Infection Prevention & Control Information

Center for Disease Control CDC Face Shields

  • A face shield is primarily used for eye protection for the person wearing it. At this time, it is not known what level of protection a face shield provides to people nearby from the spray of respiratory droplets from the wearer. There is currently not enough evidence to support the effectiveness of face shields for source control. Therefore, CDC does not currently recommend use of face shields as a substitute for masks.
  • However, wearing a mask may not be feasible in every situation for some people for example, people who are deaf or hard of hearing—or those who care for or interact with a person who is hearing impaired. Here are some considerations for individuals who must wear a face shield instead of a mask:
    • Although evidence on face shields is limited, the available data suggest that the following face shields may provide better source control than others:
      • Face shields that wrap around the sides of the wearer’s face and extend below the chin.
      • Hooded face shields.
    • Face shield wearers should wash their hands before and after removing the face shield and avoid touching their eyes, nose and mouth when removing it.
    • Disposable face shields should only be worn for a single use and disposed of according to manufacturer instructions.
    • Reusable face shields should be cleaned and disinfected after each use according to manufacturer instructions or by following CDC face shield cleaning instructions .
    • Plastic face shields for new-born’s and infants are NOT recommended.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html

Face Shields/Visors  

While plastic face shields do provide a barrier of protection, droplets in the environment can still be inhaled through the open areas around the plastic visor. This is why Dr. Joy Henningsen, clinical assistant professor, VAMC Section, at the University of Alabama at Birmingham School of Medicine, noted that plastic face shields work best to “protect the wearer from an infected person when used with a mask.”

https://www.healthline.com/health-news/why-plastic-face-shields-arent-a-safe-alternative-to-cloth-masks#Face-shields-can-help-reduce-the-spread-of-COVID-19

 Stephen Donnelly Face Mask v’s Visors

Health Minister Donnelly has said the National Public Health Emergency Team (NPHET) is looking at whether to update advice to mandate the use of face masks where visors are being used. Speaking on RTÉ’s Prime Time, the minister said it would appear that visors are “not as effective” as face masks but said he did not know and had asked the public health team to inquire. It is also understood that a graduated fines system for breaching Covid-19 rules, such as not wearing a face mask or leaving the county when restrictions are in place, are also being considered by government. One idea under consideration for graduated fines include a €50 on-the-spot fine for not wearing a face mask or leaving your county during restrictions .Currently anyone who does not wear a face covering without a reasonable excuse being given can receive a fine of up to €2,500 or up to 6 months imprisonment. However, it is understood that government is concerned about the task of enforcement by gardai given the high penalty, with a view that perhaps something smaller like a €20-€50 fine for leaving the county or not wearing a mask would work better. The government is likely to focus encouraging public compliance and watch how on the ongoing garda operation goes in the coming days. Justice Minister Helen McEntee confirmed the government is looking at what measures worked in other jurisdictions and the possibility of on-the-spot fines

https://www.thejournal.ie/face-masks-not-visors-ireland-5225830-Oct2020/

Fine and penalties for nomn compliance with mandatory Mask Warr in Public Settings

Anyone who does not wear a face covering (or anyone who ignores a request to wear one) without a reasonable excuse may get:

  • A fine of up to €2,500
  • Up to 6 months imprisonment
  • Both a fine and imprisonment

Wearing face Masks Outdoors?

Experts have advised that one should wear a face mask outside if in a crowed space where it difficult to adhere to social distancing guidelines, the rate of outdoor infection of Covid-19 is very low. A Japanese study showed that you are 19 times less likely to be infected outdoors with Covid-19 than indoors.

Visualizing droplet dispersal for face shields and masks with exhalation valves. Physics of Fluids

Several places across the world are experiencing a steep surge in COVID-19 infections. Face masks have become increasingly accepted as one of the most effective means for combating the spread of the disease when used in combination with social-distancing and frequent handwashing. However, there is an increasing trend of people substituting regular cloth or surgical masks with clear plastic face shields and with masks equipped with exhalation valves. One of the factors driving this increased adoption is improved comfort compared to regular masks. However, there is a possibility that widespread public use of these alternatives to regular masks could have an adverse effect on mitigation efforts. To help increase public awareness regarding the effectiveness of these alternative options, we use qualitative visualizations to examine the performance of face shields and exhalation valves in impeding the spread of aerosol-sized droplets. The visualizations indicate that although face shields block the initial forward motion of the jet, the expelled droplets can move around the visor with relative ease and spread out over a large area depending on light ambient disturbances. Visualizations for a mask equipped with an exhalation port indicate that a large number of droplets pass through the exhale valve unfiltered, which significantly reduces its effectiveness as a means of source control. Our observations suggest that to minimize the community spread of COVID-19, it may be preferable to use high quality cloth or surgical masks that are of a plain design, instead of face shields and masks equipped with exhale

https://aip.scitation.org/doi/pdf/10.1063/5.0022968

Virus transmission from urinals

A virus-laden particle movement from urinal flushing is simulated. Similar to the toilet-induced flushing, results indicate that the trajectory of the particles triggered by the urinal flushing manifests an external spread type. Even more alarmingly, the particle can reach 0.84 m (man’s thigh) in 5.5 s when compared with the diffusion performance of the toilet-induced one (around 0.93 m in 35 s). A more violent climbing tendency is discovered in this Letter. Wearing masks should be made mandatory in public washrooms, and anti-diffusion improvements of facilities in public washrooms are urgently needed, especially in the current “SARS-CoV-2” crisis.

https://aip.scitation.org/doi/10.1063/5.0021450

 Likelihood of survival of coronavirus in a respiratory droplet deposited on a solid surface

We predict and analyse the drying time of respiratory droplets from a COVID-19 infected subject, which is a crucial time to infect another subject. Drying of the droplet is predicted by using a diffusion-limited evaporation model for a sessile droplet placed on a partially wetted surface with a pinned contact line. The variation in droplet volume, contact angle, ambient temperature, and humidity are considered. We analyse the chances of the survival of the virus present in the droplet based on the lifetime of the droplets under several conditions and find that the chances of the survival of the virus are strongly affected by each of these parameters. The magnitude of shear stress inside the droplet computed using the model is not large enough to obliterate the virus. We also explore the relationship between the drying time of a droplet and the growth rate of the spread of COVID-19 in five different cities and find that they are weakly correlated.

