Wednesday, November 4, 2020

PPE Tip: Update to Directive #5

If a healthcare worker cannot maintain two-metre distance with a patient or resident, the healthcare worker can determine if a fit-tested N-95 respirator is needed, and must receive it if they request it.

By Michael Reid, Ontario Healthcare Coordinator

Many people still haven’t heard that Directive #5 was updated on October 5, 2020. The key change was to grant all healthcare workers dealing with a COVID-19 outbreak the right to request and be provided with an N-95 respirator when in close proximity to a COVID-19 patient or resident.

Directive #5 is the one that requires, among other things, the following five things:

All healthcare facilities are to engage in conservation about PPE with workers and provide information on how to use it safely.
Staff in long term care homes are to wear surgical/procedural masks at all times.
A point-of-care risk assessment (PCRA) is to be performed by every regulated health professional before every patient or resident interaction in a public hospital or long term care home.
If a regulated healthcare professional determines, based on the PCRA, their clinical judgement, and proximity to the patient, that an N-95 respirator is required, it must be provided for all healthcare workers who are providing care for that interaction.
The fifth and final requirement is new: When hospitals or long term care homes are in a COVID-19 outbreak, if a healthcare worker cannot maintain two-metre distance with a patient or resident, the healthcare worker can determine if a fit-tested N-95 respirator is needed, and must receive it if they request it.

Most studies show that eye protection and a surgical mask are just as effective as an N-95 mask if aerosol generating procedures are not happening, and that COVID-19 is primarily spread by droplets and not by aerosols. Nevertheless, many cases do exist of infection from aerosol transmission.

Aerosols are created to a small degree from regular breathing in most people, and more are emitted with talking—especially loud talking—and coughing. Most aerosols are emitted during sneezing.

Flushing the toilet also generates aerosols and has been found to cause infection. The precautionary principle would suggest an N-95 mask if you suspect high levels of aerosols may be generated, or be lingering in a poorly ventilated room.

Be educated on your risks, and stay safe!

PPE Tip: Update to Directive #5

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