COVID-19 Update 06/04/2020
We hope this latest newsflash isn’t seen as serial information overload – but want to make you aware of updated and new PHE guidance released yesterday, 05.04.20.
https://www.gov.uk/government/publications/wuhan-novel-coronavirus-infection-prevention-and-control
A suite of 15 documents, published in the Infection Prevention and Control section of PHE’s COVID-19 Guidance, included updates and new directions. All these related in different ways to keeping our Workforce Safe and in particular provided background to the updated PPE which was released last week on 02.04.2020.
Today’s FOM newsflash should be seen as a continuum with our information sheets since 27.03.2020. In the first we summarised the contribution which occupational physicians and OH teams could make in the present circumstances, and in particular provided background to the challenge for the NHS and OH services of healthcare staff for whom there are concerns about specific vulnerability to COVID-19.
Over the past fortnight further communications have introduced the ethics guidance from the RCP to which FOM contributed (30.03.2020), the updated PHE guidance on PPE (02.04.2020) and the background to the evolving testing programme for COVID-19 (03.04.2020).
The Faculty continues to collaborate closely with the other Royal Medical Colleges and Faculties in trying to achieve a unified national approach to the medical and health aspects of this pandemic.
FOM’s communications on COVID-19 are informed by our participation in the briefings for medical royal colleges and faculties arranged by the AoMRC, which offer a point of input to the PHE/NHS deliberations as the pandemic situation evolves. The FOM is also in frequent contact with colleagues across the wider OH community, particularly the NHS Health at Work Network who represent the majority of OH teams who provide services to NHS staff, and the Society of Occupational Medicine who have arranged many informative and lively discussions to contribute to an understanding of the changing OH landscape during this national emergency. We value the many contacts from our members and others which are by turns informative and questioning, providing a much appreciated steer to the deliberations of FOM’s officers and others at this time.
The ‘new’ PHE guidance issued yesterday has already been described by one correspondent as ‘posing as many questions as answers’.
PHE reminds us that the evidence base for their recommendations about this new infection is developing but that infection control advice at this stage is informed by the reasonable assumption that the transmission characteristics of COVID-19 are similar to those of the 2003 SARS-CoV outbreak. Predominant modes of transmission are currently assumed to be droplet and contact with additional risks associated with aerosol generating procedures which require airborne precautions when carried out on a suspected or confirmed case of COVID-19.
Welcome aspects of the guidance include recognition of the:
- legal responsibilities of employers
- hierarchy of control measures in relation to potential exposure to COVID-19
- importance of risk assessment
- role of employers in the risk assessment of staff ‘at risk or pregnant’ in decision making about deployment.
The documents include clarification of the basis upon which changes were made to PPE guidance; the accompanying tables on recommended PPE in different circumstances confirm endorsement by the four nations and the AoMRC.
The new guidance includes a specific document titled Occupational health and staff deployment.
Recommendations within this guidance note that:
- In the event of a breach in infection control procedure staff should be reviewed by occupational health
- Occupational health departments should lead on the implementation of systems to monitor staff illness and absence.
Whilst we welcome the apparent value placed on OH in this new guidance from PHE these recommendations are imprecise and have significant implications for OH services. The FOM will be seeking further clarification and discussion with PHE and the NHS.
Dr Anne de Bono
President, Faculty of Occupational Medicine