Previous studies have reported that infectious diseases such as influenza spread through respiratory droplets. The respiratory droplets could transmit the virus from one subject to another through the air. These droplets can be produced by sneezing and coughing. Han et al.1 measured the size distribution of sneeze droplets expelled from the mouth. They reported that the geometric mean of the droplet size of 44 sneezes of 20 healthy subjects is around 360 μm for unimodal distribution and is 74 μm for bimodal distribution. Liu et al.2 reported around 20% longer drying time of saliva droplets as compared to water droplets deposited on a Teflon-printed slide. They also predicted and compared these times with a model and considered the solute effect (Raoult’s effect) due to the presence of salt/electrolytes in saliva. The slower evaporation of the saliva droplet is attributed to the presence of the solute in it.2 Xie et al.3 developed a model for estimating the droplet diameter, temperature, and falling distance as a function of time as droplets are expelled during various respiratory activities. They reported that large droplets expelled horizontally can travel a long distance before hitting the ground. In a recent study, Bourouiba4 has provided evidence that droplets expelled during sneezing are carried to a much larger distance (of 7–8 m) than the distance previously found. The warm and moist air surrounding the droplets helps in carrying the droplets to such a large distance.

https://aip.scitation.org/doi/10.1063/5.0012009

 Covid-19 Remains on surfaces

 The new coronavirus may remain infectious for weeks on banknotes, glass and other common surfaces, according to research by Australia’s top biosecurity laboratory that highlights risks from paper currency, touchscreen devices and grab handles.

Scientists at the Australian Centre for Disease Preparedness showed SARS-CoV-2 is “extremely robust,” surviving for 28 days on smooth surfaces such as glass found on mobile phone screens and plastic banknotes at room temperature, or 20C.That compares with 17 days survival for the flu virus.

Virus survival declined to less than a day at 40C on some surfaces, according to the study, published in Virology Journal. The findings add to evidence that the Covid-19-causing coronavirus survives for longer in cooler weather, making it potentially harder to control in winter than summer. The research also helps to more accurately predict and mitigate the pandemic’s spread, the researchers said. “Our results show that SARS-CoV-2 can remain infectious on surfaces for long periods of time, reinforcing the need for good practices such as regular hand washing and cleaning surfaces,” said Debbie Eagles, the centre’s deputy director. The coronavirus tended to survive longer on non-porous or smooth surfaces, compared with porous complex surfaces, such as cotton. The research involved drying the coronavirus in an artificial mucus on different surfaces, at concentrations similar to those reported in samples from infected patients, and then reisolating the virus over a month. The study was also carried out in the dark, to remove the effect of ultraviolet light, as research has demonstrated direct sunlight can ­rapidly inactivate the virus. “While the precise role of surface transmission, the degree of surface contact and the amount of virus required for infection is yet to be determined, establishing how long this virus remains viable on surfaces is critical for developing risk-mitigation strategies,” Ms Eagles said. The persistence on glass is an important finding, given that touchscreen devices such as mobile phones, bank ATMs, supermarket self-serve checkouts and airport check-in kiosks are touch surfaces which may not be regularly cleaned and therefore pose a transmission risk, the researchers said in the paper.

They found the longer survival time of SARS-CoV-2 than seasonal flu on banknotes “of particular significance, considering the frequency of circulation and the potential for transfer of viable virus both between individuals and ­geographic locations”.

Before SARS-CoV-2 was declared a pandemic, China had started decontaminating its paper currency, suggesting concerns over transmission via paper banknotes existed, the researchers said, noting that the US and South Korea have also quarantined bank notes as a result of the pandemic. (© Washington Post)

 The Irish Independent Monday 12th of October

Face Covering extended by law till November 9th

By law, you have to wear a face covering:

You should also wear a face covering:

  • when staying 2 metres apart from people is difficult
  • in a healthcare setting – this includes hospitals, GP surgeries, care settings, nursing homes and dental practices
  • when visiting anyone who is more at risk from COVID-19 (coronavirus) – such as people aged 70 or over or people who are medically vulnerable

HSE Reducing Contacts

It’s always safer to meet fewer people, less often, for less time. If we do this, we have a better chance of stopping the spread of #coronavirus. Apart from the people you live with, limit the number of people you meet and the time you spend with them. Share this post to remind others of this important message. #StaySafe #ProtectEachOther

WHO

Here are 3 basics measures you can follow while attending a small gathering or event during COVID-19:

Maintain at least metre distance from others

Clean your frequently

Avoid touching , &

Cover a sneeze/cough with a tissue or bent elbow

Every time we do the right thing, we’re protecting ourselves and the people around us so please continue to keep washing those hands.

Wear a face covering when you’re shopping or on public transport and if you cough or sneeze – cover it or have a tissue handy. Because COVID-19 is still a problem and we’re all the answer.

