Interim guidance for the use of P2/N95 particulate respirators by general practice or urgent medical care health providers
Kia ora koutou
Please find attached ‘Interim guidance for the use of P2/N95 particulate respirators by general practice or urgent medical care health providers’. This is an update on the previous interim guidance released on 18 February 2021. The new interim guidance simplifies and clarifies the guidance provided in February following consultation with sector leads and the national IPC TAG group. It will be incorporated into the next update of the Primary Care Quick Reference Guide.
Click here for the P2 N95 interim Guidance
Practice Support Team
Kia ora koutou,
Recent community acquired cases of COVID-19 in Auckland have been the B1.1.7 variant first identified in the United Kingdom, as confirmed by whole genome sequencing. These recent cases have been presenting with the more atypical symptoms of COVID-19. We also saw this presentation with the recent community case in Northland who was infected with the variant of SARS-CoV-2 first identified in South Africa.
Please be aware of these less typical symptoms, which may include muscle aches and pains and fatigue (which individuals may attribute to causes such as exercise), or only; fever, diarrhoea, headache, nausea/vomiting, or confusion/irritability. See the Ministry of Health website for details.
It is still important to test for COVID-19 if a patient presents with any acute respiratory infection with at least one of the following symptoms (with or without fever):
· new or worsening cough
· sore throat
· shortness of breath
· coryza – head cold (eg, runny nose, sneezing, post-nasal drip)
· anosmia – loss of sense of smell
Thank you again for the important part you play in supporting the health and well-being of New Zealanders. We appreciate your continued partnership in our response.
Ngā mihi nui
Director of Public Health
Ministry of Health
26 February 2021
Efficiency measures across DHBs to make best use of vaccine
To ensure efficiency in the COVID-19 vaccine delivery district health boards are using different approaches, appropriate to their specific regional delivery models, to ensure as much of the available vaccine as possible is used.
One of the unique logistical challenges of the Pfizer / BioNTech vaccine is that once a dose of the vaccine reaches above -70 degrees it will expire in five days even when kept in a fridge.
Once the vaccine has been removed from the fridge it must be mixed within two hours and then used within six hours.
New Zealand’s border and MIQ workers are our first line of defence – that is why we need to protect them and the families they live with first, with the vaccine roll-out.
However the requirements of keeping the border and our MIQ facilities fully operational 24/7 means that only part of that workforce can be freed up at any one time.
This means that in Auckland metro DHBs, when a batch of vaccine is a day away from expiry, the local immunisation team process is to first ask employers at MIQ and the airport and port if any of their workforce can be made available to get their vaccination in the next 24 hours in addition to the scheduled vaccinations that day.
The team is also then asking the local DHBs for a standby list of frontline healthcare workers – including hospital staff, primary care, and community testing centre workforce – who can be individually invited to fill any remaining vaccination appointments at short notice.
Invitations to the standby list have been extended to individual frontline hospital staff, and individual community healthcare workers including Mâori primary care providers, Pacific primary care providers and community testing centres.
This approach enables Auckland DHB to keep appointment slots open for border and MIQ workers as long as possible but to also minimise any potential wastage of the vaccine.
In Christchurch a standby list of people within the MIF or Port facility who can be called in at short notice is used.
In Wellington the immunisation teams are addressing the same issue by over-booking for the vaccine and the DHB is also looking at generating a standby appointment system.
The vaccine is a precious commodity and its special properties present challenges different from our usual vaccines.
Our goal is to make our vaccination process as efficient as possible to ensure the best use of the vaccine available.
Dear primary care colleagues
As you will know, when there are community cases of COVID-19 the Ministry of Health announces any ‘locations of interest’ on its web site. These are places where the cases have visited while infectious and other people may have been exposed. The web site also contains information and advice for these people, appropriate to their exposure. As the advice often changes depending on the specific situation, we recommend that this web site is consulted to obtain the correct, up to date information for your patients if required.
The locations of interest and advice for others who were present are also loaded onto the Ministry’s website, here:
If a patient thinks they may have been at a location of interest within the time specified and asks for advice, please check this site in the first instance. It is regularly updated.
We would be grateful if you shared this information with any patient facing staff.
Ministry of Health
Please can you ensure the below update and attachment is urgently distributed out to reach General Practice and Urgent Medical Care facilities via your communications channels, thank you.
Kia ora koutou
As you may be aware, last year the Ministry of Health centralised the purchasing of PPE for the New Zealand Health and Disability System as part of the response to COVID-19 heightened Alert Levels. This was done to ensure we could buy and manage PPE for the whole country so that no one missed out and that PPE was where it needed to be. This centralised model has worked well and we continue to directly supply district health boards, general practice, aged residential care and some other providers, relative to each Alert Level. We work closely with Infection Prevention and Control teams and our Science and Technical Advisory Group to ensure the model reflects best practice use of PPE.
Use of N95/P2 particulate respirators for General Practice and Urgent Medical Care facilities within specific settings
Effective immediately, general practice and urgent medical care (i.e. general practitioners, nurse practitioners, nurses or midwives) staff interacting with a patient in a closed confined space such as an examination or procedure room where:
Updated knowledge about the modes of COVID-19 transmission suggest that it may be more airborne than previously considered and this is a precautionary step that can be taken to help mitigate any potential impacts particularly in light of recent confirmation of community transmission of COVID-19 and the subsequent Alert Level change. The National PPE Supply Chain has been working to ensure that there are adequate supplies of these particulate respirators. These can be ordered direct from the central supply once fit testing has been completed. Please refer to the attached document ‘Interim Guidance on the use of N95/P2 particulate respirators by general practice or urgent medical health care providers (i.e. general practitioners, nurse practitioners, nurses or midwives) for more information and for guidance.
Can General Practice and Urgent Medical Care facilities order online?Most general practice and urgent medical care facilities can login to order PPE from the online central supply. Onelink (for the Northern Region) and Health Care Logistics (HCL) for the rest of the country will pack the PPE you order and send it to you once a week. Onelink and HCL will work with those people you identify as key the reference point to finalise accounts in the portal and support you in the ordering process. Onelink and Healthcare Logistics are ready for you to contact them to set up the direct ordering. We will be prioritising the Auckland region first given the Alert Level status and confirmed community transmission.
It is essential that fit testing to a N95/P2 particulate respirator is done. Fit testers are available, but a cost will be incurred by the general practices and urgent medical care facilities. The Ministry of Health will only supply N95/P2 particulates to those practices that have undertaken fit testing. We intend to make this transition as smooth as possible and will be working closely with Onelink and HCL to ensure you have what you need within the settings and principles of supply. We will continue to work with the New Zealand Royal College of General Practitioners and the Royal New Zealand College of Urgent Medical Care as we learn more about COVID-19 variants and PPE requirements to ensure you are protected.
When will this happen?The portal will provide access from Tuesday 23 February 2021 with priority given to those in the Auckland region given the current Alert level status.
Who can we contact to discuss our needs?If you need to make contact with Onelink or HCL regarding PPE, the contact details at Onelink, for those located within the Auckland Region, are email@example.com or phone 09 815 2612. For afterhours contact Kylie Corsbie on 021335694.
The contact details at HCL for those located outside the Auckland Region are email:firstname.lastname@example.org or phone 0800 657775.
For more information refer to the attachments accompanying this email:
Thank you for your support and importantly thank you for the work you are doing to help keep New Zealand safe.
Ngā mihi nui
Health Supply Chain
Ministry of Health