Airborne protection for staff is associated with reduced hospital-acquired COVID-19 in English NHS Trusts

Abstract

Introduction Hospital-acquired infection with COVID-19 (HAI) has reduced from 14.3% to 4.2% over the last year, but substantial differences still exist between English NHS trusts. Methods We assessed rates of HAI, comparing trusts using airborne respiratory protection (RPE, eg FFP3 masks) for all staff, as a marker of measures to reduce airborne spread, against those using mostly droplet precautions (eg surgical masks). Results/Discussion RPE use was associated with a 33% reduction in HAI odds in the Delta wave, and 21% in the Alpha wave (p<0.00001). We recommend all hospitals make airborne mitigations a priority.

Comparison of COVID-19 survival in relation to CPAP length of treatment and by comorbidity and transmission setting (community or hospital acquired) in a medium-sized UK hospital in 2020: a retrospective study

“…These proportions are comparable to those of other UK and European studies 23. Hospital-acquired COVID-19 reduced to 4% after summer 2021, corresponding with the rollout of vaccines in the UK 24. The causes lay in building design, ventilation of rooms, huge pressure on overcrowded beds, short staffed and overwhelmed clinical teams, a lack of testing and inadequate patient and public involvement in the early months of the COVID-19 pandemic 25 26.…”

Prevention of SARS-CoV-2 and respiratory viral infections in healthcare settings: current and emerging concepts

“…Medical masks reduce exposure and emissions by about 40–60% whereas higher level masks and respirators such as KN95s and N95s can reduce exposures and emissions by 80–90% and 95–98%, respectively [93 ▪ ,94]. This is associated with incrementally more protection against infection and transmission [31 ▪ ,95,96 ▪▪ ]. Both personal protection and source control are particularly pertinent in healthcare settings where there is a dual obligation to protect healthcare personnel from getting infected by patients and to protect patients from getting infected by healthcare personnel.…”

How covid-19 spreads: narratives, counter narratives, and social dramas

“…There remains wide variation in infection control policies in different NHS trusts (perhaps because some interpret the guidance as mandatory); those that provide respirator grade protection seem to have much lower nosocomial infection rates for covid-19. 63…”

“…It did not recommend respirator masks for all covid-19 patient care. But the document glossary states, “Airborne particles can be released when a person coughs or sneezes, and during [aerosol generating procedures].” There remains wide variation in infection control policies in different NHS trusts (perhaps because some interpret the guidance as mandatory); those that provide respirator grade protection seem to have much lower nosocomial infection rates for covid-19 63…”