 

Learn more: by clicking here

WHO Video to encourage children to wash hands properly

WHO has teamed, Africa-based children’s education and entertainment producer, to launch ‘Will you wash your hands with Akili?’. The sing-along video by Akili and Me shows children how to wash their hands to stay safe during the COVID-19 pandemic

https://www.facebook.com/watch/?v=2418622385105669&extid=2tL0hz0JRPQcLjmH

Covid-19 Tips

Welcome few

Wash your hands

Watch your distance

Wear your mask ( properly)

HSE Mask Wear

As the use of face coverings becomes more widespread, it’s important to remember that not everyone is able to wear them. They are not recommended or required for children under 13 or those who have specific difficulty wearing them.

Some people affected by hidden disabilities, such as autistic people or those with brain injuries, find wearing a face covering particularly challenging and are exempt from wearing them if this is the case.

We are asking people to be understanding and continue to support one another during this difficult time.

Learn more: https://bit.ly/2Zs1TLj

HIQA launches new digital learning module to support infection prevention and control in community services

The Health Information and Quality Authority (HIQA) has  launched a digital learning module to support staff in community health and social care services to implement safe practice in infection prevention and control and antimicrobial stewardship, such as appropriate antibiotic use. These services include, for example, residential services for older people and people with a disability, day care services, general practices and care delivered in the home. The online module aims to support services to implement the National Standards for infection prevention and control in community services.

Rachel Flynn, HIQA’s Director of Health Information and Standards, said: “Infection prevention and control is about supporting people to access care that is as safe as possible. The COVID-19 pandemic has further highlighted the importance of good infection prevention and control practices in all health and social care services to prevent the spread of infection. While overall responsibility for infection prevention and control and implementing the national standards rests with senior management, everyone working in health and social care services has a responsibility to provide care and support that is in line with good infection prevention and control practices.”

HIQA developed the module to support front-line staff working in community services to implement the standards in their day-to-day practice and to identify barriers to good hygiene practices. The training highlights the importance of good communication between people and services, and the importance of ensuring standard precautions are in place at all times.

Ms Flynn continued: “Preventing the spread of infection depends on everyone working within a service understanding their responsibilities and engaging in ways to reduce the risk of infection, such as ensuring hands, equipment and the environment are kept clean. It is also essential that antibiotics are used appropriately to reduce antibiotic resistance and ensure antibiotics remain effective. “We hope that people will use this digital learning module to strengthen and improve standard infection prevention and control practices in community services across the country.”

HPSC Cover your Cough and sneeze the right way Poster

 

HSE Face Coverings Poster

HSE

As the use of face coverings on public transport and in shops becomes the norm, it’s important to remember that some deaf or hard of hearing people may find it hard to communicate with you without lip-reading.

It is safe for you to lower your face covering while keeping 2 metres away to allow lip reading. Alternatively, the use of transparent visors could be considered as an option.  Click Here:

WHO :Wear a Mask Challenge?

 Today, we launch a new #WearAMask challenge! By wearing a mask, you are sending a message of solidarity and protecting people, especially those most vulnerable, from COVID-19.Take a photo or a video of yourself wearing a mask, share it and nominate friends to do the same. Masks alone will not stop the virus – we must do it all:

-Wear a mask that covers your nose, mouth, and chin

-Keep physical distance

-Clean your hands

-Keep away from big crowds

-Cover your mouth and nose when coughing

We are the ones that can end this pandemic!

HPSC Acute Hospital Infection Prevention and Control Precautions for Possible or Confirmed COVID-19 in a Pandemic Setting V.1.3

This document replaces the previously issued ‘Interim infection prevention and control precautions for possible or confirmed 2019 novel Coronavirus (2019 nCoV), Middle East Respiratory Syndrome Coronavirus (MERS CoV) and   Avian Influenza A in healthcare setting’s’.  The guidance has been updated to reflect the declaration of a pandemic event, recent decisions of the National Public Health Emergency Team and to address questions that have arisen from colleagues managing COVID-19. Please note that further updates in guidance are likely to be required therefore it is essential that you confirm that you are using the latest version of guidance Click Here:

WHO Coronavirus disease (COVID-19) advice for the public: When and how to use masks

Please see posters on mask wear from WHO on the following :

  • How to wear a fabric mask safely
  • How to wear a medical mask
  • How to wear a non-medical fabric mask safely
  • How to wear a medical mask safely

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks

Infection prevention and control and preparedness for COVID-19 in healthcare settings 

Fourth update – 3 July 2020

Click Here:

This document aims to provide guidance to EU/EEA healthcare facilities and healthcare providers on infection prevention and control (IPC) measures for the management of possible and confirmed cases of COVID-19 infection in healthcare settings, including long-term care facilities (LTCF). It also offers guidance on the management of specimens at laboratories in the EU/EEA.  This is the fourth update of the ECDC guidance dated 13 May 2020 ‘Infection prevention and control and preparedness for COVID-19 in healthcare settings’ [1].  The second update included measures to be applied in settings in areas with community transmission and addressed a growing demand for care of COVID-19 patients and ensuing staff issues in the event of shortages of personal protective equipment (PPE) for healthcare facilities in EU/EEA countries and the United Kingdom. The third update included updated recommendations for healthcare staff, including long-term care facilities staff, regarding medical masks and FFP2 respirators, and actions for staff with mild symptoms of COVID-19. It also contained additional references to current ECDC surveillance guidance for long-term care facilities recommending laboratory testing as soon as possible after the detection of a case, to guide infection prevention and control measures.

