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SPEECH: Infection control is not rocket science

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Amanda Cohn
NSW Greens MP
26 June 2024

“The Robodebt of medicine” is what Perth-based anaesthetist Dr Andrew Miller and chair of OzSAGE has called our current approach to transmission of airborne infections including COVID.

Hospitals are presently struggling with waves of rapidly spreading airborne infections, including COVID-19, influenza, and RSV. Minister Park has correctly noted that pressure on NSW hospitals is critical and unprecedented, with over 800,000 people visiting emergency departments in the last quarter alone. In the past week, state and territory health ministers banded together to plead for increased funding for their public hospitals as the current funding arrangement nears expiry.

Many of the solutions to this problem are complex - turning around workforce shortages and declining primary care services will take years. But some solutions to the challenges we are facing in health care are not complex. Infection control is not rocket science. Good ventilation, air filtration, routine infection testing, and adequate PPE should all be standard practices. It is also not controversial, with this House passing a motion last month, that the implementation of air quality standards is needed to protect against COVID-19 as well as other airborne diseases, such as measles, whooping cough, influenza, and pollutants such as bushfire smoke. All workers, including gig and casual workers, must have access to adequate sick leave. Especially in a cost of living crisis, it is cruel and unethical to ask those in insecure work to choose between their health, and the health of others, and making ends meet. And it’s not just acute illness that’s the problem - between 5 and 10% of cases of COVID are resulting in long-term complications.

According to the NSW Clinical Excellence Commission’s Infection Prevention and Control Framework for Respiratory and COVID Safe Healthcare, we should not be on foundational or baseline requirements for infection control here in NSW. The ACT and Victoria have both reintroduced mask wearing in health facilities. In a return of the cross-border absurdity I remember well from the border closures era of the pandemic, my former workplace Albury Base Hospital is again requiring masks only because it is managed by Victoria.

It is both absurd and horrific that we are not counting hospital-acquired infections in NSW. In Victoria, data released under FoI revealed one in ten patients died after catching COVID in hospital. Perhaps that is why Victoria is taking more responsibility for infection control, including commissioning research that found testing patients on admission and wearing masks in hospitals save both lives and money.

I questioned NSW Health on this issue at budget estimates, and the department acknowledged the need to improve its infection controls, particularly regarding hospital-acquired infections and providing clearer, more accurate public information. But we’ve actually gone in the opposite direction - the National Notifiable Disease Surveillance System, which relies on reporting from states and territories to calculate mortality rates, has noted that NSW is likely to be significantly underestimating COVID-19 mortality because of changes made earlier this year to cease using linkage between death records and case notifications.

Here at the NSW Parliament, MPs, staff and visitors benefit from air ventilation and filtration system upgrades in February 2023 that exceed minimum required standards - including MERV-8 filters and ultraviolet light to assist with neutralising bacteria and contaminants. Every health facility, every school and indeed every public building in NSW should have the indoor air quality that we benefit from at the Parliament.

Reportedly near 98% of Australian schools are only ventilated by opening windows. This is called “natural ventilation”, even if the windows are shut because it’s cold in winter. According to the Centre for Advanced Building Systems Against Airborne Infection, the cost of installing mechanical HVAC systems in Australian schools would be more than offset by savings from reduced sick leave among students, school staff and working parents due to improved ventilation.

All people deserve equitable and safe access to public buildings, and this includes people with chronic illness and immunocompromise. This is the responsibility of the NSW government.

I know that people are averse to draconian infection control measures like lockdowns. I know my own community of Albury-Wodonga would be horrified by any proposal to ever again close state borders. The best way we can avoid this in future is to implement the systemic solutions that we know work, and to do this important work now. The responsibility shouldn’t be on individuals to protect themselves and others. Clean indoor air benefits all of us.

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Amanda Cohn
NSW Greens MP
26 June 2024
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