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Call for urgent review of ‘flawed’ COVID-19 infection guidelines

Guidance fails to consider airborne infection as a key way the virus is transmitted, says RCN
Picture shows a nurse at Royal Blackburn Teaching Hospital wearing a mask and apron.

Guidance fails to consider airborne infection as a key way the virus is transmitted, says report commissioned by RCN

Picture shows a nurse at Royal Blackburn Teaching Hospital wearing a mask and apron.
Picture: Alamy

COVID-19 infection control guidelines issued by the government are ‘fundamentally flawed and need replacing’, according to a report commissioned by the RCN.

The college has called for a review of the UK-wide guidelines for personal protective equipment (PPE), after the report challenged the evidence behind them, saying it does not correspond with updated World Health Organization (WHO) advice.

Latest evidence shows aerosol spread is more significant

The guidance fails to consider airborne infection as a key way the virus is transmitted, instead focusing on spreading through touch, say the report’s authors, honorary professor of nursing Dinah Gould and senior lecturer Edward Purssell, both of London’s City University.

They say UK infection control guidelines to prevent the spread of COVID-19 in healthcare settings and the rapid reviews of the literature on which they were based identify droplet spread and hands as the major route, based on early advice from the WHO.

‘Updated evidence indicates that aerosol spread is much more significant and the original advice from the WHO has been superseded,’ the authors say. ‘The UK guidelines are still based on this outdated evidence, however.’

The report says the government’s guidelines do not detail the importance of ventilation and say that higher-grade PPE must be provided only in certain high-risk settings, such as intensive care, and that it is up to organisations to decide whether to provide them to other staff.

This has caused huge concern among nursing staff, especially with the emergence of new COVID-19 variants, the RCN said.

Staff need to know everything possible is being done to protect them, says RCN

RCN general secretary Dame Donna Kinnair said staff needed to know that everything possible is being done to keep them protected. ‘It is inadequate to say they have masks if they aren’t fit for purpose,’ she said.

‘Staff are scared for themselves and their families, and left any longer it’ll turn to anger.’

According to RCN figures, at least 988 UK health and social care workers had died in the pandemic by the end of January. This does not include deaths in Northern Ireland, where no data was available.

A Department of Health and Social Care spokesperson said staff safety was a priority and that it would ‘continue to work tirelessly to deliver PPE to protect those on the front line’.

‘PPE recommendations were updated in January 2021, and are agreed by an expert group of clinicians and scientists from across all four UK nations based on clinical evidence. The guidance on PPE is kept under close review.’


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