Changes to the current update This fourth update contains the following additions:

  • Addition of the section ‘Definitions’, defining mask types.
  • Alignment with information on occupational health and safety from European Agency for Safety and Health at Work (EU-OSHA), in accordance with Occupational Safety and Health (OSH) regulations and codes of practice.
  • Update of the background including evidence on transmission and the effectiveness of preventive measures.
  • Revision of the physical distancing recommendation for healthcare workers performing the first assessment without direct contact. They should maintain of at least 1.5 metres rather than 1 metre whenever possible, in addition to wearing a medical mask.
  • Addressing the uncertainty of the potential for generation of infectious aerosols through administration of nebulised treatment
  • Review the evidence and revision of clinical and microbiological criteria for discharge from isolation
  • Revision of microbiological testing criteria for new and returning residents of long-term care facilities, in the section ‘Long-term care facilities, Administrative measures’

Emerging evidence that Covid-19 may be airborne

EILISH O’REGAN

The World Health Organisation has acknowledged there is “emerging evidence” that Covid-19 could be spread through particles in the air.

More than 200 scientists wrote an open letter to the agency urging officials to recognise the possibility of airborne transmission.

Current guidelines focus on the virus being spread primarily through droplets from the nose or mouth, which are expelled through coughs or sneezes.

Prof John Wender, a professor of chemistry at UCC and one of the scientists who wrote to the WHO, said: “We should avoid spending a long time indoors, particularly in smaller rooms with other people unless wearing masks.”

He said loud singing or shouting should be avoided, particularly indoors, and rooms should be well ventilated.

Irish Independent 9th July

 Should  more of us wear face masks in the office and will classroom windows have to remain open in winter?

 Airborne virus may mean facemasks in offices and windows open even in winter

EILISH O’REGAN

The possibility of airborne transmission of Covid-19 -especially in “crowded, closed, poorly ventilated settings” -cannot be ruled out, according to the World Health Organisation (WHO).It has responded to a letter signed by 239 scientists in 32 countries – including Ireland – asking for more clarity and calling for this mode of transmission to be considered. How does this differ from what we already know and what precautions are needed to reduce the risk of catching the virus in this way?

Sinking droplets

The WHO has previously said that Covid-19 primarily spreads in small droplets expelled from the nose and mouth of an infected person through, for instance, coughs and sneezes. These droplets quickly sink to the ground. Because these droplets are large, they fall within a metre or so – hence the advice on physical distancing. The droplets can land on surfaces and if these are touched by someone the virus may be picked up.

Lingering particles

The difference between the droplets and airborne disease is that tiny particles from a sneeze, cough or breath can linger in the air.

These aerosols can travel further than a metre. It means the infectious person moves on, but the virus remains airborne. Another person can breathe it in.

Jury is out. It is still not clear-cut if airborne transmission is possible and, if so, what is the extent of the role it plays in the spread. The WHO is to publish a scientific brief summarising the state of knowledge on modes of transmission of the virus in the coming days.

Benedetta Allegranzi, the WHO’s technical lead for infection prevention and control, said there was evidence emerging of airborne transmission of the coronavirus, but that it was not definitive.

”The possibility of airborne transmission in public settings – especially in very specific conditions, crowded, closed, poorly ventilated settings – cannot be ruled out. However, the evidence needs to be gathered and interpreted, and we continue to support this.”

Reducing risk

There are so many aspects about the virus that started out being suspected and then proven to be correct. So even if there is no strong proof of airborne transmission, there are likely to be recommendations by some countries to tighten up safety precautions.

It could lead to wider use of face masks or coverings in offices or even classrooms.

The occupancy levels of some rooms may be looked at and also the length of time people spend indoors in confined workplaces, bars or restaurants with others unless wearing a mask. There may be stricter guidance on singing and shouting in indoor areas.

Better ventilation

A key measure to reduce the risk of airborne transmission is likely to include ensuring there is better ventilation where people are gathered in a room. Windows and doors could end up having to be opened in schools, colleges and workplaces, even in colder weather. Filtered air conditioning systems will be needed. Researchers at the University of Hong Kong highlighted the case of nine people in three families in China who caught the virus after eating at the same restaurant as a “source” patient. They said coughing and sneezing alone could not explain the spread. The conclusion pointed to aerosol transmission.

Healthcare settings

There could be potential consequences for healthcare settings and the grade of face mask that staff wear. It could mean they will have to don the most secure masks which filter out even the smallest respiratory droplets as they care for patients and look after residents in nursing homes and residential centres.

This could lead to problems with supplies of these masks.

Absence of evidence

The scientists who wrote the letter to WHO say an absence of evidence around airborne transmission is not evidence of absence.

They insist the potential for this kind of transmission is important as countries increasingly move out of lockdown and people mix more for longer in workplaces, pubs and other enclosed spaces

Irish Independent 9th July

Mask Wear Update

National Transport Authority NTA stated mask wear is compulsory on public transport from 29th June as capacity increases from 20% to 50%

Mask Wear compliance Update 2nd July

Just over half of Dublin Bus users are wearing face coverings, according to a survey of Irish public transport services, despite the Government making them compulsory.

Dublin Bus users ranked among the worst for covering their faces in the National Transport Authority (NTA) survey, with 52pc wearing a face covering, up from 41pc on Monday.

As part of Phase Three of the Roadmap for Reopening Society and Business, since Monday the capacity on buses, trains and trams has been increased from 20pc to around 50pc and the wearing of face coverings on all public transport was made compulsory.

While the NTA said there is a 90pc compliance rate on some services, others are faring much worse.

