Health Services

12 The Hon. T.A. FRANKS (31 March 2021).

1. What measures are currently in place to prevent airborne spread or spread through ventilation of infectious disease/viruses in SA Health facilities, and hospitals in particular?

2. Are there any plans to revise current standards for SA Health facilities, especially for emergency departments and hospitals, regarding airborne spread—particularly through ventilation—of infectious disease/viruses?

3. Regarding the new Mt Barker Hospital emergency department, how is the potential for airborne spread of infectious diseases going to be managed given that current plans look like they leave the negative pressure room in a corner so that the treatment area has to be traversed by possibly infectious patients to get to it?

4. Is the issue of airborne or nosocomial spread of infectious diseases/viruses—particularly COVID-19—within SA Health facilities and particularly hospitals something that has been raised by clinicians with the Minister and/or SA Health?

The Hon. S.G. WADE (Minister for Health and Wellbeing): I have been advised:

1. There are a range of measures currently in place at SA Health facilities to help mitigate airborne transmission such as:

Designated COVID-19 care areas and patient flow pathways.

Physical segregation of COVID-19 patients via distancing, barriers, single patient rooms and negative pressure isolation rooms.

Good ventilation of COVID-19 patient care areas.

Use of appropriate personal protective equipment (PPE), including surgical or N95/P2 masks where required, and hand hygiene for staff, patients and visitors.

Airborne transmission through air conditioning and ventilation systems is unlikely; however, SA Health facilities are designed to comply with the relevant standards and guidelines that recommend measures such as:

Suitable quantities of fresh air supply and exhaust air.

Minimum number of air changes per hour.

Minimum filtration efficiencies for return air.

Airflow directions, and pressure differentials where required, to support infection control principles.

Taken together these measures ensure that internal air within patient areas is continually replaced with fresh air, and any possible airborne viruses are exhausted, captured and diluted to help minimize the risk of airborne transmission.

In specific higher risk locations (such as the RAH emergency department), the air conditioning can be converted to provide 100 per cent fresh air in designated areas to prevent any recirculation of air, and enhanced airflow directions for the area to improve containment, as additional measures to help minimize the risk of airborne transmission.

2. The relevant standards and guidelines will be reviewed and revised (where necessary) in the wake of the COVID-19 pandemic. The Department for Health and Wellbeing has been proactive in considering lessons learned from the COVID-19 pandemic in the design of new hospital buildings and redevelopments currently in progress. In addition, the Department for Health and Wellbeing continues to collaborate with interstate health jurisdictions including monitoring any potential changes to the Australasian Health Facility Guidelines literature as a result of COVID-19.

3. The new Mt Barker Hospital emergency department considers COVID-19 and pandemic management throughout the facility design, including relevant control measures such as:

Waiting areas will have the ability to 'cluster' chairs (rather than consolidated), enabling families to group or single patients to socially distance.

A negative pressure isolation treatment bay has been included within the new facility that will be designed for infectious diseases; complete with an independent mechanical ventilation system.

A patient bay special room has also been provided with its own ensuite bathroom to isolate patients requiring privacy and infections such as gastroenteritis.

Hand washing basins are distributed throughout the department and hand sanitising stations will be provisioned throughout.

The mechanical ventilation system has been designed as a 'block', separable to the remainder of the hospital, with pressure control to the ED as a whole. This allows the space to be effectively isolated from the rest of the hospital via the building management system (BMS), through air pressure and airflow control, minimising potential transfer of airborne contaminants through departments.

Additionally, patients will be triaged on entry. If a patient is suspected to have an infectious airborne disease, they will be required to adopt the appropriate PPE before moving through the emergency department into the negative pressure isolation room or other areas.

4. There has been open communication and consultation between the local health network clinicians and the Department for Health and Wellbeing throughout the COVID-19 pandemic. The Department for Health and Wellbeing has provided ongoing advice and guidance in relation to airborne transmission evidence, learnings and recommendations.