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Rachel, as one of the experts who knows a lot about respiratory viruses, IPC/PPE and writes national guidance, I have no choice but to intervene, because you are wrong on this and may cause panic, given your prominence and large Twitter & media following. https://twitter.com/doctor_oxford/status/1239908972456534019
When #COVID19 started back in January, PHE issued guidance rapidly and recommended FFP3, gown, eye protection and gloves for all scenarios in hospitals. This was in excess of what is needed, but it was early days (in learning mode) & we wanted a single, easy to follow approach.
The main transmission risks for coronaviruses are exposure to droplets, inhalation of which is prevented by a surgical mask, & contact-transfer of virus (prevented by gloves, apron, careful doffing, hand hygiene etc.). This is fine & true for most clinical scenarios in hospitals.
The exception is when we do something to a patient that generates an aerosol (tiny droplet nuclei that can penetrate surgical masks and linger in the air). This risk is mitigated by engineering (e.g. negative pressure rooms) and ultra-fine close-fitting masks, plus eye protection
As #COVID19 patient numbers increase, and continue to increase in coming weeks in the UK, we no longer have the luxury of using the easiest "no need to think" single ensemble approach for every scenario. We should not and cannot use PPE that is not necessary for the task at hand.
Unsurprisingly, there is a massive global demand for PPE right now. Thanks to advanced pandemic planning, the UK has some reserve stocks of PPE and we are better off than many other countries. But this is not an infinite supply and most PPE is made in... China
By rationalising the PPE recommendations, so that the right tools are used for each job (clinical scenario), according to transmission risks, we will help ensure that we do not run out of PPE, especially the components needed for AGPs.
So please, I beg you, as a respiratory IPC expert and someone who still looks after sick patients in hospitals: please stop peddling the idea that we are skimping and knowingly putting colleagues at risk; it's simply not true and is making this whole situation scarier for people.
Everyone just needs to follow the table. Right tool for the job, risk-assessment approach. I stress again, safety is not being compromised. However, we all still need to take care. Whatever the PPE, use it carefully and remove it safely. We are all in this together. Thanks.
PS: the full guidance is available here: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control It's a bit of a long read, but it contains lots of detail and explains the transmission risks and associated precautions in more detail.
