BaptistCare & NSW Health – Q&A to control the spread of COVID-19

So I think we can we can really take
confidence that there are things we can do, and it is normal to be a bit worried
but keep that worry under control, do the sensible stuff, clean your hands lots.
You should have access to alcohol hand rub. I feel like I need to now so
somebody grab me a bit because I just touched a surface and I don’t know who’s
been there. So it’s really important that we do that and as you can see I’m
just clasping my hands there because I don’t know where they’ve been. I think alcoholing them is really good
and there’s a good way of alcoholing too. So you want to get both surfaces of your
hands and in between your fingers and actually get that alcohol around the
hands and that gives you the confidence that your hands are clean. Now the hands
are the vector for this virus. If we catch this virus we catch it from our
own hands and we do know where those hands have been. And the way we catch it
is we rub it in our eyes and around our face. So this is the target and this is
the vector and we have to all start being conscious of our hand to face
contact, okay? So you have control of that and you can stop yourself getting this
virus by having clean hands and not rubbing your eyes with dirty hands. So
that’s much more important than the droplet spread that everyone focuses on. If you are dealing with people who have a respiratory virus, so if somebody in
your house has a respiratory virus or one of your patients or if you’re
looking after patients with respiratory illness, with respiratory infections then
you do need to put droplet precautions on. That’s where you wear a mask and
if you’re going to have clinical contact with them, you know, quite close contact
in that one meter zone we would also have you in a gown and gloves. And what we’re doing in Dorothy Henderson at the moment, in the lockdown
situation, is that when we need I go in and I examine the patients if they’ve
got a new symptom and I will have a gown and mask and gloves on. I still clean my
hands lots in that process, okay? And for those clinical people amongst you, you
would be familiar with the way you particularly with you doffing your PPE,
your personal protective equipment, you need to alcohol your hands several times
in that process and if you’re not sure about that get some help there is help around to explain that process to you. But you
alcohol your hands at least three or four times in that process and it’s
really important that you do that, to keep yourself safe. [STAFF] If there is any area that is infected by a virus, for how long the virus can be alive in that area?
[JAMES] Yeah really good question.
So surfaces like the one I touched before can have virus on them
for a little while and probably the right answer to that, and I hate to be
non-scientific, but the the probable answer is a little while. And it will
vary bit by bit. If you sneezed on the
pavement out there where you’ve got sunlight, the virus is not going to last
very long in in UV light. It destroys viruses pretty quickly. So the answer to
that question is a little while and it depends exactly on the circumstances. The
literature would suggest that it might be as long as two days, if if it’s in
perfect condition. However this virus is really easily killed by what we
use – by alcohol, by bleach, by all the other disinfectants, the disinfectant wipes that we use. So in general terms, if a COVID patient has
touched this microphone or something we would wipe that down with disinfectant
wipes, and that will kill the virus. [STAFF] A sneeze – how close is close?
[JAMES] Less than 1.5 meters is what I’m saying, Kathy? [KATHY] It depends on what you read, World Health Organisation for example say it’s within 1m. Since COVID-19 we’ve been a little bit cautionary over that, and we’ve expanded that to less than 1.5 metres. But anywhere from that 1 to 1.5 to 2 metres. [JAMES] So just to illustrate that, Kathy and I are safe currently. If she had COVID, I’m not gonna get it, okay? Unless we cuddle up. This is what’s called social distancing. We
do want people to maintain their own personal space and we can have
conversations with people at 1.5 meters quite simply, and we stand back. This
morning when I arrived I got offered a few hands and we did this. So you can
actually protect yourself by – other people are the risk factors here – so you don’t need to be miles away from them, this is enough.
[STAFF] For a sneeze?
[JAMES] For a sneeze, yes. [KATHY] I might just take this opportunity to focus on some of the infection control requirements. Obviously we have
standard precautions contact droplet and airborne precautions. Currently COVID-19 is managed by contact and droplet airborne precautions when we do
aerosol generating procedures of which many would not be done in these
environments. These are precautions that are your business as usual precautions.
They set us in good stead for managing normal droplet spread
infection, so normal influenza type illnesses. We’re coming into winter,
it’s about making sure that we’re across those precautions normally and I think
sometimes what these types of situations teach us is that we often let
some of those good standards go by the wayside. But it’s really important that
we manage around standard precautions so all those things – cough etiquette,
respiratory hygiene, washing hands, good environmental cleaning, social
distancing, cleaning equipment, protecting yourself for any person who’s got influenza like illnesses and you need to be close then you put a mask on.
They’re the things that we wouldn’t do normally, but obviously do we do need to
be aware that sneezing and coughing is a normal defence mechanism. So it’s not
like everyone’s going to instantly stop sneezing and coughing. We have
to be aware of that and making sure that people do it appropriately into tissues,
hankies, elbows, get rid of them it’s about knowing your cough or
sneezing. If you have allergies and things like that, it’s about
recognising a change and aligning those with symptoms and James might want to say a little bit more about that. I’m just cognisant that some people get very cranky when somebody sneezes beside them or
