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02/Jul/2020

This article was written a week before Melbourne and Mitchell Shire in Victoria resumed Stage 3 restrictions from 11.59pm 8 July 2020.

We’ve updated it as information has changed for different parts of Australia. Latest update 30 July 2020

Another week, another edit 😕

“The advice from the Victorian Department of Health and Human Services has been updated. People living in metropolitan Melbourne and Mitchell Shire and will now be required to wear a face covering when leaving home for one of the four reasons, following a concerning increase in coronavirus cases in recent days. To give people time to purchase or make a face covering, this new rule won’t be enforced until after 11.59pm on Wednesday 22 July – but for those who can, please start wearing yours immediately. The fine for not wearing a face covering will be $200.”(1) 

  • All people in regional Victoria will be required to wear a face covering from 11.59 Sunday 2 August 2020.
  • NSW now recommends people wear a mask when physical distancing can’t be guaranteed.(8)

 

Just as restrictions began easing across Australia, Victoria started recording outbreaks of COVID cases. For more than two weeks the number of Victorians infected has been in the double-digits 😯 And on Wednesday many suburbs in Victoria were locked down to stop the spread of the virus.

So if you’re immunosuppressed and feeling really vulnerable no one can blame you. This is a scary time, and having a condition or taking medication that makes you more at risk of getting ill from any contagion or infection, adds another level to this.

Although, we’re being advised to stay at home as much as possible, sometimes we just have to go outside the house. Some of us can’t work from home, or we have an appointment that can’t be done online or via video chat, or we have to use public transport.

So how do we protect ourselves when we have to go out?

Three months ago we wrote a blog about face masks. We thought it was timely to revisit this blog in light of the latest evidence, and advice from the Federal and Victorian Governments.

The advice from the Federal Government

This information is general advice about the use of face masks in Australia. It’s important to note that the advice from your local state or territory health department supersedes any general advice about face masks and coverings.

“In Australia the routine use of face masks in the community is currently not recommended, while the rate of community transmission of COVID-19 is low.” (2)

“However, some members of the public may choose to wear a mask in situations where it is not feasible to maintain physical distancing e.g. on public transport and/or if they are at increased risk of severe illness if infected (e.g. because of their age or a chronic medical condition). This may provide some additional protection in these circumstances.” (3)

This advice takes into account the fact that restrictions are easing, and people are going out more. And with the opening up of our communities, the risk of coming into contact with people who have the virus, whether they appear to have it or not, is increased.

The advice also reinforces the message that masks aren’t a substitute for all the other things we’ve been doing: staying at home as much as possible, physical distancing, washing/disinfecting our hands regularly, not touching our face, coughing/sneezing into our elbow and staying home when we’re sick.

The advice from the Victorian Government

Parts of Victoria are currently experiencing significant outbreaks of COVID-19. For that reason the recommendations about face masks have changed.

The Victorian Premier Daniel Andrews and Chief Health Officer Brett Sutton have advised that it will be mandatory from 11.59pm on Wednesday 22 July 2020 that people living in metropolitan Melbourne and Mitchell Shire must wear a face covering when leaving home for one of the four reasons, following a concerning increase in coronavirus cases in recent days.

People in regional Victoria will be required to wear a face covering from 11.59 Sunday 2 August 2020. That means that it will mandatory for ALL Victorians to wear a face covering when they go outside of their homes from next Monday.

What type of face covering?
If you haven’t been able to get a surgical or cloth mask, Premier Andrews has said: “It need not be a hospital-grade mask. It need not be one of the handmade masks … it can be a scarf, it can be a homemade mask.” He admits “nothing is perfect” and a “face covering is just as good”. (4)

What else do you need to know? 

  • Wearing a face covering protects you and your community by providing an additional physical barrier to COVID-19.
  • Keeping 1.5 metres between yourself and others and washing your hands are still the best defences against COVID-19.
  • There will be some reasons not to wear a face covering. For example, those who have a medical reason, kids under 12 years of age, those who have a professional reason or if it’s just not practical, like when running. However you’ll still be expected to carry your face covering at all times to wear when you can.
  • The fine for not wearing a face covering will be $200.
  • Face coverings in regional Victoria continue to be recommended in situations where maintaining 1.5 metres distance is not possible – however regional Victorians will have to wear a mask when visiting metropolitan Melbourne or Mitchell Shire for one of the permitted reasons. (4)
  • Read the full Department of Health and Human Services update.

