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New infection control guidance still ‘falls short’, says RCN

A mask.


The Government’s new infection control guidance to protect healthcare staff from Covid-19 still ‘falls short’ as it fails to adequately take into account airborne transmission, the RCN has warned.

The updated guidance, published yesterday, said higher-grade PPE such as FFP3 masks may need to be used when ‘unacceptable risk of transmission’ remains following a risk assessment of ventilation, the prevalence of infection and new variants of concern in the area.

Previously, this higher-grade respiratory PPE was only recommended during aerosol generating procedures or in intensive care units.

But RCN acting chief executive Pat Cullen warned the infection control advice ‘still focuses too much on aerosol generating procedures’ instead of airborne transmission of Covid-19 – and repeated calls for higher grade PPE to be used more widely across all healthcare settings.

She added: ‘As we see new variants of concern emerge, we continue to demand FFP3 masks are made more widely available and increased levels of ventilation as a standardised approach.’

The updated guidance comes as growing evidence shows that Covid-19 can be spread through both airborne and droplet transmission, as noted by Independent SAGE in April this year.

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.

The RCN is concerned that fluid repellent surgical face masks and face coverings are not protective against airborne transmission.

Although, it did welcome the new guidance outlining the need to carry out proper local risk assessments, but stressed staff need support and training to implement this effectively.

The guidance also noted that although there had been ‘no changes to the recommendations’ in response to new Covid variants, ‘this will remain under constant review’.

British Medical Association council chair Dr Chaand Nagpaul said the guidance was ‘a step in the right direction and asserts the legal obligations of carrying out proper risk assessments and implementing specific measures to manage risks’.

But he added: ‘Despite the majority of staff now having been vaccinated with two doses, it is important that those working on the front line should be given stronger guarantees with appropriate PPE (rather than just surgical masks), given that no vaccine provides complete protection.’