My niece recently became engaged and to celebrate, she and her fiancé are holding a masked ball. Well, not actually a ball, more like a bush dance… but there will be masks. Maybe not the kind of masks you’re thinking of… or, then again, perhaps due to the current environment, the ones you are thinking of.

Yes, I’m talking about those lower-face-covering, three-layered, hook-over-your-ears face masks – albeit with a vintage fabric outer layer as befits the trendy younger set.

Why are they having face masks at the party?

Well, there will be a lot of younger people all coming together; we can still have up to 100 people in an outdoor venue up here in Queensland, and my niece knows that there will be people coming up to congratulate them and not everyone will remember to stay 1.5 metres apart at all times. Combine that with a number of older relatives also attending and dancing, let’s just say this is a precautionary measure aimed at protecting any vulnerable attendees.

Authorities are now saying that masks are likely to become an increasing feature of life as we learn to live with COVID-19. So, if an outbreak occurs here in Queensland, those who attend the party will have at least one face mask they can use.

But how effective are masks in mitigating the risk of catching or passing on the virus and how does it impact on aged care providers?

Mask wearing has been made mandatory in Victoria with the current restrictions, but there still appears to be cases of community transmission. It was speculated that the wearing of masks may have created a false sense of security among the wider public, who perhaps viewed masks as a more effective (single tool) and were disregarding other key safety aspects of social distancing and good hygiene (hand-washing and sanitising). At the time, Premier Andrews noted that “far too many people” were going to work sick and labeled this as the key driver of transmission in the State.

Masks are only one line of defense against this virus, but the mounting evidence is that they do play a key role in reducing the risk of transmission, both for the wearer and for others in close proximity. We are just starting to see the effect of lockdown measures combined with mask-wearing in the State of Victoria, with better results emerging and a gradual reduction in the number of new cases.

So why wear a mask?

You remember how we talked about immunisation being more about protecting the vulnerable in one of our recent posts? Well, it’s a similar thing here. The primary reason for wearing a mask is to protect others. If you are an unknowing carrier of the virus, one of those asymptomatic cases, a mask will help reduce the chance that you will spread the virus to others by acting as a physical barrier.

This means that while wearing a mask is an important protective measure for those people at increased risk of severe COVID-19 outcomes due to age or chronic illness, it is up to those of us who could potentially be silent carriers to step up and do our bit to minimise risk to those in the vulnerable category. If everyone wears a mask when necessary, along with the other recommendations of social distancing and regularly washing and sanitising our hands, we protect one another and reduce overall community transmission.

How does it work?

As noted above, masks are more effective as a “source control” because they can block larger droplets that are expelled when you cough, sneeze or even when you talk from evaporating into smaller droplets that are more easily spread.

Wearing the mask will also offer a degree of protection from you picking up the virus, although droplets carrying the virus can enter your body through any of the mucous membranes (wet parts) of your face, including your eyes, nose and mouth, so masks aren’t a full protection. This is why face shields are recommended when carrying out tasks where there is close contact with a person who is known to be infectious, such as showering.

What sort of mask should you use?

There are a range of answers to this question and in some instances it really does relate to where you are and what you are doing.

For people going about in the wider community, the best face mask for you is the one you can wear comfortably and consistently, but generally you are looking at either using a surgical mask or a cloth mask.

Surgical masks, the blue ones that you’ve probably seen in hospitals or care homes, are disposable. They cannot be washed and should not be reused. They should be disposed of appropriately after a single use*, but surgical masks can be expensive and sometimes hard to obtain.
*The definition of single use varies due to the task and conditions experienced in use.

If surgical masks are in short supply, reusable cloth masks, along with good social distancing practices, will offer a degree of protection during activities such as transportation and assisted shopping.

Support workers using cloth masks for general duties would need a number of these for each day, as the masks need to be changed before moving on to support another client due to the risk of being compromised. They will require appropriate laundering before reusing.

How effective are cloth masks?

A properly constructed and fitted cloth mask can meet most people’s needs on a day to day basis. Recent studies by Canadian researchers reported that cloth masks, particularly those with several layers of cotton, can block viruses carried via microscopic particles in the air. While cloth does not stop the virus itself, it does help block particles created when speaking, coughing, and sneezing, which carry the virus. This means a virus-laden particle emitted by an infected mask wearer is generally kept within the mask or limited to a shorter distance of emission from the wearer if they sneeze or cough and is less likely to hang in the air or settle onto a surface.

Their review of a large number of existing studies suggest that cloth masks can potentially help prevent the spread of COVID-19 by blocking up to 99 percent of infectious particles.

