders will not be accepted within five business days (Mon-Fri) of the previous request.

 

How to apply to receive surgical masks from NTPHN

The Northern Territory PHN advises that they have not yet received masks and do not have an ordering process in place. We advise members to contact the PHN via their website: https://www.ntphn.org.au

 

Q) Where can I get masks?

Simply type ‘Surgical Mask’ or ‘P2 / N95 mask’ into your online search bar to see what is available.

Amidst a huge increase in demand the answer to this question changes daily but supply lines seem to be improving as many factories overseas and locally pivot to making PPE.  Online suppliers selling surgical masks as at 14 May 2020, still  have stock available from Australia for quick delivery.

It may be worth splitting orders with different suppliers (rather than putting all your eggs in one basket) as members are reporting some orders being cancelled and refunded or transit and shipping delays.  You may wish to consider P2 masks for yourself and staff and surgical masks for patients.

Here are some suppliers that have let us know that they have masks available, or we have been alerted that members have been successful in getting orders. Optometry Australia does not endorse, or have any corporate relationship with any of the following companies, nor guarantee quality or supply. If you know of any available suppliers (or are one) that should be added to this rapidly changing list, please let us know.

  • Aviva & Mann Optical group has face masks arriving shortly
  • ANSIC has surgical and N95 masks, many of which are TGA / FDA approved
  • Kogan Australia has multiple sellers providing masks, many of which are TGA / FDA approved
  • PPE Masks Australia has sanitiser plus surgical and N95 masks, many of which are TGA / FDA approved.  They have offered a discounted rate to OA members. You will need to enter a password: (staysafe) to enter site and at the checkout use your AHPRA number when registering and discount code OPTOM2020. Pricelist available here and guide to mask selection here.
  • Space Tank has been a successful supplier for some members. An Australian based company in Coburg, Victoria, they make face masks.

 

Q) Should I make my own mask?

Professor Mary-Louise McLaws, a Professor of Epidemiology of Hospital Infection and Infectious Diseases Control at the University of New South Wales and a member of the World Health Organization (WHO) Health Emergencies Program Experts Advisory Panel for infection Prevention and Control Preparedness answered this issue with the following on the 9th of April 2020;

“No. The production of masks is complex, for example some masks are made up of polypropylene central layers that are charged to prevent penetration of particles and designed to fit the face to provide a seal to prevent small particles from entering the mask. Both N95 and surgical masks are lab tested to ensure they filter at least 95-98% of lab particles (referred to as the ‘most penetrating particle’).

It is understandable that people in places like New York City where the COVID-19 infection rate is very high are nervous and may resort to making their own masks. While a mask made out of cotton may provide a small amount of protection from droplets, it is incredibly important that this does not give people a false sense of security. If you want to wear a mask, remember it may not be hospital grade. If you wear a mask don’t forget to hand hygiene, avoid touching your face and apply social distancing as these simple actions are still the best ways to avoid being infected with COVID-19 even while wearing a non-hospital grade mask.”

 And the CDC on the 17th of March 2020 in their release titled “Strategies for Optimising the supply of facemasks” stated;

“In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.”

Q) How do I know the quality of my mask, or if it is appropriate for clinical use?

There have been multiple rumours about inadequate masks entering the Australian market, and deciding if a product is suitable for clinical use is challenging. The following is not an exhaustive list, but some recommendations include:

  1. Look for TGA, FDA or CE certification where possible.  Please be aware the ‘China Export’ mark and  European standards logo “CE” look very similar.
  2. Check how many layers do the surgical masks have?
  3. Is it from Australian stock or being sent from overseas and what is the estimated delivery window (often months away)
  4. Is it a reputable seller?
  5. The ABC reported on the 1st of April 2020 that the Australian Border Force had seized up to 800,000 counterfeit or otherwise faulty masks
  6. How fluid repellent is the mask? Halyard has this infographic to explain the different standard of masks (Note: Halyard does retail masks)
  7. According to the Australian Department of Health “Safe Use of PPE”, The P2 mask is the Australian equivalent of the United States’ N95 mask. Both masks are designed with a high filtration capacity and essentially provide the same level of protection.
  8. For in depth description of how masks were developed the American Centers for Disease Control and Prevention recently put out this extensive blog.

Support for our members

We realise this is a difficult and uncertain time for all of us. Optometry Australia’s optometry advisor helpdesk  offers our members dedicated experienced optometrists ready to provide confidential support.

Optometry Australia’s advisor helpdesk
Email: national@optometry.org.au
Phone: (03) 9668 8500
Operating hours: Monday to Friday, 9.00am to 5.00pm AEST

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