New research punches holes in basis for COVID-19 infection control guidance

A report commissioned by the RCN claims that the government’s COVID-19 infection control guidelines, which are used across the UK, are “flawed and need replacing."  
The report, written by independent experts, analysed a literature review which underpins the current guidance and found that the review met just four of the 18 criteria the experts deemed essential. Crucially, the report found that the review failed to consider a key way in which COVID-19 is transmitted – airborne infection – about which growing evidence has emerged during the pandemic.  
For these reasons, the experts concluded the review provided only a “superficial account” of the available COVID-19 evidence and that the current guidelines based on the review need replacing.  
In the report, the authors Professor Dinah Gould, an Honorary Professor of Nursing at London’s City University, and Dr Edward Purssell, also from City University, say: “UK infection prevention and control (IPC) guidance to prevent the spread of COVID-19 in healthcare settings, and the rapid reviews of the literature on which it was based, still identify droplet spread and hands as the major route, based on early advice from the World Health Organization (WHO).   
“Updated evidence indicates that aerosol spread is much more significant and the original advice from the WHO has been superseded. The UK guidelines are still based on this outdated evidence, however. They urgently need thorough revision and replacing.”  
The report highlights that the guidelines omit detail on the importance of ventilation and advise that higher level personal protective equipment (PPE) must only be provided in certain high-risk settings like intensive care, but that it’s up to individual Trusts to decide whether or not to provide them more widely to other staff.   
This has caused huge concern for members, especially with the emergence of highly infectious new COVID-19 variants. Members have also expressed concern about the lack of action on ventilation in UK hospitals as research suggests airborne transmission is a particular problem in poorly ventilated rooms. 
The RCN has repeatedly tried to engage the government on these issues and is calling for all NHS staff to be given a higher level of PPE as a precautionary measure pending the outcome of a review. RCN Chief Executive & General Secretary Dame Donna Kinnair says: “We have been battling this pandemic for more than a year now. 'Following the science’ is a hollow boast when we have evidence showing the flaws.   
“The report and its findings must launch an official review and not be swept under the carpet as an inconvenience.
“Healthcare workers need to know everything possible is being done to keep them protected. It is inadequate to say they have masks if they aren’t fit for purpose. Staff are scared for themselves and their families and left any longer it’ll turn to anger.”

Download the report here.