On Bus Éireann commuter services in the Greater Dublin Area, compliance is running at 75pc on some services and 98pc on others. Three in four passengers on Bus Éireann city services in Cork and Waterford are complying, while the rate in Limerick and Galway is at 40pc.

Iarnród Éireann has reported that 60pc of passengers arriving and departing from Heuston Station are using face coverings, compared to over 90pc of passengers on rural Link services.

Irish Independent 2nd July

WHO has updated the interim guidance on infection prevention and control during healthcare when coronavirus disease (COVID-19) is suspected or confirmed?

This is the third edition of the guidance and expands the scope and structure of earlier guidance, bringing together other interim recommendations as well as considerations and advice from subject matter experts.

The main differences and additions compared to the previous versions include the following:

  • Expansion of all sub-sections to include clarifications and further recommendations.
  • Addition of new guidance and practical advice for the management of visitors especially in areas with COVID-19 community transmission.
  • Inclusion of a sub-section on ventilation in the section “Environmental and engineering controls”; new guidance on IPC considerations for surgical procedures for patients with suspected or confirmed COVID-19, as well as those patients whose COVID-19 status is unknown.
  • Updated considerations for dead body management in healthcare facilities
  • Practical advice and tools to assess healthcare facility IPC readiness and to monitor and evaluate IPC measures for COVID-19.
  • This guidance is intended for health workers, including healthcare managers and IPC teams at the facility level, but it is also relevant for the national and district/provincial levels

https://www.who.int/publications/i/item/WHO-2019-nCoV-IPC-2020.4

HSE Update on Mask Wear

NPHET have stated the level of mask wear is at 40% . HSE live emphasised the importance of correctly wearing masks . Improper use of masks can add to the risk of contracting Covid-19 .

HSE How to Use Face Coverings

A helpful poster to guide you use face coverings

ICGP Update on Mask Wear

The Irish College of General Practitioners has called on the public to use face coverings when shopping and on public transport. “While full scientific evidence is not yet available on the efficacy of face coverings, we are encouraging people to use them when possible, as they are another barrier against transmission of the virus,” said Dr Nuala O’Connor of the ICGP. “They do not replace the measures we know with greater certainty stop the virus spreading – 2m social distancing, practicing good hand hygiene and cough etiquette.”

HPSC Infectious Diseases weekly report

This gives a detailed breakdown of all the notifiable disease in the past week

Report Link :Click Here:

Government expert backs calls to send every home a bundle of reusable masks

Oireachtas  Eilish O’Regan Health Correspondent

Calls to send every household in the country a bundle of reusable face masks to reduce Covid-19 transmission are being supported by Dr Cillian de Gascun, chair of the Government’s expert advisory group on the virus. Dr de Gascun said there is a current inequity where people cannot afford to buy them or make their own homemade masks.

He was responding to a suggestion by Labour TD Duncan Smith at the Special Committee on Covid-19 Response who said there was precedent for this measure. He pointed to the distribution of iodine tablets by former Fianna Fáil energy minister Joe Jacob in 2002 as part of a plan in the event of a major nuclear accident. Mr Smith said: “In the past in this country we have mass provided preventative products in the form of iodine tablets to each household. Providing proper reusable face masks and clear instructions on how and when to use them is something we need to strongly consider. “Especially as there is a concern that there could be a seasonal element to the Covid-19 virus with prevalence in the winter months more likely.”

Dr de Gascun described it as a “very good suggestion” and said now is the time to scale up manufacturing masks.

A packet of 10 standard masks in a supermarket costs around €10 and a medical grade mask – which the World Health Organisation has said people over 60 and those with underlying health conditions should wear – costs €130 for a pack of 200.

The World Health Organisation’s revised advice is to be reviewed by the National Public Health Emergency Team.

Dr de Gascun, however, said the evidence around how effective cloth masks are is not fantastic. He said face masks or cloths should only be seen as an add-on to physical distancing, handwashing and respiratory etiquette.

There is good evidence medical grade face masks work in healthcare settings.

They act as a barrier in cases where people cough or sneeze, but studies have not shown if the virus is not transmitted, he said.

PPE Update

The Taoiseach confirmed personal protective equipment (PPE) is also being stockpiled for the possibility of a second wave  [Irish Independent 11th June]

Guidance for Imaging and Radiotherapy services during the Covid-19 pandemic: Use of face coverings for patients, clients and carers 26 May 2020 Click Here

Information surrounding the use of face coverings during the Covid-19 pandemic has been published by the Society and College of Radiographers, alongside the Royal College of Radiologists (RCR).

According to government guidance, “Face coverings should be worn by everyone in crowded areas where social distancing is not possible.”

Created for imaging and radiotherapy services to help promote good practice, evidence is highlighted that cloth coverings decrease the amount of virus passing from the wearer by as much as 99%.

“Please note that this advice is intended to supplement the most important and effective measures of physical distancing, hand washing and respiratory hygiene, not to replace them.”

Guidance for Imaging and Radiotherapy services during the Covid-19 pandemic: Use of face coverings for patients, clients and carers.

