And many have paid the ultimate price. The International Council of Nurses (ICN) reported in late October that at least 1500 nurses had died from COVID-19 across 44 countries—equivalent to the total number of nurses who died during World War I.
However, they estimated the true cost—taking into account unreported deaths—was likely closer to 20,000 amongst all healthcare workers worldwide, even assuming a conservative fatality rate of 0.5 percent.[2]
In Australia, we have been incredibly fortunate to not lose a single healthcare worker to COVID-19, but our incidence of illness has been just as high, putting a huge burden on our healthcare system and creating significant anxiety and stress amongst those working hardest to halt the pandemic.
“Healthcare worker infection adds substantial pressure to the healthcare system,” says Associate Professor Anand Ganesan, a Matthew Flinders Fellow in Cardiology in the University’s College of Medicine and Public Health.
“It creates additional workload on other staff, it impacts morale, and we lose key, highly skilled workers, who are all needed to look after the community,” he says.
This was highly evident during Victoria’s second wave of COVID, where the number of infected healthcare workers climbed dangerously from 1000 in August, to 3,500 by mid-November, representing over 17 percent of the state’s total cases[3] even though Victorian healthcare workers comprise just three percent of the population. At one point during Victoria’s lockdown, at least one hospital had as many as a hundred staff in quarantine.
With health professionals only learning about COVID as quickly as it spread, debate also raged throughout the year about the benefit or otherwise of masks—both in and out of healthcare settings.
Even as late as August, authorities believed the majority of Victorian healthcare workers were infected at home or in the community and brought the virus to work. However, research by Victoria’s Health Department now shows 70 to 80 percent of infections most likely occurred in the workplace.[3]
This evidence, along with international studies, puts the spotlight very firmly on the critical role of personal protective equipment (PPE) for keeping our healthcare workers safe—not only its accessibility, which has been one of the worldwide desperate challenges of this pandemic, but also its effectiveness.
While surgical masks were initially thought sufficient to guard against the droplet-borne pathogen, within months it became clear that COVID is also airborne, making the P2/N95 respirator mask a much safer option. While the surgical mask protects against liquid splashes, it still allows airflow around its edges, while the more snugly fitting N95 filters out at least 95 percent of airborne particles.
However, even the N95 does not provide fully effective protection for at least 30 percent of healthcare workers.
Through our Flinders Health and Medical Research Institute (FHMRI), Associate Professor Ganesan, who is also a cardiologist in the Flinders Medical Centre, is currently working with colleagues in our Medical Device Research Institute (MDRI) to significantly improve the effectiveness of face masks.
“Face shape varies from person to person, and we know that at least 30 percent of healthcare workers are failing the mandatory fit testing in South Australia and around the country, because their faces do not fit the masks we have available to us,” he says.
“This is the problem we are trying to solve.”
With the support of $40,000 in research funding, Associate Professor Ganesan, biomedical engineer Darius Chapman, and microbiologist and software engineer Campbell Strong (UNSW) are using mobile phone technology to create a much more personalised—and potentially life-saving—solution.
Using an app to scan the geometry and co-ordinates of individual facial profiles, they are designing reusable custom-made seals which, when 3D printed, will sit much more neatly between a standard N95 face mask and an individual’s face.
The aim is to prevent gaps between cheek and nose—where viruses, bacteria and fluids can leak through—as well as provide a measurably more comfortable fit for healthcare workers, many of whom have been wearing masks for up to 16 hours per day during the pandemic.
“We’ve seen images of our colleagues, particularly in other parts of the world, with bruises and pressure sores on their nose and cheeks from the force of continually wearing masks with the straps pulled tightly to protect themselves,” Associate Professor Ganesan says.
“The elastic also causes tenderness in their ears and can lead to headaches.”
This research is part of a wider initiative to also make PPE much more accessible to healthcare workers both nationally and regionally, with the recent development of the South Australian Mask Testing Facility (a collaboration between the South Australian State Government, Flinders University, and the University of South Australia), and Australia’s first dedicated testing facility for protective gowns. Both of these facilities will also run through the MDRI at our Tonsley at Flinders innovation hub, bringing significant onshore capacity to ensuring Australian healthcare workers are much better equipped with PPE to meet any level of future demand.
“At the moment most of the supply chain for N95 masks is devoted to North American and European countries, so we have less access in Australia,” Associate Professor Ganesan says.
“Both of the new testing facilities are key pieces of local infrastructure for businesses that can support the supply chain for PPE in Australia and the near region.”
If Associate Professor Ganesan’s trial is successful, the new mask seals have the potential to also benefit many other areas of occupational mask wearing, including for emergency service fire fighters. They may also help improve the comfort and efficiency of CPAP machines for sleep apnoea patients.
This research project was one of a number that received valuable funding through the University’s COVID-19 Research Grant Program, but will require a further $500,000 to complete. Associate Professor Ganesan is currently seeking other sources of research funding as well as philanthropic investment to reach this goal.
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[1] 1,500 nurses dead from COVID-19 across 44 countries: International Council of Nurses | CTV News
[2] Why did so many healthcare workers in Victoria catch COVID-19? - ABC News
[3] About '70 to 80pc' of Victorian healthcare workers with COVID-19 caught it at work, Government reveals - ABC News