The advice from the New South Wales Government

The NSW Government now recommends wearing a mask if it’s difficult to stay 1.5 metres away from other people. For example, on public transport, when caring for vulnerable people or when indoors.

Find out more on the NSW Government website.

The evidence for using face masks

Up until recently the evidence for the use of face masks to protect against COVID-19 has been conflicting. But over the last several months the evolving evidence has come down firmly on the side of wearing masks.

Many people cite an article published in The Lancet in June 2020 as the turning point in the debate for wearing masks in public. It provided robust evidence for the benefits of face masks. It reported on a systematic review and meta-analysis that investigated a range of measures used to prevent person-to-person virus transmission. It looked at physical distancing, eye protection and the use of face masks.

Researchers analysed hundreds of studies involving SARS-CoV2 (the virus that causes COVID-19), as well as SARS (severe acute respiratory syndrome) and MERS (Middle East respiratory syndrome), across 16 countries in healthcare and non-healthcare settings, including more than 25,000 people.

They conclude that “wearing face masks protects people (both healthcare workers and the general public) against infection by these coronaviruses”. (5)

However the authors also state that “none of these interventions offers complete protection and other basic protective measures (such as hand hygiene) are essential to reduce transmission.” (6)

While there were several limitations with this study, it does provide good evidence for the use of masks by the general public.

So if you choose (or are required) to wear a mask there are some things to keep in mind:

  • Follow the latest guidelines from your state/territory health department. There’s no ‘one size fits all’ when it comes to face masks or coverings in Australia.
  • Don’t let wearing a mask give you a false sense of security. Masks will provide some level of protection – depending on what they’re made of, how porous the fabric is, how well you use them – but they’re not a magical, virus-repelling shield (though how cool would that be?)
  • Use masks correctly:
    • Wash or sanitise your hands thoroughly before you put a mask on and when you take it off.
    • Only touch the mask by the straps.
    • Make sure it covers your nose and mouth and fits snugly under your chin, over the bridge of your nose and against the sides of your face.
    • Don’t touch the front of the mask when you wear it. That means no pulling it down to talk to someone, to eat or drink or to smoke a cigarette.
    • And don’t touch the front of the mask when you remove it. If you do accidentally touch it, wash or sanitise your hands immediately.
      Basically imagine the front of your mask is covered in something messy or gross – like paint or a virus (!) – that you don’t want to get all over yourself and the things you touch (e.g. your phone, your kids).
  • If it’s a disposable, single use mask, only use it once and then dispose of it properly.
  • If it’s a cloth mask, wash it thoroughly in warm, soapy water and allow it to dry properly before you use it again.
  • Don’t wear a mask if you have breathing difficulties or when you’re exercising strenuously.
  • Don’t put a mask on a baby or small child.
  • Replace the mask if it gets damp or wet, or if you sneeze inside it.

The World Health Organization (WHO) has some great videos to help you learn how to use a mask correctly.

And finally, remember to keep doing all the other important things: stay home when you can, wash your hands regularly and thoroughly, use hand sanitiser when you don’t have access to soap and water, physically distance yourself from others, cough and sneeze into your elbow and stay at home and get tested if you feel even the slightest bit unwell.

Stay safe and be kind.

Contact our free national Help Line

If you have questions about things like COVID-19, your musculoskeletal condition, treatment options, telehealthmanaging your pain or accessing services be sure to call our nurses. They’re available weekdays between 9am-5pm on 1800 263 265; email (helpline@msk.org.au) or via Messenger.

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References

(1, 5)  Face coverings mandatory for Melbourne and Mitchell Shire
Victorian Department of Health and Human Services, 19 July 2020

(2-3) Use of masks by the public in the community
Australian Government Department of Health, updated 11 June 2020

(4) Face masks will be mandatory in Melbourne and Mitchell Shire to combat coronavirus. What about regional Victoria? Do children need to wear them?
ABC News, 19 July 2020

(6-7) Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis
The Lancet, 1 June 2020

(8) Face masks
NSW Government, 28 July 2020

 

Photo by visuals on Unsplash


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08/Apr/2020

If you’re immunosuppressed and feeling really vulnerable, no one can blame you. This is a scary time for us all; having a condition or taking medication that makes you more at risk of getting ill from any contagion or infection adds another level to this. So how do we protect ourselves when we’re out? There’s a lot of information/misinformation about wearing masks, gloves and DIY hand sanitiser (cos no one can get their hands on the real thing).

