Do people realise that covid patients don't wear masks?

[Arundelclassrom]

Just interested to hear if people know this. I see a lot on these threads that people think it's "ok for doctors and nurses because they have effective ppe". Do you realise that masks do not protect you, they protect others from you? Do you realise covid patients who are struggling to breathe do not wear masks? Do you realise they are coughing all over us as we provide care?

I'm not saying this to complain - this is my job and I do it willingly because I care. I'm just getting really frustrated seeing people who apparently think there is no risk involved in my job, and that theirs is somehow more risky than a job where we are in an enclosed space with actual confirmed covid patients...

www.ons.gov.uk/employmentandlabourmarket/peopleinwork/employmentandemployeetypes/articles/whichoccupationshavethehighestpotentialexposuretothecoronaviruscovid19/2020-05-11

Can't find the original now. It isn't specific to Covid but assumptions were made that it would be the same.

I can confirm that a surgical mask, a plastic apron and a pair of gloves is the 'recommended' PPE on the COVID Ward I'm working on. Has been since April. They added goggles at some point in the summer. We've treated hundreds of COVID patients up close and personal wearing just this. Huge numbers of our staff have caught COVID but thankfully all recovered.

Doesn't help that when the media were still bothering to film in hospitals they always seemed to go to ITU where they always got full PPE.

AGP's is a nonsense, I'm pretty sure all the patients with hacking coughs on my ward are generating as many aerosols as the tubed patients on ITU but hey ho

OP and all the other nurses on here-i can assure you that the vast majority of the public do NOT know that you are only wearing the same masks as we all in in shops. We were all horrified and lobbying for your PPE back in March and we assumed you now all had it. And by PPE, I mean something a hell of a lot more adequate.

But please don't try and start a fight with teachers. I can't imagine any teacher would swap places with you or say anything against you. But all I keep hearing is many of you slapping teachers down. This is so depressing, especially at the moment.

Out of interest, when you've heard teachers on other threads saying about the lack of PPE and saying you have it...why haven't you spoken up?

@Piggywaspushed

You are using the risk of infection index right?

That's also the one that puts nursery nurses, TAs and primary teachers right near the top.

It's an odd report that one but i can link tot he actual study although it is quite hard to find and based on US data and self reporting.

Just being a data geek.

Funny that

Not sure what you mean dom?

Has any other nhs staff had the change in the AGP rooms? We used to be able to go in them with a paper mask if it had been switched off for 20 minutes because that's how long it took for the covid to 'settle'. Now they are saying 3h 45 mins until it settles? Where did the 20 minutes that we've followed for the last 7 months come from?

@Piggywaspushed the data I've seen from this country suggests teachers are LESS likely to get the virus than the general population. Admittedly that might be different now that numbers are rising and more are back at school.

Taxi drivers and security staff (most likely men) most at risk from dying.

Dental nurses, dentists, hairdressers, care workers likely to get the virus.

@Arundelclassrom

"Medical staff working with known Covid patients do have PPE to properly protect them from others though? It's only the face coverings required for shopping etc that don't"

No we don't! I'm really impressed at the propaganda that makes people think we do. We get a basic surgical mask which does not protect us from the covid being breathed out by our actual covid patients. We are not protected in any way. Staff in Icu get full ppe. Staff on general medical wards do not. This is reflected in infection rates - ICU staff low infections, gen med staff v high

That is shit. Does it vary by trus. My friend is a nurse and in the first lockdown she worked in a medical ward where patients were admitted awaiting Covid results. She definitely had an ffp2 or ffp3 mask and visor as she sent me photos in her PPE gear and she was definitely not wearing a surgical mask. I am not sure what she is wearing nowadays though.

Unfortunately Public Health England , (which was taken out of the NHS a few years ago and is part of the government) changed the rules for PPE in mid March, such that on Covid wards the staff just "need " to wear surgical masks , gloves and plastic apron, plus visor if possible. A dangerous and fatal scandal, done because of shortages of PPE. FFP3 masks are only provided for aerosol generating procedures. Same across NHS. Shameful.

@Piggywaspushed

Not sure what you mean dom?

The fact that a report which relied heavily on self reporting of risk heavily featured teachers

That was based on the time when most teachers were wfh, staples. there appears to be some consternation that occupations aren't being studied and monitored now. Prof Calum Semple said on tell yesterday that there is an alarming number of 18-40 year old women in hospital, working in care,health, hospitlaity and education.

This

autonomy.work/portfolio/jari/

is a general infection of risk of infection for jibs, as is aid not specific to Covid but extrapolated.

@gertrudemortimer

Has any other nhs staff had the change in the AGP rooms? We used to be able to go in them with a paper mask if it had been switched off for 20 minutes because that's how long it took for the covid to 'settle'. Now they are saying 3h 45 mins until it settles? Where did the 20 minutes that we've followed for the last 7 months come from?

We’re still on 20 minute guidance for NiPPI, cough assist etc? Haven’t had any guidance to say that’s changed.

It's amazing how what counts as an AGP has changed since covid put pressures on PPE availability, too. Half the procedures that, pre-Covid, generated aerosols, miraculously no longer do so.

The reality is that the one thing that has kept us pretty safe over the summer is that the odds of any particular patient having covid were low. That safety net (for us and for teachers, who I have full sympathy for) is clearly wearing a bit thin. And never applied if you worked with known covid patients.

For those who are disbelieving, the official guidance on what PPE to where when is at assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/910885/COVID-19_Infection_prevention_and_control_guidance_FINAL_PDF_20082020.pdf Page 32 has the PPE for nursing covid +ve patients, and confirms that FFP3 masks and gowns are for AGPs only.