coughs, but it is a normal defence mechanism that we sneeze and cough. It’s about how we manage that and making sure that we’re aware of things
that are different to that. Any symptoms that are outside of those that
may be aligned with an influenza-like illness then you need to exclude
yourself from work. Quite often as workers within providing health,
we like to soldier on because we’re very much about making sure that
our patients and residents are cared for. This is the time that you really need to
take heed and go, “You know what? I’m not feeling very well, I’ve got a bit of
a fever, I’ve got a scratchy throat, I really shouldn’t be going to work.” you
know those sorts of things. [JAMES] Yeah well said Kathy. I think separating when you’re worried and you’re imagining symptoms, from when you
genuinely have symptoms is what Kathy’s pulling out there. Because many
people have a little bit of allergy, a little bit of sinusitis, if you
focus on your throat could it be slightly more tender than usual? I think
if you get a fever, a headache and you’re unwell, you shouldn’t be at work. [JAMES] I think one of the risks in this situation is the worried well. So a lot of people worried out there and wanting
to go and get swabs. And if they all come to our Emergency Department at the
same time, we’re not going to be able to look after the heart attacks, the strokes,
all the things that an Emergency Department needs to look after.
So what we want to identify is people who are contacts, and whether they’re
either close contacts or casual contacts and this is a big suburb and
yet we have a small number of cases in a very isolated area. So if you have sat
with one of those cases and had 15 minutes of face-to-face discussion with somebody who goes on to be definitely COVID positive, then you
are a close contact. Public Health will be chasing those individuals and
they’ll be on a list and they’ll be followed up. Contacts outside of that get
much more diffuse as you go out and it’s much less likely that there will be a
problem outside of that immediate close contact group. So what we tend to do is
try and identify that close contact group and follow that group quite
intensely. And if people are in that group then yes they will be followed and have that problem managed. If they’re outside of their group they probably
won’t, but they might think they should be in that group and that’s the the
issue you’re discussing. We want to try and avoid too many people trying to
insert themselves into the close contact group when they’re not part of that
group. So the fact that you’ve worked on this site is not a risk factor. You need
to actually have a specific risk factor. [STAFF] People who are recovering, are they developing antibodies? Are they developing resistance to COVID-19?
[JAMES] We believe so. With every other virus that’s the way, it works so there’s no reason to
believe it won’t work that way with this virus. The only hesitation in my voice is
because those studies are actively being done. And they’re being done at Westmead
and they’re been done at Prince of Wales and all the other hospitals that are
involved in the research aspects of this. People like me and Kathy are getting
10 research articles a day and trying to condense that and
understand exactly what’s happening. But it would be very unusual if that wasn’t
the case given what we know about this virus – and we know it’s cousins.
We know it’s cousins that are SARS and MERS the high pathological viruses and
we know it’s less pathological viruses you know the other corona
viruses and we see that in in most respiratory viruses. So without saying
absolutely yes, we believe that. [STAFF] What does self-quarantine mean? How a normal day would look like if advised to self quarantine? [KATHY] Yeah another really good
question because I think unfortunately in some circumstances, people haven’t
quite understood what self isolation means. So self isolation really does mean
you take yourself out of the community and you stay at home in isolation.
If you have support that can deliver food or other supplies.
Obviously if there’s a need for you to go out into the community,
whilst we’re not recommending against that… whilst we are recommending
against that if there’s any reason why you need to go then you need to put on a surgical mask. Those people that are being self
isolated are in fact being provided with self isolation kits from Ministry of
Health that have those sorts of things. Now about going home to other loved ones, it’s about social distancing from those loved ones so trying not to be in the
same room as them and if there’s no way that you can keep that spatial
separation then it’s about either putting masks on and just increasing your
general hygiene. So if I had, if I myself for example went home
and went, “Oh, now I’m a contact,” I would put myself in the spare room. I would just be saying to my family members, “Look, listen if you
cannot be within one-and-a-half metres of mum.” If you can keep distancing, make sure you use your own towel, cleaning, that kind of stuff. I have a son who’s immune compromised, I still
wouldn’t have any worries. I may keep him a little bit more separated but
I can do online shopping those sorts of things. I can do
a lot of online shopping. It’s not self isolate and then go out to the shops. It’s not self isolate and not go to work
but “Hey, I can go to the football.” Self isolation really means you go home
and you stay home for the 14 days and unfortunately we’ve had a few cases
where they’ve perhaps broken isolation. And that sets up another kind of dominoes
effect for risk factors and that’s probably because they really didn’t
understand what self isolation means. There are online numbers that you can
ring if you’re having issues or you need some additional support and usually the
self isolating people are being checked in through public health systems across
New South Wales.


  1. Great Q&A.

  2. Great initiative from BaptistCare for staff.

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