European Centre for Disease Prevention and Control ECDC 13th May  ‘Infection prevention and control for COVID-19 in healthcare settings’ update of the ECDC guidance dated 31st March

This third update contains the following additions:

  1. The recommendation that all healthcare staff providing care to patients in areas with community transmission should consider wearing surgical masks or FFP2 respirators, if available, in addition to practising meticulous hand hygiene.
  2. The clarification that the recommendation for long-term care facility (LTCF) staff not to come to work if they have symptoms compatible with COVID-19 also includes those with mild symptoms.
  3. The recommendation that in areas with community transmission all LTCF staff who provide care for residents or have contact with residents or communal areas of the LTCF should consider wearing surgical masks or FFP2 respirators, in addition to practising meticulous hand hygiene.
  4. Additional references to current ECDC surveillance guidance for long-term care facilities recommending laboratory testing as soon as possible after the detection of a case, to guide infection prevention and control measures. If a suspected case is detected, samples should be tested from all suspected cases in residents and staff as a minimum, but preferably from all staff. If a laboratory-confirmed case is detected, all residents and staff should be tested, preferably with staff being tested weekly as a follow-up [1a]. Click Here:

HSE Updated Advice on Mask Wear 16th May

Wearing a cloth face covering is recommended in situations where it’s difficult to practice social distancing. For example, in shops and on public transport. They may help prevent people who do not know they have the virus from spreading it to others.
If you wear one, you should still do the important things necessary to prevent the spread of the virus. Click on the link for more information Click here:

Who should wear a face mask?

This is an interesting article debating whether or not one should wear a place if asymptomatic in public places such as supermarkets .Opinion is divided and advice on this varies greatly and can change. Current advice from the World Health Organisation is that you should wear a mask if you are coughing or sneezing. Click Here:

 

RSCI Conversations that Matter

PPE Impacting how we communicate with patients  Dr Miriam Colleran St Brigid’s Hospice

PPE is another layer over health care workers and its uncomfortable for the wearer . Discussed the way healthcare workers have changed the way with communicate with patients .All healthcare workers have to stand when  communicating with patients as they can’t sit down to avoid contamination . Healthcare workers have to decrease their time with patients to rinse the risks. It’s difficult to make eye contact and non-verbal cues due to PPE .There are staffing and resources implications dealing with covid-19 we are working in different ways.

https://www.rcsi.com/dublin/coronavirus/healthcare-professionals/conversations-that-matter

Center for Disease Control CDC Optimising PPE Webinar

The presenters will provide a COVID-19 update and discuss strategies for healthcare facilities to optimize personal protective equipment (PPE) supplies such as eye protection, isolation gowns, facemasks, and N95 respirators. Click Here:

Centre for disease control CDC  and prevention  Webinar Infection Prevention and Control Recommendations

Learn how to implement infection prevention and control measures for COVID-19, assess risks for exposures, and optimize the use of personal protective equipment supplies Click Here:

ISRRT. What personal protective equipment (PPE) should I wear?

Patients case definitions

ISRRT E-learning Book

PPE Poster Safety Tip of the Week brought to you by Declan Morey, DGSA Consultant Eco Online

‘Be aware of your limitations when wearing PPE, the protective equipment is your last line of defence and a precautionary measure, but it does not eliminate health or physical hazards. Ensure PPE fits you correctly and that any defects are reported and replaced.’

Sample poster on PPE procedures for COVID-19 safety measures Click Here:

ISRRT How to sanitize portable X-ray equipment

When chest X-rays are performed on bed-ridden patients, some important considerations to reduce mobile X-ray machine contamination are: Click Here:

Printable Infographics on Cleaning Guidelines Varian machines Click Here:

Aunt Minnie

Radiographers speak on PPE and COVID-19 infection control

Radiographers have found themselves on the front lines during the COVID-19 pandemic, and there’s a growing awareness that radiology departments must develop and implement a strategy to keep radiographers and patients safe. But how can this be done?

Click Here:

ISRRT .Experiences of wearing Personal Protective Equipment (PPE) when examining patients

The routine working life of a radiographer has changed dramatically in a few short weeks due to the current Coronavirus pandemic. One of the main aspects of this change is the mandatory requirement to wear various levels of PPE, in order to minimise the potential for transmission of the virus from a patient to staff; staff to patient and staff to staff etc, thereby facilitating the (uncontrolled) spread of disease

Click Here:

COVID-19  ISRRT Response Document – Appropriate and safe use of Medical Imaging and Radiation Therapy with infection control measures considered in addition to standard radiation protection procedures

Click Here:

Extended Mask Wear

I have included some articles on extended mask wear and associated side effects .

Increased Face Mask Wear Can Lead to Skin Irritation and Infection—Here’s How to Reduce Risk

https://www.realsimple.com/beauty-fashion/skincare/face-mask-skin-irritation

https://www.magonlinelibrary.com/doi/full/10.12968/jowc.2020.29.Sup2a.S1

https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html

Faces of the future: inventive Cork students fix faulty masks Kinsale Community School

MAEVE SHEEHAN IRISH INDEPENDENT Sunday Independent 26th April

I read this article on Sunday and had to include and commend the wonderful work being done by Kinsale Community school making PPE and  also fixing a consignment of faulty PPE from China . Fergal McCarty , school principal opened the school to a small group of pupils including Oisin Coyle (17) and Shane Collins (16 and teachers and production has not stopped since. They have produced more than 5,000 protective face shields for frontline health care staff in big hospitals   — Cork University Hospital, the Mercy and the Mater Private — and for care centres, nursing homes, local GPs, pharmacists and even the local convent Read More:

Guidance on the use of Surgical Masks in the Healthcare Setting in the Context of the COVID-19 Pandemic

Introduction
This guidance replaces previous guidance on the use of surgical masks in healthcare settings in the context of the COVID-19 pandemic. This guidance is for immediate implementation. The content will be incorporated into other Infection Prevention and Control guidance documents as they are updated.

Use of surgical masks by healthcare workers in the context of viral respiratory tract infection has two objectives:

  1. To reduce the risk of droplet transmission of infection to the wearer.
  2. To reduce the risk of droplet transmission of infection to others.