This blog, and our one on gloves and DIY hand sanitisers, gives you evidence-informed advice on the good, the bad and the ugly on using these protective measures.

To wear or not to wear, that is the question

Last week the Centers for Disease Control and Prevention (CDC) in America recommended that Americans should wear “non-medical, cloth masks” to help prevent the spread of the virus. Up until this change they were like the Australian Government and World Health Organization and recommended that only those with COVID-19 symptoms should wear masks.

So why the change?

One of the key issues is that a significant number of people have COVID-19 but don’t know they have it. They’re what’s called asymptomatic – meaning they have no symptoms. But even though they may not look or feel unwell, they can spread the virus. The use of masks is to prevent the spread of the virus from those who are asymptomatic to the rest of the population. It’s hoped that by wearing a mask any droplets breathed, coughed or sneezed out by people remain inside their mask, and not falling on surfaces that other people will touch.

In Australia, we’re still being advised to only wear a mask if we have COVID-19 or care for someone who does. But the problem is, if you’re asymptomatic you don’t know you have it. And because we’re only testing people who have symptoms and fit certain criteria, how would you ever know if you’re asymptomatic? Gah!! So what do we do?

As with everything COVID-19 related there’s no simple answer, so we need to consider several factors to make our own, informed decisions:

  • There’s a worldwide shortage of masks. The medical grade masks should be reserved for healthcare workers, those who are on our frontline as far as COVID-19 goes.
  • If we practise physical distancing as we’ve been advised to and we practise good hygiene then we shouldn’t need to wear masks, or if we do, only for short periods of time if we’re in a crowded indoor venue.
  • Some experts say that due to the population density in Australia, we have fewer problems with crowds at supermarkets and other essential places than do more populated countries. That is, we’re more able to keep the necessary space between ourselves and others, especially now that these centres have introduced strict physical distancing measures.
  • We just don’t know how to wear them properly. Most of us have never had to wear masks regularly so we don’t know how to secure them properly, remove them without contaminating ourselves, how long to wear them etc. So if you’re going to wear a mask – whether it’s a disposable mask, or you’re making your own, it’s really important that you know how to wear and care for them. For example: if it’s a disposable mask, you need to throw it away after every use. Do not put it in your pocket or bag to use again. It needs to be thrown away. And if you’re using a cloth mask, wash it after every use. Again, do not put it in your pocket or bag. Wash it before reusing it. The WHO has lots of information on when and how to use masks – including how to put them on and take them off without contaminating them or yourself.
  • Don’t let wearing a mask give you a false sense of security. The evidence is clear that the best things we can do to prevent the spread of the virus is to wash our hands with soap and water thoroughly and frequently, use alcohol based hand sanitiser when there’s no access to soap and water, avoid touching our face, sneeze or cough into our elbow and continue to practise physical distancing. Masks may provide some level of protection – depending on what they’re made of, how porous the fabric is, how well you use them – for when you absolutely have to go out in public, but they aren’t a magical, virus-repelling shield (though how cool would that be?)
  • There are many websites, including the CDC, that have instructions and videos for making your own face masks. This New York Times article has some really good information about home-made masks, including the fact that not all fabrics are created equal when it comes to making masks.

More to explore


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08/Apr/2020

Gloves | DIY hand sanitisers

Gloves and COVID-19

Along with masks, we’re now seeing lots of people wearing gloves when they’re out in public. Masks I understand, gloves I have more concerns about.

One of the main reasons is cross-contamination.

I’ve seen countless people in public wearing plastic gloves selecting fruit and vegies, picking and choosing what they want, putting back what they don’t and then putting their hands back on their shopping trolley, reaching into their bags for their phone or wallet, putting their phone up to their ear, all without removing or changing gloves. Basically they may as well have no gloves on at all.

By now you’ve probably seen the video circulating widely of an American nurse demonstrating how fast germs can spread even if you’re wearing gloves. She uses green paint to represent germs and pretends she’s at a supermarket. Pretty soon her nose, cheek, phone and wrists have green paint on them. If you haven’t seen this video, it’s worth viewing.

