Mask & PPE Distribution to Adelaide Primary Health Care Providers

All surgical masks supplied to general practice from National and State Medical Stockpiles are to be used in line with current COVID-19 PPE recomendations. 

Supplied surgical masks (Commonwealth Tranche 4) are intended for general practices and, when no local commercial supply is available, allied health and community pharmacies:

• for the protection of health professionals and practice/pharmacy staff who are in direct contact with people presenting with fever and/or respiratory symptoms including cough, sore throat and/or shortness of breath
   
• for provision to community members who are suspected/confirmed to have COVID-19 infection and where the person is not already wearing a mask (this is for the protection of other patients, staff, and general public while the patient returns home)
   
• for the protection of health professionals and practice/pharmacy staff who are required to have contact with patients at a distance of less than 1.5 metres in areas where there may be community transmission of COVID-19, and where local public health directions recommend masking in all clinical settings

For context, supplied surgical masks are NOT for general distribution to community members, cannot be sold as commercial stock and should not be supplied to all practice staff for general everyday wear (eg. currently in South Australia, with no evidence of community transmission and no direction for general masking in clinical settings, a general practice receptionist is not recommended to wear a mask across the work day).

General practice reminder: where ANY of the appropriate PPE is unavailable at your practice, patients seeking COVID-19 testing should be recommended to use the alternative COVID-19 testing pathways (referral no longer required at any dedicated COVID-19 testing service in metropolitan Adelaide). 

Relevant resources and information:

• Current SA Testing Recommendations (via SA Health's Public Health Alert 'COVID-19 Update #25' or 'Testing for COVID-19 Overview' page)
• Distribution of PPE & Guidance on Supply Commonwealth Factsheet (Tranche 4, August 2020)
• Find a list of alternative testing options via SA Health's Testing for COVID-19 webpage

Adelaide PHN, like all PHNs, have been directed to conserve stocks of P2/N95 respirators as far as possible. Where distribution has been supported, P2/N95 masks use must be strictly limited to use within current guidelines. 

In the vast majority of circumstances when managing the care of a patient with confirmed or suspected COVID-19 infection, including specimen collection, surgical masks are effective. P2/N95 masks are only recommended for use during during aerosol generating procedures.

In addition, supplied P2/N95 masks should only be used by staff when all of the following criteria is met:

• staff are appropriately trained in P2/N95 use and
• staff have been fit checked and
• staff have access to and are utilising all other required PPE as reccomended (i.e. gowns, gloves, eye protection)
   

General Practice
Includes Aboriginal Community Controlled Health Services (ACCHS), after-hours GP home visiting services, Medical Deputising Services (MDS), and Nurse Practitioner owned or led primary care practices

As supplies are limited, Adelaide PHN is distributing surgical masks to practices within the Adelaide metropolitan region with a demonstrated need, including:

• where there is no commercial supply available
• where practices are in a location where there may be community transmission of COVID-19
• where practices have an unusual number of patients presenting with respiratory symptoms

Community pharmacies

Adelaide metropolitan community pharmacies are eligible to access the supply for their staff to use when there is no available commercial supply, and:

• the pharmacy's staff are required to be in direct contact with patients/clients at less than 1.5 metres, and there may be community transmission of COVID-19 in their area
• the pharmacy's staff are have significant contact with people presenting with fever or respiratory symptoms (irrespective of level of community transmission of COVID-19)

Please note, supplied masks distributed through PHNs cannot be sold as commercial stock (anyone found to be onselling masks will be charged full cost for all stock and no further provisions will be made).

Allied health

Adelaide metropolitan allied health professionals are now eligible for limited access to surgical mask supply for their staff when there is no available commercial supply and they are working in higher-risk clinical areas and with higher risk vulnerable patients or in areas where there may be community transmission of COVID-19.

