Universal face masks for staff and masks or coverings for all patients or visitors should remain an infection prevention or control (IPC) measure within health and care settings in England, Wales and Northern Ireland until at least March or April 2022, the government has said.
The recommendation has come in spite of the removal of mask mandates more generally in England from this week (Thursday).
The guidance from NHS England, the UK Health Security Agency, the Northern Ireland Public Health Agency, and Public Health Wales has also recommended that physical distancing of one metre should still remain, increasing whenever feasible to two metres, across all health and care settings.
Two metres’ distancing should also be in place where patients with suspected or confirmed respiratory infection are being cared for or managed.
In response to omicron and other Covid-19 variants of concern, the guidance has recommended that staff and organisations continue to undertake risk assessments using ‘hierarchy of controls’ measures.
This should include an evaluation of the ventilation in the area, operational capacity, physical distancing and prevalence of Covid-19.
The guidance has also made a range of recommendations for occupational health practitioners working within the NHS, health or care settings.
This has included re-emphasising that “prompt recognition” of cases of respiratory infection among health and care staff remains essential to limiting transmission.
“All staff should be vigilant for any signs of respiratory infection and should not come to work if they have respiratory symptoms. They should seek advice from their IPC teams/occupational health department/GP or employer as per the local policy,” it said.
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Symptomatic staff should avoid contact with people both in the hospital and in the general community, it added, while bank, agency, and locum staff should follow the same deployment advice as permanent staff.
“Systems should be in place to ensure that country-specific vaccination and testing policies are in place as advised by occupational health/public health teams,” the guidance stated.
“Staff who are fully vaccinated against Covid-19 and are a close contact of a case of Covid-19 may be allowed to return to work without the need to self-isolate. There are country-specific variations on the requirements for polymerase chain reaction (PCR) and lateral flow device (LFD) testing, and these policies are under continual review,” it added.
The British Medical Association, meanwhile, has welcomed recognition within the guidance that Covid-19 is an aerosol-based virus, or one that primarily spreads through the air rather than on or via surfaces.
Professor Raymond Agius, BMA occupational medicine co-chair, said it was good the guidance had been changed “to reflect undeniable evidence that Covid-19 spreads through the air”, as this would affect the use of and demand for respiratory protective equipment (RPE).
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“For doctors and other healthcare staff working in hospitals, having access to safe RPE – such as FFP3 respirators – when they are caring for patients with confirmed or suspected Covid, offers them a level of protection that they should have had for nearly two years. We therefore call on hospital trusts to ensure RPE is available and respirators are fit-tested as quickly as possible,” he added.
However, Professor Agius also emphasised this level of RPE now needed to be extended to GPs and healthcare staff working within primary care. “Now that doctors and healthcare workers in hospitals will be wearing RPE it makes no sense that GP colleagues are still having to make do with ineffective surgical masks, often in small and cramped surgeries, particularly as we know that the omicron variant is highly transmissible,” he said.
