Responding to Omicron - PPE 

11 February 2022

Dr Bryan Betty, College Medical Director
Dr Peter Moodie, College Clinical Advisor

It is difficult to get clear advice from MOH websites under what circumstances clinicians and supporting staff should be wearing N95, or the equivalent, in their practices. This lack of clarity has been brought into sharp relief when you watch demonstrators at parliament being watched over by police all wearing N95 masks.

The College view is that access to N95 masks should be clear and focused on infection prevention for clinicians in general practice. Ideally all N95s should be fit tested as this gives maximal protection. It’s accepted non fit tested N95s do have a slight advantage. 

Our view is that standard medical masks are primarily worn to reduce infection spread from the person wearing the mask, although there is some protection from acquiring infection from another.  Fit tested N95 equivalents are there to reduce the chances of the wearer becoming infected from another person.   

We therefore recommend that:

  1. All staff working in close contact with patients who have respiratory of other airborne infections (red stream patients) should be wearing N95 masks.  If there is addition risk then a visor should be added.
  2. For clinicians treating low risk patients (green stream) in a low-risk environment standard masks are acceptable.
  3. If there is no, or very low prevalence of COVID in the community then all other staff can wear a standard medical mask.
  4. If the prevalence COVID increases, so that asymptomatic patients become a potential concern, then all members of the clinical team should wear N95 masks.
  5. All patients entering the practice should wear or be supplied with a standard medical mask.

On another issue, there is a lack of clear direction about the need for pulse oximeters during the Omicron outbreak; however people are being encouraged by commercial organisations to buy their own.

It appears that vaccinated patients contracting COVID are likely to develop mild flu like symptoms and in the past we have never suggested that such people should get a pulse oximeter. Whether this means long term change in the way we manage patients with the flu and respiratory symptoms in winter remains to be seen.

However, there is no evidence of the outcome benefit for the use of pulse oximeters with widespread omicron. All the recommendations revolve around delta. It appears the decision to use pulse oximeters will be locally guided.