Why are there so many large outbreaks among NHS staff?

[HomerRoberts]

...despite mask wearing?

In my local hospital it seems to be that high numbers of staff are simultaneously being infected despite mask wearing and distancing being in place.
Masks need to be worn at all times apart from lunch breaks, when staff still need to ensure social distancing.
I know that masks aren’t 100% effective at preventing spread but even accounting for that I’m still surprised at the high level of infection, so I wonder what’s going on here?
Shoddy masks?
Masks give even less protection than we thought?
Poor ventilation?
Or are the break times the weak point that create the opportunity for spread?

Mmmm maybe they are just having to look after really sick patients who cannot wear a face covering

I’m talking about all hospital staff, including those in “clean” non covid areas and even those who are not in patient facing roles.

The windows don’t open and hospitals are kept at stuffy temps.
Patients with Covid coughing over you and your simple surgical mask, gloves and pinny not sufficiently protective.
Moving immobile patients with other staff assisting- social distancing impossible.
Tiny treatment rooms to prepare iv drugs with several other staff doing same.
Everyone commuting on public transport in confined, poorly ventilated conditions.
Minuscule staff rooms and one loo.
Lots of staff testing positive but asymptomatic.

None of the masks are 100% effective and without patients wearing masks then in an enclosed space with a higher density of vital material from unwell patients it is not surprising some gets through. You can't provide a patient personal care from 2m away.

See table for mask effectiveness by type.

We can't effectively offer care and socially distance. Often offices/rooms are too small and multiple staff are cramped in.

I'm afraid it was a non-heroic reason in our trust.
They traced the contacts back to the break room and found that staff just hadn't been as diligent at distancing etc there from colleagues as they are from patients.
It is far too small and the windows don't open either. Queues develop for the kettle and the microwave. You know you are supposed to come back later but your break is short.

When you are wearing a mask and PPE all shift it's really nice to be able to take it off occasionally and since you are allowed to to eat you maybe keep it off a bit longer.
It's hard to regard your trusted colleagues as an infection risk the way you do patients and sometimes after a hard shift you relax a bit and think it won't harm to get a bit closer or talk with your mask off.

After my mum died recently I did hug one of my closest colleagues. It would have been so very hard and odd not to although I know I shouldn't. So as a one off in a very emotional moment I did.

So basically it's because we are human and we don't perfectly observe infection control and we are at high risk of being exposed.

I know you can’t distance from patients of course!

I have to stress this wasn’t about criticising anyone (in case it came across that way), but rather trying to understand what’s going on & if there’s something we’re missing or more that could be done to protect people.

in our trust it seems to be asymptomatic staff spreading it in breaks where they un mask and are closer than 2 m. Also not cleaning phones and keyboards when hot desking. There is still a lack of regular testing of staff...... only when symptomatic or ward has out break

NHS staff at all levels have been stressed, overworked, tired for months now, so they are going to be more susceptible to infections, as their resistance will be low.

Many reasons as listed, also for some insane reason, uniform washing was taken out of hospital and given to staff to do.
So instead of proper boil washes all contained its left down to each person's discretion. Also wearing that uniform home.

Because the PPE is not adequate. We wear more than that during the last pandemic!

Because hospital staff are being routinely tested and others aren’t.

Test a big workplace and you will likely find loads of positive “cases” who didn’t know they had it as well

I remember there was a thread on here months ago saying they had a call froM their doctor who they'd just been to see and was in full PPE ringing them to tell them they had tested positive for COVID. And I pointed out that surely it showed the PPE was not effective as he had been exposed to people presenting with COVID symptoms and then had gone on to catch it himself.

Well mumsnet completely disagreed and came up with all the excuses in the world because they absolutely couldn't believe it would ever be the fact that the PPE was useless, I still think it's useless.

It's not completely useless but it's always been acknowledged that the PPE is more effective at stopping staff passing it to patients than in stopping us getting it from patients.

You need a full on NP3 mask plus visor and gown to be safer from infection but they can't afford it for everyone. You only get that in very high risk areas eg ICU.

I'm pretty sure I read that a normal surgical mask stops being effective in protecting the wearer after 15mins but we are wearing the same 1 or 2 for whole 8hr shifts because otherwise they'd run out.

I'm most cases the staff are wearing PPE mainly to avoid passing infection to patients rather than the other way around.

@HomerRoberts covid is exceptionally infectious.

In our hospital there is a zero blame culture when we have covid cases amongst staff .

Staff are extremely tired from the first wave . You can only remove your mask for ten seconds at a time to be able to drink , something that is extremely difficult when you are very thirsty ( wearing ppe makes this worse) . Not all patients are compliant with reducing risk ... many patients get agitated & confused. Some violent.

We have had covid positive patients rip masks off staff .

As well as everything ^, don’t forget that there are many procedures in hospital that cause patients to expel more droplets than you would expect. I’d imagine ventilating a patient would be right up there in terms of being a high infection risk to surrounding staff

[quote IfOnlyOurEyesSawSouls]**@HomerRoberts* covid is exceptionally* infectious.

In our hospital there is a zero blame culture when we have covid cases amongst staff .

Staff are extremely tired from the first wave . You can only remove your mask for ten seconds at a time to be able to drink , something that is extremely difficult when you are very thirsty ( wearing ppe makes this worse) . Not all patients are compliant with reducing risk ... many patients get agitated & confused. Some violent.

We have had covid positive patients rip masks off staff . [/quote]
Genuine question. If it’s so infectious, how come my wife provided a positive test back in April and I, who was sharing everything with her up until the day she went for the test (bed etc, you can work out the rest) didn’t?

Loads of examples of people in the same home not infecting others

NHS supplied PPE is basically just a load of plastic that may or may not fit correctly. It’s not a magic wand.

Sorry, I know that sounds snappy but so much of what has been supplied isn’t adequate, and it really upsets me to think that the public can’t understand why NHS staff are being infected. There are literally hundreds of us who have died, with more infected than we will ever know.

High viral load? It's a high risk job. Plus lots are over weight, BAME and over a certain age. All increases their risk.

@Ihg27 many tests have been inaccurate....my old boss ended up in ITU after 4 negative tests, but with breathing difficulties and unmistakable “covid lung” on x Ray

@Ihg27

Yes it is extremely infectious.

Some people are less vulnerable- there is lots of research into some blood types being more susceptible/ less susceptible and also looking at T cells responses in differing groups of people.

@ohfourfoxache I literally cant be arsed with armchair scientists who have not got the foggiest idea what is actually going on in the NHS .

I think people that ask questions like this literally rely on Twitter / social media /naff newspapers for their info .

There's no very easy answer to why some get it and some don't

Scientists have found some evidence of some people having some pre-existing level of immunity from other coronaviruses. Might be that.

Certainly people are more infectious when they are very unwell and pumping out lots of virus coughing and spluttering so staff would get a high dose from sick patients and be exposed to many patients.

Fortunately for 'aerosol generating procedures' like ventilation we do get the proper filtration masks. Resuscitation is an AGP so we've been told we have to struggle into the full kit which can take a few minutes before providing emergency resus or its at our own risk if we don't. Haven't had to make that call so far thank goodness.