Australian doctors are increasingly critical of the expert advice on protective equipment, saying surgical masks protect the patient but "are not designed to shield the clinician".
Victoria recorded 139 new infections among healthcare workers on Friday, bringing total active cases in the group to 911.
The Australian Medical Association hit out at the Infection Control Expert Group on Friday for failing to recommend that P2 or N95 masks be mandatory in all COVID-19 care settings.
The ICEG is made up of 16 medical experts from across the country, led by Professor Lyn Gilbert AO.
It advises the Australian Health Protection Principal Committee, which in turn advises federal and state governments in their response to the pandemic.
The ICEG recommends surgical masks for routine care of COVID-19 patients who are in quarantine or have acute respiratory symptoms.
It only recommends particulate filter respirators - P2 or N95 masks - for COVID-19 patients who are cognitively impaired, unable to cooperate or exhibiting "challenging behaviours" such as shouting.
"It is uncertain that the risk will be reduced by use of a [particulate filter respirator] and past experience indicates that health care worker infections can occur despite their use," the guidance says.
It advises healthcare workers using such masks be trained in their use, including how to fit and remove them, otherwise their effectiveness will be compromised.
AMA president Dr Omar Khorshid disagreed with the advice, saying the masks should be recommended in all COVID-19 care situations.
"If a doctor or nurse is caring for a patient with or likely to have COVID-19, P2 or N95 masks are essential, regardless of the presence of potential challenging behaviours," he said.
They protect the patient but "are not designed to shield the clinician", he said.
He called on the ICEG to strengthen its mask guidance.
Limited supply of P2 or N95 masks could be the reason the superior masks are not yet mandatory, but Dr Khorshid said this was no excuse.
Australian Society of Anaesthetists is "seriously alarmed" at the numbers of infected Victorian healthcare workers and says control guidelines in hospitals are "clearly insufficient".
The ASA wants mandatory 'fit-testing' of masks to ensure healthcare workers can don their protective gear so that virus particles cannot penetrate them.
The Australian Institute of Health and Safety on Thursday called for federal and state governments to mandate the use of P2 and N95 respirators, saying many building site workers have better personal protective equipment than doctors and nurses.
David Story, Chair of the Australian and New Zealand Colleague of Anaesthetists Safety and Quality Committee, said despite P2 or N95 masks not being mandatory in all COVID-19 settings, major Melbourne hospitals were using them anyway.
The Austin Hospital-based anaesthetist backed the ICEG, however said it would be good to know how the body interpreted data on health worker infections so frontline clinicians can trust the advice.
Australian Associated Press
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