Use of surgical masks for these purposes is in addition to and not as a replacement for other measures to reduce the risk of transmission of infection. These measures include hand hygiene and maintaining a distance of 2m between people whenever possible. Surgical masks must be donned correctly and should remain in place covering the nose and mouth throughout the period of use. Masks should not be moved up and down over the nose and mouth. When a mask is no longer required or if a fresh mask is needed the mask must be removed and disposed of safely as healthcare risk waste.

Guidance

  • Surgical masks should be worn by healthcare workers when providing care to patients within 2m of a patient, regardless of the COVID-19 status of the patient.
  • Surgical masks should be worn by all healthcare workers for all encounters, of 15 minutes or more, with other healthcare workers in the workplace where a distance of 2m cannot be maintained Click Here:

Health Protection Surveillance Centre HPSC

Risk Assessment of Healthcare Workers with Potential Workplace Exposure to Covid-19 Case V8.1

This is a useful poster to guide HSCP;s carrying out risk assessments. Click Here:

Cochrane

This Special Collection has been created in response to the COVID-19 pandemic and is regularly updated. It aims to ensure immediate access to systematic reviews most directly relevant to the prevention of infection. It includes reviews that are relevant to the WHO interim guidance, as well as other potentially relevant reviews from three Cochrane Networks: Cochrane Public Health and Health Systems; Cochrane Musculoskeletal, Oral, Skin and Sensory; and Cochrane Acute and Emergency Care, and also draws on the knowledge of Cochrane groups in affected regions. Many reviews in this collection have associated Cochrane Clinical Answers (CCAs), with links provided.

https://www.cochranelibrary.com/collections/doi/SC000040/full

The Role of Vaccines in Preventing Infectious Diseases and Antimicrobial Resistance

Learn how vaccines work and can be used for infectious disease control with this online course for healthcare professionals. You need to register but this link is free after that. Click Here:

NICE

NICE scientific advice Guide for COVID-19 evidence collection. We have produced a draft guide on clinical evidence generation for developers of medicinal products for COVID-19. The guide provides advice on considerations including clinical trial design, the trial population, the length of the trial and real-world evidence collection. Click Here

Health  Protection Surveillance Centre HPSC

How to put on and take off PPE full coveralls, face shields and masks (new PPE regulations ) 15/04/2020 Click Here:

College of Radiographers /RCR PPE poster’s

The posters, Personal protective equipment advice for imaging and oncology departments and teams, offer advice for aerosol generating procedures or high-risk areas and general contact with confirmed or possible Covid-19 cases

PPE Poster for Diagnostic Imaging Department and teams Click Here:

PPE Poster for Radiation Oncology Department & teams Click Here:

EFRS

A statement reminding political leaders across Europe of the importance of medical imaging in diagnosing Covid-19 patients has been supported by the European Federation of Radiographer Societies

The document “emphasises that governments bear the responsibility to ensure healthcare professionals are sufficiently equipped with personal protective equipment (PPE) and other resources necessary in the battle to save lives.” Read More:

BMJ

A cluster randomised trial of cloth masks compared with medical masks in healthcare workers

The aim of this study was to compare the efficacy of cloth masks to medical masks in hospital healthcare workers (HCWs). This study is the first RCT of cloth masks, and the results caution against the use of cloth masks. This is an important finding to inform occupational health and safety. Moisture retention, reuse of cloth masks and poor filtration may result in increased risk of infection. Further research is needed to inform the widespread use of cloth masks globally. Click Here:

HPSC

Daily COVID-19 surveillance reports Click Here:

 Reproduction Rate of Covid-19 National Public Health Emergency Team (NPHET)

The National Public Health Emergency Team’s modelling data has revealed that Ireland’s effort to date has greatly reduced the transmission of the virus: Professor Philip Nolan, Chair of the NPHET Irish Epidemiological Modelling Advisory Group (IEMAG) said: “When an R number increases by even a fraction above 1, the number of new cases per day will rise, slowly but inexorably. The number of people, on average, that someone with COVID 19 is likely to infect was high at the beginning of the outbreak at 4.5. We now see this ‘R’ (reproduction) number reduced very significantly. The growth rate has reduced from 33% daily in the early weeks of this outbreak to  below 1 at .7 which is very positive news

RTE news 16.04.20 / NPHET

PPE Usage

This spreadsheet is designed to help you track how quickly PPE is being used at your facility.  Click Here     

UK SoR PPE guidelines  now consistent with WHO guidelines Click Here

Covid19 & Decontamination of medical devices

Dr Colleran’s Lecture on Covid 19

Dr . Gerard Colleran  BSc PhD. School of Science Institute of Technology Tallaght Dublin  24,

The recommendations below are a guide and will not supersede local or national policy.

Be prepared by being informed and keeping up to date with the latest Covid-19 information .

Remember this virus is spread by droplets and the only way it can transfer to you is via the nose, mouth or eyes. Keep your hands clean and you have to learn NOT to touch your face

Hand Hygiene Procedure

  • clean your hand soap & water or alcohol gel for 20-30 seconds (cover all areas of hands and do not forget tops of the finger, nail beds, in-between fingers and thumbs).
  • Remember hand hygiene after touching any surfaces especially door handles and do not forget about your 5 moments for hand hygiene
  • Bare below the elbow – clinical and non-clinical staff. This will make it easier for you to clean your hands properly. NO hand/wrist jewellery and NO nail varnish. NO fit bits or watches.