Gloves may make us feel protected, but if we don’t use them correctly – as highlighted in this video – they’re no use at all. In fact they may give us a false sense of security.

It’s understandable to feel anxious as we try to find ways to protect ourselves and our families from COVID-19. It began with panic buying and the run on toilet paper, hand sanitisers, pasta, masks and now gloves. And like panic buying, the more people you see wearing gloves and masks, the more you start to think you should too.

But do gloves provide any extra protection?

The quick answer is no. Washing your hands thoroughly and regularly using soap and water provides more protection against catching COVID-19 than wearing gloves. If you don’t have access to soap and water, then hand sanitisers are your next best option.

The disposable gloves we have access to (if you can find any at the moment) aren’t intended to be used for long periods of time. They’re designed for single use, for short periods of time. Because of this, they’re flimsy and can rip easily. They can also develop tiny little holes that you don’t notice – but are big enough for a virus and many of his closest friends to slip through.

Gloves are hard to find, so the temptation is to wear them more than once. But because they’re disposable they’re not designed to be washed and reused. Reusing them can lead to them becoming more damaged. And remember, this damage may be so small you don’t see it, but it’s enough to mean they’re not protecting you at all.

Good news is that many stores and shopping centres are now providing hand sanitiser stations. You can apply it when you enter and when you leave, and other times when needed. So when you have to go out for essentials, the best thing you can do is:

  • wash your hands before you leave and when you get home
  • avoid touching your face at all times
  • avoid unnecessarily touching things (which I know I’m always doing subconsciously…but not now)
  • avoid touching your phone
  • clean your groceries when you get home
  • take advantage of hand sanitiser stations at the shops
  • stay calm, we’re all in this together.

Finally – if wearing gloves when you’re out in public makes you feel less anxious, then that’s important. Anything that makes us feel calm and in control is essential in these crazy times. It’s just important that you’re aware that gloves aren’t infallible, that they have lots of issues associated with them, and that you know how to use them correctly. In the More to explore section below we’ve provided a link to a video that shows you how to correctly put gloves on and take them off.

More to explore

Hand sanitisers

OK, so gloves aren’t great.

But it’s hard (almost impossible) to find hand sanitisers. So what about making your own? There’s been a proliferation of websites, social media posts and conversations over the back fence about how to make your own hand sanitiser. All you need is vodka, right?

Ahhh, that’d be a big NO. For hand sanitiser to be effective against COVID-19 it needs to be at least 70% alcohol. Vodka is typically 80 proof, which means it’s only 40 percent alcohol*. So save your vodka for a Saturday night cocktail.

Making products like hand sanitiser also requires an understanding of chemistry. Remember that high school subject many of us barely passed?? You’d also need the right equipment to ensure your measurements are exact, so the sanitiser is made safely and effectively. If you had all of that, you still need to be able to buy the ingredients. Like many things at the moment, they’re harder to access because everyone – from distilleries to the person down the street – is trying to make hand sanitiser. So when it comes down to it, hand sanitiser isn’t something you can or should try to whip up at home. There are reasons companies spend lots of time, research and resources making their hand sanitisers. It’s not so simple.

Hand sanitisers also contain ingredients that protect our skin from drying out. When your skin is dry from frequent hand washing and from using harsh chemicals, it can become damaged. Germs can get in through cuts and abrasions. This includes COVID-19, but also bacteria and other microbes that can lead to nasty infections and pain. Some hand sanitiser recipes do include ingredients such as aloe vera to combat this, however it can dilute the alcohol concentration, making the sanitiser ineffective. Read this article by Choice for more info: What you should know before making your own hand sanitiser.

So where does this leave us?

Unfortunately there’s no quick fix. Hand sanitiser isn’t something we should try to make at home. And with commercial hand sanitiser so hard to find, we’re left with good old hand washing. Frequently and thoroughly, for at least 20 seconds, singing your favourite song. And physical distancing. It’s frustrating, because we like to be doing things to make our lives and world better. But during this pandemic, the doing thing that we know works, is doing nothing*. (*except exercising, staying at home with your family, reading, singing, dancing, having fun, working, cooking, creating, staying safe, watching movies, catching up on home jobs, gardening, jigsaws…read our blog about things to do while in iso.)

Reference

*Will vodka work? What you need to know about using hand sanitiser against coronavirus
Science Alert, 15 March 2020

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