Addenbrooke’s NHS staff cleared Covid cases with simple change of PPE
Upgrading the type of face masks used by Covid service staff at Addenbrooke’s Hospital has resulted in a dramatic drop in hospital-acquired coronavirus infections among workers by up to 100%.
Masks used by Covid service personnel have shifted from Fluid Resistant Surgical Masks (FRSMs) to Facepiece Filter Respirators 3 (FFP3), with the change made by Cambridge University Hospitals NHS Foundation Trust in late December in response to its own staff test data.
The UK Infection Prevention Control (IPC) unit had, until recently, recommended healthcare workers caring for Covid-19 patients to use FRSMs as respiratory protective equipment.
Read more: Huge spike in Covid cases seen at Cambridge University
He said an FFP3 respirator should be used if an aerosol-generating procedure is underway, such as inserting a breathing tube into the patient’s trachea.
The guidelines were recently updated to require NHS organizations to assess the risk Covid-19 poses to staff and to provide FFP3 respirators where appropriate.
Covid service staff were at higher risk of infection, even with PPE
Addenbrooke’s has been testing staff for Covid-19 since the start of the pandemic, even when workers have no symptoms.
This testing program indicated that healthcare workers caring for Covid-19 patients were at greater risk of infection than staff in non-Covid-19 departments, even when using the recommended respiratory protective equipment. .
In response, the hospital’s infection control committee improved the type of masks used by Covid-19 ward staff.
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Prior to the upgrade, Covid cases were higher among staff in Covid services compared to non-Covid-19 services in seven of the eight weeks the researchers analyzed.
Following the change of protective equipment, the incidence of infection on the two types of service was similar.
The research has yet to be peer reviewed, but is being published early due to the urgent need to share information related to the pandemic.
Cases “dropped dramatically” as a result of the change
Dr Chris Illingworth, of Cambridge University’s MRC Biostatistics Unit, said: ‘Before the face mask upgrade, the majority of infections among healthcare workers in Covid-19 wards were likely due to direct exposure to patients with Covid-19.
“Once FFP3 respirators were introduced, the number of cases attributed to exposure in Covid-19 wards decreased dramatically – in fact, our model suggests that FFP3 ventilators may have reduced infection in wards to zero. “
According to the researchers’ mathematical model, the risk of work-related direct infection in a non-Covid service was low throughout the study period and consistently lower than the risk of community exposure.
On the other hand, the risk of work-related direct infection in a Covid-19 department before the change of respiratory protective equipment was considerably higher than the risk of community exposure: the staff of the Covid-19 departments was 47 times more at risk of contracting an infection. in the department than staff working in a non-Covid-19 department.
Dr Michael Weekes, from the university’s medical department, said: “Our data suggests that there is an urgent need to review the PPE offered to frontline healthcare workers.
“Upgrading equipment so that FFP3 masks are offered to all healthcare workers caring for patients with Covid-19 could reduce the number of infections, ensure the safety of a greater number of hospital staff and alleviate some of the burden of health services already in demand due to the lack of key staff. due to illness.
“Vaccination is clearly also a top priority for anyone who has not yet accepted their offer.
Rose Gallagher, Professional Infection Prevention and Control Manager for the Royal College of Nursing, said: “This important study adds even more weight to the RCN’s continued call for nurses to be better protected against Covid- 19 and have routine access to the highest levels of respiratory protective equipment whenever needed.
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“We are still seeing cases of Covid-19, even in some who have been vaccinated, and it is vital that staff are fully protected and there is no attempt to restrict or relax measures to further reduce the risk. infection. “
A spokesperson for the Department of Health and Social Affairs said: ‘The safety of the NHS and social service staff has always been our top priority and we continue to work around the clock to provide PPE to protect people. people on the front lines.
“The advice on the appropriate levels and standards of PPE is expertly written and approved by the four chief medical officers across the UK.
“An update to the infection prevention control guidelines was released this month to reflect the latest scientific knowledge on how to prevent the transmission of Covid-19.
“Evidence and emerging data are continuously monitored and reviewed and guidelines will be amended accordingly, as appropriate. “