New infection control guidance falls short – nurses

New infection control guidance to help keep NHS workers safe from Covid-19 “falls short”, leading nurses have said.

The Royal College of Nursing (RCN) said that the updated official Covid-19 infection prevention and control guidance “focuses too much on aerosol generating procedures as the main risk”.

But doctors have welcomed the new guidance as a “step in the right direction”.

Concerns were raised early on in the pandemic that medics were not able to get access to appropriate personal protective equipment (PPE) amid a worldwide shortage.

The guidance, issued jointly by the Department of Health and Social Care (DHSC) as well as public health agencies across the UK’s four nations and NHS England, has been updated to “strengthen existing messaging”, it states.

But “no changes to the recommendations, including PPE, have been made in response to the new variant strains at this stage”, the guidance adds, though this is under constant review.

Commenting on the updated guidance, RCN acting general secretary and chief executive Pat Cullen said: “This new guidance focuses too much on aerosol generating procedures as the main risk and falls short of the precautionary approach we have been advocating.

“Those working in community settings, care homes and many other areas are being let down and remain unsure how best to protect themselves.

“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. This is in line with the advice from the WHO and the CDC on the risk of aerosol transmission.

“Along with many other organisations, we have consistently urged that the Health Secretary and Prime Minister provide greater protection for all nursing staff. However, this guidance fails to properly consider the voices of those who were forced to work without protection at the start of the pandemic and act on those lessons.”

The British Medical Association (BMA) highlighted that the guidance recommends considering the wider use of respiratory protective equipment for staff where a risk cannot otherwise be managed.

Commenting, BMA council chair Dr Chaand Nagpaul said: “Today’s updated guidance is a step in the right direction, and asserts the legal obligations of carrying out proper risk assessments and implementing specific measures to manage risks.

“Crucially, it recommends that respiratory PPE (such as FFP3 masks) must be considered where the threat from passing on Covid remains high, and should not be limited to those areas where ‘aerosol-generating procedures’ (AGP) are taking place.

“This means extending their use to those staff whose exposure to airborne particles from a patient is no less, and whose risk of contracting Covid is therefore no less than for those engaged in those procedures classified as AGPs.

“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.”

Aerosols are tiny respiratory particles that are small and light enough to remain suspended in the air for long periods of time

And aerosol generating procedures are medical treatments which can result in the release of these airborne particles – including intubation, tracheotomy and many dental procedures.