Covid-19

New PPE plan leaves community care workers without masks

The Government yesterday reassured us there are plenty of masks for front line staff dealing with the public. Yet it seems home care workers, who provide up-close personal care for tens of thousands of people every day, won’t be given them.

Yesterday two documents hit my inbox. One was a press release from Health Minister David Clark headlined “Face masks flowing to DHBs”.

“Face masks and other personal protective equipment (PPE) are vital tools for our doctors, nurses and midwives, and other essential workers at this time,” Clark said in the statement, adding that 640,000 masks were sent to DHBs on Thursday. 

“These workers deserve all the support and thanks we can give them."  

Clark finished with the usual reminder: “The best thing we can all do is stay safe at home and limit the potential for Covid-19 to spread.”  

Good news. But...

The second document showed the Ministry of Health’s just-released guidelines for protective gear for community care providers. These include all the workers providing personal care for the more than 100,000 elderly and disabled people in their homes and in rest homes, plus those caring for cancer and other patients in the community through the hospice service.

This is what PPE they will get:               

Source: Ministry of Health

No masks. In fact, virtually no protective gear at all.

Think about this. On the one hand, the Government is telling the rest of us that we can’t walk within two metres of someone in the street, or share the same playground equipment, otherwise we might get and spread Covid-19.

On the other hand, it is telling home care workers, who might visit eight different households in a day, potentially touching or being within touching distance of all these people for 1-2 hours at a time, that they - and the people they are caring for - don’t need masks. These are people whose job necessarily involves them coming right up close to their clients - lifting them, washing them, feeding them, changing their clothes. 

And then moving on to do the same thing to someone else.

And it’s not just about the carers and the people they care for. The net of people who could potentially be infecting these two groups - and through them the community - is much wider.

Many disabled and elderly people don’t live alone; they may well have family members who have been overseas or been in contact with someone with Covid-19 another way. The same with the caregivers - they almost certainly have other people in their home bubbles.

The Government is talking about masks for supermarket and banking staff, who almost certainly don’t come as close to their customers as home care workers do to theirs.    

Isn’t the point of the lockdown that we don’t know who is Covid-free? 

These are healthy people, government says    

The Government argues that home care workers and their clients are Covid-free, so don’t need masks and other protective equipment. 

That doesn’t make sense.

Isn’t the point of the lockdown that we don’t know who is Covid-free? 

So, what if a community care worker goes into the home of someone where there is the possibility of Covid infection? Even then, the Ministry of Health says they won’t be given masks, gowns, gloves, unless they are dealing with bodily fluids (see table below). 

But what about beds, tabletops, sheets, taps, doorknobs? The person’s hands, face, and clothes? Any of the myriad things the Government is telling the general population to avoid coming into contact with, in case someone with Covid-19 touched them first.

Source: Ministry of Health

Note the ministry’s table suggests home care workers ask the patient to wear a mask when providing care “if possible”.

But where are these masks going to come from, if the DHBs aren’t providing them? Most of us don’t have a supply of surgical masks - or better the tight-fitting P2 or N95 masks with built-in filters that are recommended protection against Covid-19 for healthcare workers - sitting in the bathroom cabinet. 

Only if care workers are dealing with a confirmed or suspected case will the Ministry provide them with full protective gear, the guidelines say. And even then they won't get a N95/P2 mask unless "aerosol generating procedures are performed". These are things like suction, which can sometimes be performed by care workers. 

No care workers Newsroom spoke to had any P2 masks.

Source: Ministry of Health

And while the guidelines specify a full gown or apron, community care workers Newsroom has spoken to say they are almost always given an apron, which doesn’t protect their arms or sleeves, not a gown, which does.    

Newsroom asked the Ministry of Health why it wasn't giving masks to home care workers, despite the potential risks to workers, clients and the wider community. 

Spokesperson Charlotte Gendall said the country had 23 million masks, 1.9 million aprons and gowns, 2.7 million pairs of gloves, and 60,000 sets of eye protection in either the national stockpile or in DHBs' reserves. 

But she didn’t say why so few were being deployed to home care workers.

“There are a number of developments in train and we expect to be able to come back further on this next week,” Gendall said.

In the meantime, thousands of home care workers will be going into households this weekend, without protection. 

Or, increasingly, families will be coping with the tough job of caring for sick and disabled children, family members with disabilities or cancer, and frail elderly parents without any outside help - because they are too scared to let home care workers through the door.

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