Advice regarding COVID-19 transmission risk in response to PHE face mask re-use guidance
22 April 2020 (Last updated: 4 May 2020 13:35)
Surgical associations issue advice on how to reduce COVID-19 viral transmission risk, advising patients with non-healing mouth ulcers to use NHS 111 to get hospital care
Surgical associations whose members work close to the face have issued further advice for their members in response to Public Health England (PHE) guidance changes that allow re-use of surgical masks. The associations also stress that patients with non-healing mouth ulcers, or any other indication of oral cancer, should ring NHS 111 for referral to hospital-based oral and maxillofacial surgery (OMFS) departments that are still open for business.
Nirmal Kumar, President ENT UK, said: “With supplies of Personal Protective Equipment (PPE) under extreme pressure, the Government has issued guidance on how to re-use face masks that are designed for single use. No combination of PPE and process can completely eliminate the risk of COVID transmission. Our members have to use their clinical judgement and treat the outside of the mask as contaminated at all times including covering them with a visor.”
Chair of the British Association of Oral and Maxillofacial Surgeons (BAOMS), Patrick Magennis, commented on the complexity of risk mitigation: “We know that some COVID patients are completely symptom-free, and that speech or coughs can generate transmission of viruses. These are called Aerosol Generating Exposures (AGE). They are lower risk than Aerosol Generating Procedures, but do pose a risk and surgeons must wear a mask. For short exposures, using a disposable surgical mask may have a lower risk than re-using an FFP3 mask.”
Both ENT UK and BAOMS highlight that masks are just a small component of preventing transmission between patients and clinicians in either direction. All patients must be treated as potentially COVID-positive, and follow the PARA mnemonic of wearing PPE, Avoiding unnecessary exposure/procedures with excellent telephone/video triage, Reducing the number of people exposed during the clinical episode by efficient patient pathways, and Abbreviating the duration of any episode by using the most expert clinicians available; will keep the risks to a minimum.
BAOMS President Rob Bentley raised concerns that patients with mouth cancers are not being referred to OMFS departments: “Patients with mouth ulcers that have not healed after a month would previously have spoken to their dentist or doctor about it and be sent straight in to the OMFS department. The COVID crisis has disrupted this pathway. Some patients with mouth cancer, which can be treated easily by surgery if caught early, might come to harm if treatment is delayed. OMFS departments are still open for business and NHS 111 staff know how to direct people to them.”
Full information about the new guidance go to BAOMS, BAOS and ENT UK websites.
For further information and interviews contact: Siân Evans on 020 8674 8921 / 07752 414433 or BAOMS
Notes to editors
- The British Association of Oral and Maxillofacial Surgeons (BAOMS) promotes the advancement of education, research and the development of oral and maxillofacial Surgery in Great Britain, and encourages and assists postgraduate education, study and research.
- ENT UK is the professional membership body representing Ear, Nose and Throat surgery, as well as its related specialities, in the United Kingdom. We support members at every stage of their careers, from student-level right through to retirement – a total of more than 1,600 medical practitioners.
- Aerosol Generating Procedures (AGP) are medical procedures that generate a mist of fluid such as using a water spray cooled drill or passing an endoscope which may stimulate coughing. The aerosol is responsible for airborne transmission of viruses.
- Aerosol Generating Exposures (AGE) are caused simply by speech, clearing the throat or sneezing.
- Personal Protective Equipment (PPE) - protective garments or equipment designed to protect the wearer's body from injury or infection.
- Public Health England Coronavirus (COVID-19): guidance for health professionals and other organisations
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