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Australian researchers have found that the spread of COVID-19 aerosols puts some health care workers at greater risk than others.

 


More people are at risk of becoming infected with COVID-19 unless a better masking protocol is introduced — including front-line medical staff, according to a new Australian study.

Scientists at the University of Sydney, the University of New South Wales, and the United Kingdom National Health Service have investigated what happened when a person breathed, coughed, or spoke.

They found that these behaviors were the main cause of the spread of small aerosols.

Professor Euan Tovey of the University of Sydney, one of the authors of the study, said these physical processes produced far more droplets and aerosols than those produced by oxygenated patients. ..

“We misunderstood the risks associated with these steps,” he said.

“Our data is [patients on oxygen] Not a high risk.

“It’s actually coughing, talking, deep and heavy breathing that produces levitating particles.”

Professor Tovey, who also designed the equipment used in the study, said the results provided strong evidence: Healthcare professionals should wear an N95 or P2 mask when exposed to all COVID-19 patients.

“Healthcare professionals wearing surgical masks that are suitable for droplets but not for aerosols [are] You will be exposed to some aerosols. “

“Generates more than 300 times more particles”

Queensland is currently working on two separate COVID-19 clusters. Both come from health care workers infected with the virus at work.

A graphic showing people connecting to a coronavirus cluster.
New cases related to clusters have only emerged in the last few days.(((

ABC News: Lewis Hirvela

).

Doctors at Princess Alexandra Hospital tested positive in early March 2020, And a nurse at the same hospital was infected with the virus while working at night shift.

Both have a highly contagious British variant of COVID-19.

In the latest experiment, researchers have built a new room that provides very clean air for 10 healthy volunteers to sit inside.

After the volunteers breathed into a large cone, researchers used a special machine to collect the particles to measure the number and size of the particles.

A woman being tested during a study at the University of Sydney
The study also showed that respiratory activity, such as coughing and deep breathing, is a major source of aerosol particles.(((

Courtesy: Euan Tovey

).

After that, he spoke loudly to the participants, coughed repeatedly, and breathed violently.

“They were probably producing 300 times more particles than quiet breathing,” said Professor Tovey.

“When we put them on those different things [oxygen] The treatment used did not produce anything [or] Up to about 8 times.

“Cough and deep breathing, which are common in patients with COVID-19, have been shown to increase aerosols by more than 100-fold over when patients receive oxygen therapy,” said Professor Tovey.

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Play the video.Time: 2 minutes 38 seconds

New studies show the risk of COVID-19 from aerosols to healthcare professionals.

Particle controversy

The role of respiratory particles in guidelines for preventing COVID-19 infection is still controversial.

Larger particles are called droplets. They travel about 1-2 meters from the infected patient before falling to the ground.

However, aerosols are smaller particles that float in the air longer.

These can spread further, accumulate in poorly ventilated spaces, and can be inhaled into the lungs through a loose-fitting face mask.

Illustration of aerosol propagation between two people, one of whom is wearing a mask
Discussions continue on the propagation of droplets and aerosols.(((

Courtesy: Getty Images

).

Healthy volunteers in the study performed breathing, talking, screaming, coughing, and exercising designed to mimic lung function in patients with respiratory infections such as COVID-19.

Volunteers repeated the experiment while receiving oxygen supplementation, a procedure commonly used for patients hospitalized with severe COVID-19.

Much of the current official guidance on personal protective equipment is designed to protect the wearer from droplets, and the spread of aerosol infections is only at risk if caused by medical intervention such as intubation of the patient. Is considered.

“Surgical face masks provide inadequate protection against aerosols, and staff safety can only be improved by the wider use of specialized snug respirators (N95 or FFP3 masks) and increased indoor ventilation. There is, “says Professor Tovey.

Guy Marks, a professor at the University of New South Wales who was also involved in the study, said the findings have broad implications beyond hospital workers.

“The production of both droplets and especially aerosols from daily respiratory activity has good ventilation in buildings and transport, strengthening the importance of maintaining social distance,” he said.

Today, many schools in Europe need to open windows to ensure ventilation.

Poor ventilation is also suspected as a cause of leaks from hotel quarantines throughout Australia.

Professor Tim Cook of the UK-based Royal United Hospitals Bath NHS Foundation Trust said the results strongly support a reassessment of current guidelines.

“The findings show that staff working in wards wearing only surgical masks are more likely to be infected with COVID-19 than staff working in intensive care units with more complete personal protective equipment such as N95 / FFP3 breathing masks. Can explain why the hospitalization rate is 2-3 times higher. It is being used. “

Many healthcare professionals are asking Australian hospitals to upgrade the masks of all hospital staff to more protective masks that prevent the spread of aerosols.

These new discoveries add ammunition to those calls.

Dr. Susi Nou of the Australian Academy of Anesthesia said the findings need to strengthen recommendations for protecting healthcare workers, hotel quarantine and border workers from the aerial spread of COVID 19.

“It also adds the argument that when COVID19 is diffused by aerosols or small droplets and is close to the patient, you are likely to be exposed to both small and large particles,” she said. It was.

The findings are published in the journal Anesthesia.

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