As a trade union rep for the Workers of England, I have spent the last two years defending our members against intrusive, ineffective and potentially injurious COVID-19 policies. Until three months ago, when the vaccine mandate in health and social care was revoked by the Government, almost all of my cases were workers who refused to take two or more injections to keep their jobs. Since then the battleground has shifted to mask-wearing rules (often involving the same employees).
Forcing staff to wear a mask for their entire working day is unprecedented in most healthcare settings. As it is now accepted by all but the shrillest of Covid zealots that morbidity of the SARS-CoV-2 virus is similar to influenza, many of the radical interventions from lockdown to face covering seem disproportionate, if not damaging.
A month ago, national guidelines for the NHS dropped ubiquitous masking in clinical areas. However, most NHS trusts were unwilling to relax from pandemic mode. Absurdly, no exemptions are accepted for face covering. And so we have had a steady stream of cases, with several members being threatened with dismissal despite valid health concerns.
In disciplinary proceedings I have challenged employers with a set of six questions:
- Do you consider masks as a medical intervention?
- Do you promote informed consent?
- Do you honour exemptions?
- Please provide evidence (in summary) that masks are effective
- Could you give assurance that prolonged mask-wearing is not detrimental to physical or mental health?
- Could you explain why masks are required for COVID-19 but not influenza?
No employers have given satisfactory answers. The first question is fundamental: if the employer were to define masks as a medical intervention, consent would be necessary. Instead, they tend to place the requirement within policy for personal protective equipment (PPE).
Trust policy documents repeatedly label masks as “fluid repellent”. For an airborne respiratory virus, blocking the projectiles of sneezes and coughs has benefit. But this will certainly not stop infection or transmission, as found by numerous experimental and observational studies of masks. Yet these devices were imposed in every corner of the hospital estate, often tyrannically, affecting patients and visitors as well as staff. My friend Sian, taking her daughter to A&E after a nasty accident, was basically told ‘no mask, no entry’ (she eventually agreed to wear a visor).
As a fellow union rep discovered, the Health & Safety Executive (HSE) does not regard the widely worn type of surgical mask as PPE. Here is a quote from the HSE guidelines for influenza:
What is the difference between a surgical mask and a FFP3 mask?
Surgical masks are plain masks that cover the nose and mouth and are held in place by straps around the head. In healthcare settings, they are normally worn during medical procedures to protect not only the patient but also the healthcare worker from the transfer of microorganisms, body fluids and particulate matter generated from any splash and splatter. Whilst they will provide a physical barrier to large projected droplets, they do not provide full respiratory protection against smaller suspended droplets and aerosols. That is, they are not regarded as personal protective equipment (PPE) under the European Directive 89/686/EEC (PPE Regulation 2002 SI 2002 No. 1144).
Therefore, there is no justification for NHS trusts demanding use of surgical masks, which do not protect against airborne respiratory viruses. But then, shouldn’t doctors, nurses, midwives and senior managers have known that already?
Dr. Niall McCrae is a rep for the Workers of England Union and a mental health ethicist.