Cough etiquette

  • Cough/sneeze into you sleeve or use a tissue (remember to dispose the tissue into a bin and clean your hands)
  • Teach your patient to also use tissues and give them a bag to dispose of themselves. Remember they also have to clean their hands and if they are unable to do this, assist them.

Workwear/uniforms

  • Machine wash at 60 degrees (separate from another household laundry).
  • Please ensure that you do not wear your work uniform outside the hospital campus.
  • Clean your ID badge/swipe card/bleep and lanyard Clean them all regularly during the day and the lanyard can be put in the washing machine.
  • Mobile phones need to be cleaned regularly
  • Come into work and leave work in your day clothes and remember to clean your hands as you leave the building
  • Have hair tied back with clips and away from your neckline  – helps you stop touching your hair especially when wearing PPE
  • Facial hair – clean shaven

There is a lot of inaccurate information out there so please read the following:

  • Staff looking after COVID patients (suspected or confirmed) – can use the canteen and staff toilets
  • Surgical masks can remain in situ provided they do not become wet or heavily contaminated – no need to change your mask every 10 minutes
  • FFP respirator masks can remain in situ up to 4 hours (European norm) – no need to change every 20 minutes
  • With the necessary PPE on, an HCW can remain in a COVID room/bay as long as needed for a procedure or task (including multiple tasks).
  • Regardless of any patient’s infectious status (COVID/MRSA/CPE), treatments or procedures should be undertaken as deemed necessary whilst complying with the necessary IPC precautions.

Aerosol generating procedures (AGPs)– know the list! Nebulisation is not an AGP. Refer to national guidelines – link is below

  • AGPs in room or bay without ventilation – airborne precautions is required during the procedure and up to 1 hour after the procedure has ended.
  • AGPs in room or bay with ventilation– airborne precautions is required during the procedure and up to 20 minutes after the procedure has ended.

Air conditioning  units must remain TURNED OFF if a suspected or confirmed COVID patient is in the bay/room

 

Care of the dying patient – immediate family should be allowed to attend for a short period of time and can wear apron, gloves and mask.

Funeral Director’s Guidelines Click Here:

HSeLanD

HSeLanD has created a dedicated Covid-19 page. that brings together resources related to COVID–19

Personal protective Equipment (PPE )

PPE and the importance of workplace risk assessments highlighted by the SoR  Click Here:

Putting On/Off PPE There are two E-learning modules available on HSeLanD followed by an assessment for PPE in acute and community settings. HSELAND LINK

  • Putting on and taking off PPE in acute healthcare settings’ is for nursing and clinical staff in acute hospitals and support staff who are identified as being required to use PPE working in acute hospital settings.
  • Putting on and taking off PPE in community settings’ is for any staff member, including GPs, nursing and clinical staff in community services plus residential services, GP clinics and patients’ homes who are required to use PPE
  • HPSC Videos on how to put on and take off PPE  Click Here:
  • UK Guidance for Radiographers and RTs on PPE  Click Here:

Health Protection Surveillance Centre  Provides latest guidance for clinical and non-clinical settings on Covid-19 . Video resources include how-to put-on PPE , decontamination of clinical rates, dealing with suspected Covid-19 cases. Click Here:

Additional Resources on HSeLanD :

  • Hand Hygiene for HSE Clinical Staff
  • Hand Hygiene for HSE Non-Clinical Staff
  • Breaking the Chain of Infection

 

Infection Prevention &Control Weblinks

ECDC European Centre for Disease Control and Prevention  https://www.ecdc.europa.eu/en

ECDC works in partnership with national health protection bodies across Europe to strengthen and develop continent-wide disease surveillance and early warning systems. By working with experts throughout Europe, ECDC pools Europe’s health knowledge to develop authoritative scientific opinions about the risks posed by current and emerging infectious diseases.

CDC Centres for Disease Control and Prevention Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings Click Here:

Covid-19 UK Guidance for infection prevention and control in healthcare settings

Issued jointly by the Department of Health and Social Care (DHSC), Public Health Wales (PHW), Public Health Agency (PHA) Northern Ireland, Health Protection Scotland (HPS) and Public Health England as official guidance

This was adapted from Pandemic Influenza:  This document outlines the infection prevention and control advice for healthcare workers involved in receiving, assessing and caring for patients who are a possible or confirmed case of COVID-19.  It is based on the best evidence available from previous pandemic and interpandemic periods and focuses on the infection prevention and control aspects of this disease only, recognising that a preparedness plan will consider other counter measures.  The infection prevention and control advice in this document is considered good practice in response to this COVID-19 pandemic. Read More:

American College of Radiology (ACR)Publishes Resources for COVID-19 Pandemic

ACR has also published guidance for radiology departments to support adaption of work flow practices, particularly in relation to infection control.In an effort to help radiologists make the safest, most informed decisions during the COVID-19 outbreak, the American College of Radiology (ACR) published guidance and resources Tuesday that can help providers offer the best patient care possible during the pandemic. The ACR stressed the resources are not intended to be comprehensive medical guidelines.

As information about COVID-19 and its spread continues to emerge, radiologists are urged to operate under the following recommendations.

Read More:

National Institute for Health and Care Excellence (NICE)  

NICE has published its first 3 rapid COVID-19 guidelines. They will cover the management of:

Patients in critical care
Patients who are having kidney dialysis
Patients who are receiving systemic anticancer treatments. Read More:

Society of Radiographers (SoR) UK

The Society of Radiographers (SoR) UK has information on the following : Click Here:

  • Workforce, Governance and Regulations
  • Infection control and PPE
  • Education and students
  • Radiotherapy
  • Diagnostic Radiography (FAQs)