Covid outbreaks in hospitals have been caused in part by the wrong staff receiving full personal protective equipment (PPE), a new study suggests. Official guidelines have dictated that the best PPE should be given to doctors and nurses treating patients who require medical oxygen, but new research shows that less severely ill patients are more likely to infect people around them. The Telegraph has the story.
An international team of researchers has established that less severely ill patients are far more likely to infect people around them than those critical enough to require oxygen.
The findings appear to contradict official guidelines, which ration the best PPE to doctors and nurses treating patients who require medical oxygen, on the basis that doing so requires the performance of “aerosol-generating procedures”.
Often working in intensive care units, these staff are given eye protection, a tight fitting particle respirator mask, long-sleeved fluid-repellent gowns and gloves.
Those working with less ill Covid patients had to go without eye protection, were given only a standard surgical mask, as well as a disposable apron and gloves.
However, the new findings show that the typical activities of less severely ill Covid patients – breathing, talking, shouting, coughing and exercising – actually generated 100 times more aerosol particles than those receiving oxygen.
The study found that oxygen therapies – officially considered the most high-risk for infection – actually reduced the amount of aerosols.
It was carried out after figures emerged showing that staff working on wards who wear only standard surgical masks have around two to three times higher rates of infection than those working in ICU.
One of the study’s co-authors, Professor Euan Tovey, said that less severely ill Covid patients – who have been treated by doctors and nurses with less effective PPE – posed a great risk.
The coughing and laboured breathing common in patients with Covid produces a lot more droplets and aerosols than is produced by patients being treated with oxygen therapies.
Surgical facemasks provide inadequate protection against aerosols and staff safety can only be increased by more widespread use of specialised tight-fitting respirators – N95 or FFP3 masks – and increased indoor ventilation.
Also, as the respiratory therapies did not significantly increase aerosols, these treatments should be made widely available to patients with Covid who need them.
Another researcher, Professor Tim Cook, suggested that these findings warrant a change in policy regarding the rationing of PPE.
Our findings strongly support the re-evaluation of guidelines to better protect hospital staff, patients and all those on the front line who are dealing with people who have, or are suspected of having, Covid.
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