The BMA has sent a letter to Amanda Pritchard, Chief Executive of NHS England, highlighting the increasing concerns from their members about the protection of healthcare workers and patients from Covid-19, particularly in light of the rise in cases, hospitalisations and deaths that occurred in September and October.
The letter raises concerns about the existing Infection Prevention Control (IPC) Manual for England, and the specific IPC guidance for Covid-19 which preceded it, that have contributed to the lack of protection many staff members experience. Although the manual does appear to recognise that Covid-19 is airborne, it states that Respiratory Protective Equipment (RPE), (i.e. a (FFP) respirator) must be considered when treating a patient with a virus spread wholly or partly by the airborne route. However, it then makes an unclear distinction between viruses spread wholly or partly by the airborne route, and those spread wholly or partly by the airborne or droplet route where RPE is only recommended for so called “Aerosol Generating Procedures” (AGPs) - an outdated concept based on very poor evidence.
The letter goes on to outline the concern that there has been a lack of stakeholder engagement in recent months to inform updates to the IPC Manual. The latest update on 25 October 2023 does not change the recommended PPE for routine care of a patient with COVID-19, although does include a new footnote seven which concerns patients with undiagnosed respiratory illness where coughing and sneezing are significant features but does not mention Covid-19 or provide guidance on recommended PPE or RPE. The letter seeks clarity from NHS England about how stakeholders can engage with this process to help inform future revisions of the manual and ensure the guidance is clear and recommends adequate protection for healthcare workers.
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