Australian Health Protection Principal Committee coronavirus statements on 24 April

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Statement on the recommencement of kidney transplantation

AHPPC has been approached by the Transplant Society of Australia and New Zealand (TSANZ) regarding the recommencement of kidney transplantation in Australia.

TSANZ has noted the significant reduction in community spread COVID-19 and the pleasing resumption of elective surgery in Australia, as announced by National Cabinet. TSANZ now believes a cautious recommencement of kidney transplantation is warranted.

TSANZ believes that deceased donor transplantation and living donor transplantation should be safe to recommence on clinical grounds as the balance of risk from the virus versus clinical benefit sits now in favour of transplantation. TSANZ further notes the small number of dialysis and kidney transplant patients that have been affected by COVID-19.

AHPPC supports the cautious recommencement of kidney transplantation at this time, with COVID-19 screening of donors.

Updated advice regarding schools

The Australian Health Protection Principal Committee (AHPPC) published Advice on reducing the potential risk of COVID-19 transmission in schools on 16 April 2020.

Among many measures, this statement suggested that smaller class sizes might reduce the potential risk of COVID-19 transmission in schools. AHPPC does not believe however, that the ‘venue density rule’ of no more than one person per four square metres is appropriate or practical in classrooms or corridors, nor maintaining 1.5m between students during classroom activities.

This clarification complements AHPPC’s Advice on reducing the potential risk of COVID-19 transmission in schools.

AHPPC continues to note that there is very limited evidence of transmission between children in the school environment; population screening overseas has shown very low incidence of positive cases in school-aged children. In Australia, 2.4 per cent of confirmed cases have been in children aged between 5 and 18 years of age (as at 6am, 22 April 2020). AHPPC believes that adults in the school environment should practice room density measures (such as in staff rooms) given the greater risk of transmission between adults.

Statement on non-medical face coverings for public use

The Australian Health Protection Principal Committee (AHPPC) met on 18 April 2020 to discuss the use of non-medical grade face coverings for public use as a potential infection prevention and control measure against coronavirus disease (COVID-19).

Background

AHPPC sought advice from its Infection Control Expert Group (ICEG) on the matter of public use of non-medical grade face coverings or utility masks.

ICEG sought a referenced evidence-base from the Australian Commission on Safety and Quality in Health Care (ACSQHC).

ICEG advice summary

The Infection Control Expert Group (ICEG) met on 15 April 2020 to discuss the use of non-medical grade face coverings for public use as a potential infection prevention and control measure against coronavirus disease (COVID-19).

ICEG reiterated previous advice that the most important ways to prevent spread of COVID-19 in the community are to:

  • Keep your distance (physical distancing);
  • Wash your hands (hand hygiene);
  • Cover your mouth and nose when coughing or sneezing (respiratory hygiene/cough etiquette); and
  • Stay home avoid contact with others when you have respiratory symptoms.

These are the key strategies for the protection of Australians and preventing transmission of COVID-19.

Wearing a mask in public is not recommended as it adds little if any protection.

AHPPC statement

AHPPC notes and supports the advice from ICEG and emphasises above all else, the importance of maintaining physical distance between people, hand hygiene, cough and sneeze etiquette, and staying home as much as possible, especially if feeling unwell.

AHPPC agreed that in the current Australian context of relatively low community transmission, the use of masks by Australians in public is not warranted. However, countries with significant community transmission may elect to add public wearing of masks as a strategy within a response to COVID-19. Should significant community transmission in Australia occur, mask wearing in public is an available option.

AHPPC acknowledges that public mask wearing in some cultures is normal practice and predates COVID-19.

AHPPC also acknowledges that some people may wish to complement physical distancing, hand hygiene, cough and sneeze etiquette, and staying at home with a non-medical grade face covering in the belief that these masks possibly prevent transmission if the wearer is infected and these masks may prevent infection of the person wearing the face covering. AHPPC reiterates that these proven measures should not be compromised for the sake of wearing a non-medical grade face covering.

If people choose to purchase and wear a mask, they might consider particular characteristics for such a mask. These characteristics could be considered by potential onshore manufacturers with appropriate labelling.

  • Consideration may be given to using the relevant Australian Standard, viz., AS 4381: 2015 Single-use face masks for use in health care as a baseline for manufacturing. This standard defines 3 levels of barrier protection and meeting all or most the requirements of the lowest (level 1) barrier (particularly the requirements for bacterial filtration efficiency) would provide a basis for a reasonable level of protection from a non-medical face covering.
  • A non-medical grade face covering should at a minimum cover the mouth and nose and not have any gaps.
  • The non-medical grade face covering should be able to be secured to the face in a manner which avoids the need to have fingers touching the front of the covering.
  • The non-medical grade face covering needs to be replaced whenever it gets damp either from the humidity associated with breathing or because of oral or nasal secretions. A damp covering poses a risk of transmission of infection.
  • The non-medical grade face covering needs to be able to be removed without fingers touching the front of the covering.
  • The non-medical grade face covering should be made from a fabric with sufficiently dense weave that offers resistance to the flow of air without impeding breathing.
  • The non-medical grade face covering should be washable so it can be worn repeatedly.

The Australian Government Department of Health will seek assistance from the Commonwealth Scientific and Industrial Research Organisation (CSIRO) to assess commercially manufactured non-medical grade face coverings.

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