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Health workers’ lives put in danger by official PPE guidelines, study shows

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Issue 2741
Staff working in many hospital areas are issued with looser-fitting surgical masks
Staff working in many hospital areas are issued with looser-fitting surgical masks (Pic: Wikimedia/Creative Commons)

A new study backs health workers’ claims that they are still being put in danger by not having access to the best protective equipment.

Public Health England (PHE) last month reiterated its “guidance”. This says most staff only need to wear the highest grade masks and gowns when performing what the agency defines as “aerosol generating procedures”.

That means that the highest grade PPE masks, known as FFP3, is mostly reserved for intensive care units or for emergency treatment. Meanwhile staff working in other hospital areas, and performing routine care in ambulances, are issued with looser-fitting surgical masks, which give them far less protection.

But many frontline workers insist they are at greater risk than health bosses think and that the list of “aerosol generating procedures” is far too narrow.

Now a new study has backed their claim.

It finds that patients coughing makes health workers up to four times more likely to contract the virus than the general population. And the use of lower grade protection means infection rates for those working on general wards are approximately double those of staff working in intensive care.

“A cough really is a potent generator of aerosols,” says Dr James Dodd from North Bristol Lung Centre, which carried out the study. He explained the risk “appears to be far greater than what we would have assumed”.


Campaigner and midwife Kirsty Shea last month used a Freedom of Information request to ask PHE what evidence they had based their guidance on. This week she received her reply. “Public Health England can confirm that it does not hold the information you have specified,” it said.

Staff in the groups Nurses United and NHS Workers Say No are livid.

Ambulance workers say low grade protective masks are putting lives at risk
Ambulance workers say low grade protective masks are putting lives at risk
  Read More

They are demanding that everyone in the NHS immediately gets access to the right protection to keep them safe. And they’re pointing out that their demands are backed by the World Health Organisation.

They issued a statement this week that will strike a chord with many others. It warned that “by working with basic PPE” they “are risking the safety of our patients and colleagues as well as of ourselves, our families and the wider community”.

“Many of us are suffering from an increased level of anxiety in the workplace,” the statement said. This is “due to the consistent fear that the basic standard of PPE issued to staff will not adequately prevent us from contracting Covid-19”.

Unions at some local NHS trusts have already been successful in getting the PPE guidelines at their workplaces upgraded. And the GMB union nationally is backing the demand.

But now, with more health workers needlessly contracting the virus every day, it is vital that the big health unions move quickly to take up the campaigners’ demands. 

It’s possible to fight over PPE

Health workers at Homerton hospital in east London won the right to use higher grade PPE protective equipment after a long-running campaign.

A Unison union member there told Socialist Worker about how management was pushed to change its guidelines.

“We’ve been fighting over this since the beginning of the pandemic—and over time, we’ve presented more and more evidence to back up our case,” she said.

“We won some concessions early on when management agreed that staff could use the more protective FFP3 masks for patients where there was a significant risk of coughing—it was accepted that this produced aerosols.

“The guidance included treatments or care that may induce coughing such as feeding a patient with a weak swallow.

“But these changes were dependent on that type of PPE actually being available—and it was at the discretion of individual staff, rather than a new policy. That meant the use of safer kit was not as widespread in use as it should have been.

“So, we carried on with our campaign, going back to management when we found new research to support our position.


“The continued push from us coincided with a big rise in infections among workers.

“Finally, on New Year’s Eve, management issued new guidance. It accepted that there were many cases where FFP3 protection was necessary, and it gave staff the option to use a higher level of protection when working with patients.

“And now there are sufficient supplies for this to happen.”

The example of Homerton shows that NHS management can be pushed to make workers far safer than they are now.

Every health worker should try and follow their lead.

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