Give FFP3 masks to NHS staff during Omicron, doctors say

Dec 09, 2023

Medical bodies say thin surgical masks do not provide adequate protection for frontline personnel

NHS staff treating Covid patients should be given much more protective facewear than thin surgical masks to help them avoid getting infected during the Omicron rise, doctors say.

The British Medical Association (BMA), Hospital Consultants and Specialists Association (HCSA) and Doctors’ Association UK are calling for frontline personnel to be given FFP3 masks.

Making the much higher-quality face masks standard issue would save the lives of health workers who fall ill as a result of treating Covid patients, the BMA said. "At this critical point in the pandemic this is extremely urgent – a matter of life and death," said Prof Raymond Agius, the acting chair of the doctors’ union's occupational health committee.

FFP3 masks, also known as filtering facepiece respirators, have been shown in a trial in Addenbrooke's hospital in Cambridge to reduce the number of healthcare staff who become infected.

However, the Department of Health and Social Care's (DHSC) guidance on personal protective equipment, updated last week, only recommends their use in limited circumstances.

"With a high transmissible new strain now circulating, and clear evidence that Covid-19 spreads in small airborne particles, healthcare workers must be given the best possible protection against the virus. Surgical masks don't give the necessary protection against airborne transmission of Covid," Agius said.

The BMA has written to every hospital trust in England demanding that any health professional treating patients who are or may be Covid-positive should be routinely issued with FFP3s, which are much more expensive than the surgical masks usually provided.

Surgical masks are "unsuitable" given the threat Covid poses, the BMA believes.

In its letter it has reminded hospital chief executives of their legal responsibilities as employers to keep their staff safe from harm, including by providing FFP3s.

A handful of hospitals are understood to already issued FFP3 respirators as standard, but most do not.

Dr Claudia Paoloni, the president of the HCSA, said that giving staff proper PPE would help reduce the fast-growing tide of sickness absence among frontline workers who are getting Covid.

"If we don't get PPE right we risk contributing to a further wave of sickness absences when hospitals and patients can least afford it.

"The current reliance on inadequate fluid-resistant surgical masks is likely to leave staff vulnerable in enclosed hospital settings," Paoloni said.

"The fear, as in 2020, is that we are seeing a cavalier approach to safety where infection control guidelines are once again being driven by supply issues and cost.

"We need hospitals to see sense and take a precautionary approach," by making FFP3s available to anyone who wants to use one instead of a surgical mask, Paoloni added.

The BMA has also written to NHS England asking it to ensure all GP practices are also issued with FFP3s instead of surgical masks, particularly because family doctors often work in small, cramped surgeries.

"Healthcare workers in hospitals and GP surgeries are putting themselves and potentially their own families at risk, particularly with this new, highly transmissible Omicron variant," said Dr Vishal Sharma, the chair of the BMA's pensions committee.

The DHSC's updated guidance, published last Tuesday, says "staff should assess any likely blood and body fluid exposure risk and ensure PPE is worn that provides adequate protection against the risks associated with the procedure or task being undertaken". However, it only advises frontline staff to use an FFP3 if they are undertaking an aerosol-generating procedure, such as intubating a patient who is going on to a mechanical ventilator, and not with Covid patients generally.

A DHSC spokesperson confirmed that it does not plan to recommend routine use of FFP3 masks.

"The safety of the NHS and social care staff has always been our top priority and we continue to deliver PPE to protect those on the frontline.

"Guidance on the appropriate levels and standards of PPE is written by clinical experts. Updated infection prevention control guidance was published this month to reflect the latest scientific understanding on how to prevent transmission of Covid-19.

"Emerging evidence and data are continually monitored and reviewed and guidance will be amended accordingly if appropriate."