It didn't heavily feature teachers : ahve you looked? I copied it twice!

the survey chose ALL occupations. ALL respondents self reported things like proximity and length of time of contact. It's all perfectly valid.

Don't know why you are coming for me! It puts nurses top! obviously.

I have no skin in this game.

Is that in England? I work in the EU, was in one country for the first part of the pandemic and am now in another. In both of these countries there is no way we would ever be facing COVID patients with such inadequate protection (what OP describes is not even "PPE") and not suspected COVID patients either. That's appalling.

We are already very worried over here for our NHs colleagues and furious with your government in England but this is just beyond irresponsible. And the schools without masks...really, we cannot fathom what your government is trying to achieve.

@samiamgreeneggs

I can confirm that a surgical mask, a plastic apron and a pair of gloves is the 'recommended' PPE on the COVID Ward I'm working on. Has been since April. They added goggles at some point in the summer. We've treated hundreds of COVID patients up close and personal wearing just this. Huge numbers of our staff have caught COVID but thankfully all recovered.

Doesn't help that when the media were still bothering to film in hospitals they always seemed to go to ITU where they always got full PPE.

AGP's is a nonsense, I'm pretty sure all the patients with hacking coughs on my ward are generating as many aerosols as the tubed patients on ITU but hey ho

It's funny how they removed 'sputum generating cough' from the AGP list isn't it - probably because they realised it was every covid patient and they didn't have enough FFP3!

I'm not wanting to put down teachers at all here, I agree the risk to them is scary.

The point I'm making is i don't think people have any idea what the risk is to us.

I feel personally really insulted by the post higher up where a teacher claimed she was in "the highest category of risk" because of close proximity to two confirmed cases. I understand that feels scary - but do these people honestly think that compares to what we do every shift?!

@JeanneFrench

Is that in England? I work in the EU, was in one country for the first part of the pandemic and am now in another. In both of these countries there is no way we would ever be facing COVID patients with such inadequate protection (what OP describes is not even "PPE") and not suspected COVID patients either. That's appalling.

We are already very worried over here for our NHs colleagues and furious with your government in England but this is just beyond irresponsible. And the schools without masks...really, we cannot fathom what your government is trying to achieve.

Can you please let me know what you wear for intervention with a covid positive patient, not on itu? (For non aerosol generating procedure)?

I have to admit, I didn’t realise how bad it was for healthcare professionals and I’m shocked.
Of course it’s totally incomparable to teaching and it’s offensive to suggest otherwise. That’s not to say there isn’t big risks in schools but it’s not the same. It’s not a race to the bottom.

It's amazing how what counts as an AGP has changed since covid put pressures on PPE availability, too. Half the procedures that, pre-Covid, generated aerosols, miraculously no longer do so.

I know! The list of AGPs seemed to change weekly at one point.

The reason for the change from FFP3 to fluid resistant masks is to do with cost, I think, as well as supply.

The FFP3 masks cost £5 each. In the community they would need to be changed between each visit - potentially 10+ visits per nurse, per day. In theatre, I was easily getting through the same amount (until they changed what counted as an AGP so we didn't use nearly so many) Surgical gowns are about £4 each. Then there's the cost of disposal. It's an expensive business...

@LizzyBennett

It's amazing how what counts as an AGP has changed since covid put pressures on PPE availability, too. Half the procedures that, pre-Covid, generated aerosols, miraculously no longer do so.

I know! The list of AGPs seemed to change weekly at one point.

The reason for the change from FFP3 to fluid resistant masks is to do with cost, I think, as well as supply.

The FFP3 masks cost £5 each. In the community they would need to be changed between each visit - potentially 10+ visits per nurse, per day. In theatre, I was easily getting through the same amount (until they changed what counted as an AGP so we didn't use nearly so many) Surgical gowns are about £4 each. Then there's the cost of disposal. It's an expensive business...

I remember the good old days when administering a neb was considered an AGP....

@Umbridge34

Its the care homes and agency staff that is al problem, that is allowing CV into CH's, no one really gives shit.

The impact of agency staff isn't spoken about enough imo.

We aren't allowed to pick up bank shifts outside of our units (usually 3 orn4 wards to choose from) to limit the contacts. However agency staff are working here there and everywhere. And many dont get paid to self isolate so are they going to isolate of say a family member is symptomatic?

Govt has had since March/April to sort this and have SFA.

Adult social care is done almost exclusively by agency staff on min or living wage and many on ZHC plus have cars to run.

So no, many won't isolate, how can they afford too, the £500 isn't even in place yet and its no where nr enough.

You feel personally insulted?

I spent 8 straight hours 1.8m away and in conversation with 2 positive cases with no ppe whatsoever. I thought I was comparing this to someone spending 30 hours in similar proximity to positive cases in full FFP3. I think those two things would have been comparable to be honest.

You told me that I was wrong about the FFP3 and I came in here, admitted it was me who had said that, admitted I was wrong and promised I would not make the comparison in the future. I then said I was shocked and angry on you’re behalf that you didn’t have better protective equipment.

Can you point out please what I have done to personally offend you?

What makes me angry is that we have had six months to set up our own production of ppe. We knew this wasn’t going to be over in six months. FFP3 masks may cost £5 to buy but I’m sure they don’t cost £5 to make, so why haven’t we been making them? How many billions have been “spaffed” up the wall and why weren’t we spending some of those billions on protecting nhs staff and care workers?

No because the teachers aren’t saying they are working in face to face contact with covid sufferers. You are saying you are working in face to face contact with covid sufferers. If you are aware of suitable masks which you seem to be and the employer is not providing them then buy a suitable
One in the interim until employers do buy them. Consult with unions if the trust you work with are not providing what you consider to be essential ppe kit.