Given the diverse nature of the allied health sector, when determining whether allocation of masks is appropriate, Adelaide PHN will consider:

• local transmission patterns of COVID-19 and whether or not SA Health currently recommend mask wearing in clinical settings
• the extent to which the allied health professional can manipulate their environment or practice method to minimise the chance of transmission (eg. due to the nature of their work, a diagnostic radiographer cannot easily change their mode of practice or environment whereas a dietitian or psychologist may be able to continue to provide services through telehealth)

In areas where there is no evidence or suspicion of community transmission, Adelaide PHN will consider:

• the likelihood of the worker having direct or close contact with high-risk patients who are presenting with fever and/or respiratory symptoms (eg. a respiratory physiotherapist working with patients with cough, sore throat and/or shortness of breath, as compared to an exercise physiologist who is likely to be working with well individuals)
• the relative vulnerability of the patients that the allied health professional is treating (eg. where the allied health professional is routinely treating patients who are immunocompromised, or those who are elderly or disabled)

Adelaide PHN will continue to expect that allied health professions will, where possible, not see patients with respiratory symptoms or at a higher risk of COVID-19 unless required to as part of their core business (eg. an optometrist may be able to defer seeing a patient with respiratory symptoms until that person is well).

All supplies of PPE remain very limited and allocation of masks (surgical and N95) and other PPE items will continue to take into account commercial availability, National and State distribution guidelines, demonstrated need, practice/service size, use within current guidelines and equitable access across our region.

Generally, eligible primary health care providers can expect the following allocation of surgical masks:

• General Practices and Aboriginal Community Controlled Health Services
  >> two boxes (100 surgical masks) for each requesting general pracitce/clinic/service
   
• After-hours GP home visiting services, MDS, and Nurse Practitioner owned or led primary care practices
  >> one box (50 surgical masks) per practice/service
   
• Community pharmacy
  >> one box (50 surgical masks) per community pharmacy
   
• Allied health
  >> one box (50 surgical masks) per practice

Where your practice/clinic/pharmacy/service is running low of surgical masks or other PPE, please recomplete and submit the EOI. Where available and there is evidence of use within current guidelines, Adelaide PHN is supporting resupply.

There are a range of COVID-19 testing clinics and services available across the Adelaide region:

• GP Respiratory Clinics
  For patients experiencing respiratory symptoms – please recommend patients make a booking themselves at one of the four metropolitan clinics (patients can book online or over the phone):
  • Adelaide Central Respiratory Clinic - 0401 142 608 / book online
  • Reynella Respiratory Clinic - 0478 455 771  / book online
  • North Eastern Respiratory Clinic – 7089 5799  / book online
  • Athelstone Respiratory Clinic – 0478 507 774  / book online 

• Visit SA Health's website for information on all alternative testing pathways across South Australia including drive through and pop up services, hospital based walk in COVID-19 Clinics, testing services at pathology centres and domiciliary services:
  • testing information and options
  • testing service locations across South Australia

To support the South Australian response to COVID-19, maximise PPE use across our region and minimise risk in general practice, Adelaide PHN continues to encourage general practices to utlise the dedicated COVID-19 testing services wherever possible.

Where any PPE items (including masks, gowns, gloves, goggles) are unavailable at your practice, GPs should recommend patients utlise the alternative testing pathways above (please note, from 7 Aug 2020 - no GP referral or specimen collection forms are required at any dedicated metropolitan testing service). 

• Since 31 January, Adelaide PHN has received multiple but limited deliveries of Proshield Surgical Face Mask Soft from the National Medical Stockpile for distribution to general practices, pharmacies, Aboriginal community controlled health services, and eligible allied health providers in need across the Adelaide region.
   
• From 3 April, Adelaide PHN received limited supplies of surgical and N95 masks along with other PPE items such as gloves and gowns from both the State and National Medical Stockpiles for distribution to general practices across the Adelaide region.
   
• In addition, Adelaide PHN privately sourced and funded a limited supply of hand sanitiser for distribution to general practices across our region.