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COVID-19: Current infection control guidelines are ‘fundamentally flawed’

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Current infection control guidance needs a post Current infection control guidance needs a post-COVID revamp, says the RCN

The COVID-19 pandemic has shown that the UK’s infection control guidelines are ‘flawed and need replacing, according to a new report commissioned by the RCN.

The report 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.

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‘UK infection prevention and control guidance to prevent the spread of COVID-19 in health care 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),’ said authors Professor Dinah Gould, an Honorary Professor of Nursing at London’s City University, and Dr Edward Purssell, also from City University.

‘Updated evidence indicates that aerosol spread is much more significant and the original advice from the WHO has been superseded. The UK guidelines are still based on this outdated evidence, however.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.’

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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 health 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.

‘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,’ said RCN Chief Executive and General Secretary Dame Donna Kinnair.

‘The report and its findings must launch an official review and not be swept under the carpet as an inconvenience. Health care 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.’

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