Healthcare workers may need higher grade masks and PPE when caring for patients with suspected or confirmed Covid-19, government scientific advisors have warned.
A document from the Government’s Scientific Advisory Group for Emergencies (SAGE), published last week, suggested higher-grade PPE – such as FFP3 and other respirator masks – is used more widely amid growing evidence of airborne transmission of Covid-19.
The RCN and other bodies have been calling for better PPE across the healthcare system to protect against airborne transmission. But until now the Government guidance has recommended this better PPE is used where there are aerosol generating procedures for a suspected or confirmed Covid-19 patient, or in intensive care units.
SAGE said the decision to use higher-grade PPE should be based on a local risk assessment that considers the duration and proximity of exposure to a Covid-19 case, and the existence of other infection control measures against airborne transmission such as good ventilation.
The paper noted that although most respiratory diseases were ‘classed as either droplet or airborne’, coronavirus ‘falls between these two conventional categories’.
Droplet transmission through respiratory droplets – such as from breathing, speaking and coughing – is most likely to occur when someone else is close to the infected person. But in airborne transmission, the virus spreads through smaller droplets that can stay in the air for longer.
SAGE acknowledged that extending the use of FFP3 across care areas has ‘operational implications’. There would need to be sufficient stock to ensure those healthcare workers undertaking aerosol generation – known to be at increased risk – still had sufficient supplies of FFP3, SAGE said.
It added: ‘If a decision were taken to enhance precautions in an area to include FFP3, then there needs also to be a clear strategy for how and under what circumstances the change would be stepped down.’
RCN professional lead for infection prevention and control Rose Gallagher said the assessment is a ‘step in the right direction’ but the change must be reflected in UK infection prevention and control guidance.
She explained: ‘We have heard many reports from our members that their employers do not feel able to deviate from the letter of national guidance for fear of being criticised. Changing the guidance would empower employers to find local solutions that offer a greater level of protection to nurses, midwives and patients.’
A Department of Health and Social Care spokesperson said: ‘The safety of NHS and social care staff has always been our top priority and we continue to work round the clock to deliver PPE that helps protect those on the frontline.
‘Guidance on the appropriate levels and standards of PPE is written by experts and agreed by all four UK chief medical officers. Our guidance is kept under constant review based on the latest evidence.’
Last month, a report commissioned by the RCN found the Government’s Covid-19 infection control guidelines are ‘fundamentally flawed’ and needed replacing because they do not consider the airborne transmission of Covid-19.