Several people have asked me whether I think the government is lying about its reason to say Cardiac Arrest resuscitation is NOT an aerosol generating procedure.

The government says it is because of science.

Science my arse.

It is because we don't have enough masks.

Public Health England has a very difficult job to do. It has to provide guidance to tends of thousands of staff.

I've looked at its website today: https://www.gov.uk/government/collections/wuhan-novel-coronavirus#guidance

I think it is brilliant.

Clear, concise, well-illustrated.

All of this is very important, because we need to get on and act now.

However it has classified cardiac arrest management (CPR) as not aerosol-generating.

This is of course incorrect.

If a cardiac arrest is successful, the first thing the patient does is cough.

(And then punch you in the face, but we don't mind that!)

Even if it is unsuccessful, what the hell do we think we are doing when we are pressing on the chest, other than to squeeze out the contents?

I mean, WTF?

On TV, sometimes people do dainty one-finger CPR, but that ain't gonna keep the blood circulating.

Real CPR, the type I want to have done on me when the time comes, is major shoving!

Here is the relevant page: https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control/covid-19-personal-protective-equipment-ppe

And the relevant paragraph:

To be fair, they have at least provided a link which you can follow to see that their conclusion is wrong.

And they have used this form of words, which helpfully flags up that they don't believe it really.

Not considered ... by stupid people ...

Anyway let's follow the link.

It is to here:

https://hpspubsrepo.blob.core.windows.net/hps-website/nss/2893/documents/1_tbp-lr-agp-v1.pdf

Where the buck is passed to poor old Tran et al.

But what did Tran *really* say? Let's look.

Open Science!

No paywalls for you!

Here is the Table of Doom.

I've zoomed in to the relevant bit. Three studies, and a summary estimate.

Two studies have point estimates (for Odds ratio of getting infected) of 3 to 4.

One has an odds ratio near zero, and it quenches them.

So overall it is not statistically significant. (Albeit with an error bar that goes to 11)

OK so lets see the third study, shall we?

The study that makes it safe to do CPR without a filter-mask.

It all hangs on this one, chaps.

So wait for it.

Here we go.

The study to end all studies.

The mother of all studies.

*The* definitive study. The Tran-meister's 27th Ref.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3322898/pdf/03-0838.pdf

So this is it.

The whole edifice is balancing on this single point.

Three nurses managed to do CPR without getting SARS.

That is it.

So yes, it is true that Chest Compressions "are not considered" to be an Aerosol Generating Procedure.

But only by the same people who consider Donald Trump to be a Stable Genius.

i.e. unintelligent people.

Not Public Health England. They said OTHER unspecified people believed it, not them.

So strictly speaking they are not lying.

However, I would very much prefer it if they said what they actually think, namely that Chest Compressions is Aerosol Generating.

My Trust or my neighbouring Trust have no wish to formally argue with PHE.

I am only writing this as an individual, in my scientific capacity as adviser to my friends.

My Colleague @LCC_DrMalik said it very starkly this week to all trainees.

"At a cardiac arrest, if you do not have PPE, go and get it on first, and only then start chest compressions.

Even if the arrested patient is me."

PHE are doing an excellent job.

This is a very small part of their work, but I do request they update their otherwise very well-thought out guidance.

Label chest compressions as aerosol-generating please!