Thread by @fearnley_k

Many thanks to @ProfEmer for his presentation on ‘Health and safety: lessons learnt from the pandemic” at todays BMA Medical managers conference 2022.

I would like to share with you some of his slides & key points discussed. 🧵

From past experience (2002-3 SARS and 2012 MERS) UK government @Conservatives should have been better prepared for the SARS CoV-2 pandemic.

Health and safety research in *2008* for @H_S_E showed surgical masks (FRSM) failed to protect against an airborne transmitted pathogen.

To quote verbatim:

“Live viruses could be detected in the air behind all surgical masks tested.

By contrast, properly fitted respirators could provide at least a 100-fold reduction.”

The 2008 study also warned

“The widespread use of respirators might be difficult to sustain during a pandemic unless provision is made for their use in advance.”

We know, despite these warnings, UK government failed to make such provision.

Inadequate guidance published by IPC @HIS_infection has put the lives & health of healthcare workers, and the patients they care for, at risk during this pandemic.

Guidance limited FFP3 respirators to healthcare workers performing aerosol generating procedure (AGPs).

The failure of trusts to provide RPE to healthcare workers caring for Covid-19 positive patients, is the reason why over 1500 of my colleagues are now dead, and thousands more - including myself - have sustained organ damage and continue to be severely unwell with Long Covid.

It is fallacy to believe infectious aerosols are only generated during AGPs.

Studies show normal respiratory functions, such as breathing, talking, coughing, all generate aerosols often one to two times greater magnitude than so called AGPs ncbi.nlm.nih.gov/pmc/articles/P…

AGP fallacy was an attempt to rationalise RPE.

Later studies (Ferris et al) showed the introduction of FFP3 respirators, cut rates of hospital-acquired SARS-CoV-2 infections among healthcare workers by up to 100% authorea.com/users/421653/a…

Worryingly, @ProfEmer suspects data reporting rates of COVID-19 in healthcare workers is grossly underestimated, by at least a factor of two.

Factors contributing to COVID-19 morbidity & mortality in healthcare workers include:

- failure of employers to undertake proper risk assessment

- Inadequate ventilation (or filtration)

- inadequate Respiratory Protective Equipment (RPE)

Employers must discharge their legal duties under Health and Safety at Work Act legislation and protect healthcare workers.

*IPC guidance is not above the law.*

Covid hierarchy of control measures include:

UK government must invest in the installation of #HEPA air filtration systems in hospitals.

Air quality must now be treated by the same legal standards we treat water quality. We must invest in #CleanAir

Take home points. 3 key messages:

1. One of the biggest health & safety failings of the pandemic has been the denial of airborne transmission & neglect of RPE.

The cost of this failure has been the health and lives of healthcare workers.

2. Employers have a legal duty to protect health care workers.

They must discharge their legal duties under the Health and Safety at Work Act.

3. Lessons learnt before the start of the Covid-19 pandemic (SARS, MERS, HSE study, Exercise Alice) were ignored.

We must apply lessons learnt to better manage this pandemic and future pandemics.

Once again, thank you to @ProfEmer for this presentation and kindly giving permission to share his slides.

END.

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