If you would like more information, the Australian Government has developed a fact sheet on face masks and the type of protection they offer. Note that proper use, handling and cleaning of cloth masks is important for these to be effective. Continually touching the mask to adjust it or not washing it regularly opens the wearer up to potential infection.

When should masks be worn?

We know that at this current time, care workers in Victoria are required to wear a surgical face mask when providing support to residents or aged care clients living in their own homes. Additionally, goggles and/or face shields, disposable gloves, and aprons are also recommended to be worn when undertaking showering/personal care or cleaning toilets and bathrooms.

Having trouble accessing sufficient PPE?
Aged care providers in Victoria can contact AgedCareCOVIDPPE@health.gov.au to request masks for in-home and residential aged care workers delivering close personal care and clinical care, and other PPE like gloves and gowns to aged care services with a potential or confirmed COVID-19 outbreak.

But for those staff providing home care services and supporting consumers in other parts of the country, when should you and/or your client wear a mask?

I expect that over the coming months the mandated requirement for wearing a mask when supporting seniors in the community will vary, dependent on the status of COVID-19 community transmission.

The general recommendation currently in most of Australia, except where it is mandated such as in Victoria (August 2020), is that you wear a mask:

  • when physical distancing can’t be guaranteed
  • if you have symptoms of COVID-19 and are getting tested or seeking medical advice
  • if you are in self isolation and in the same room as another person
  • if you are required to when entering a premises or facility such as medical clinic or residential facility
  • if it is recommended by the Department of Health in your State or Territory

This means that if you are providing personal care tasks to a client it will be difficult to maintain the 1.5 metre social distancing recommendation. In this instance it is important that, where possible, a surgical mask should be worn by the staff member for the protection of both them and the consumer.

Sometimes it’s also just good practice to wear a mask when out and about with a client. After all, we don’t know who might be infected. Wearing a mask, even a cloth mask, can offer a degree of protection for clients and may help alleviate the concern about going out to complete essential tasks.

If clients see staff wearing surgical masks when providing services, they may feel more comfortable about having support workers recommence service delivery in their homes. Making masks for themselves or other clients could also become an activity that some clients may wish to participate in.

Note: The health department currently recommends wearing masks where community transmission of COVID-19 is occurring and physical distancing is difficult. Further up to date information can be found on the Department of Health website.

How do I wear a mask correctly?

The World Health Organisation has developed a series of infographics that demonstrate the do’s and don’ts of wearing cloth face masks. These can be printed out and distributed to clients and staff.

There is additional safety information relating to the correct wearing of masks on the Safe Work Australia website, and further information on correct ‘donning’ and ‘doffing’ techniques can be found by watching this short video: Donning and Doffing Facial Protection – Mask alone.

Victorian Chief Medical Officer, Brett Sutton, also discussed the correct way to wear a mask in a YouTube video. He noted, “A mask should fit securely around the face, specifically covering your nose and mouth areas. The mask should fit snugly on your face and be secured by ties at the back of your head or ear loops.”

It is also important that you wash or sanitise your hands before putting it on and taking it off, and don’t touch the front of the mask while it’s on. You should not take off your mask to talk to others. Remove it by the ear straps, not by pulling it off from the front, which could be contaminated.

Where do I get masks from?

Accessing surgical masks has been an ongoing issue for aged care providers. If you are unable to source surgical masks through your regular supplier and have an urgent need for masks (if there is community transmission or an outbreak in your facility) you can request access to essential PPE from the National Stockpile by emailing your request to: AgedCareCOVIDPPE@health.gov.au

The Victorian Government, with its move to enforcing the wearing of face masks, has developed a page full of information and links that include how to make a cloth mask, and the New South Wales Government has developed a fact sheet on making a face mask.

The Victorian Government is also distributing reusable face masks to vulnerable populations through organisations such as Community Health Centres, local councils, home care services and Aboriginal Community Controlled organisations.

Helping your clients to understand when to wear a mask and why

The Australian Commission on Safety and Quality in Health Care has developed a fact sheet aimed at educating consumers on the use of face masks and includes an explanation on how to safely put on and remove face masks.

We hope this post is helpful in understanding when and how to wear a face mask. Stay safe.

If you can think of someone else who might benefit from this article, send them a link. We’d appreciate it! And if you’re looking for more helpful resources, why not check out our Resource Hub? We have culturally appropriate, tailored resources that are designed to make your job simpler and help you provide quality care to your clients. Click here to find out more.

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Carrie

Carrie is a passionate advocate for the provision of quality, community based, aged care.
In her spare time, while she ages gracefully, she helps out with kids theatre, rides an electric bike and drags her husband off to explore the world as often as possible.

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