C: Kitti Fazekas / Scopio

The Government’s advice on masks for health workers seems very strange

Paul Cullen, in the Irish Times, yesterday:

There is no evidence to support the wearing of surgical masks by healthcare workers for close patient encounters and staff meetings, according to new official guidance.

The guidance was issued by Health Service Executive clinical lead on infection control Prof Martin Cormican in response to moves towards routine wearing of face masks by a number of hospitals.

One Dublin hospital last week advised staff they should wear surgical masks for all patient encounters and meetings between staff where social distancing of at two metres cannot be maintained.

The stated aim of the guidance, which has been adopted by other hospitals, is to prevent the spread of Covid-19 from mildly symptomatic or asymptomatic healthcare workers to patients and colleagues. The recommendation is to use three masks a day if working a 12-hour shift and two for shorter shifts.

However, Prof Cormican said the recommendation “is not supported by evidence and is not consistent with national guidance”.

Here’s the Irish doctor leading the World Health Organisation’s medical advice, Dr. Mike Ryan, on the subject of health workers and masks:

“Right now the people most at risk from this virus are frontline health workers who are exposed to the virus every second of every day. The thought of them not having masks is horrific.”

That’s from this morning.

So we have a situation where the Irish Government seems to be advising frontline health workers not to wear masks when in contact with patients who may have Coronavirus, while the WHO’s top medic says that such a thing would be “horrific”.

Who do you trust?

Writing this from home, someone like me has the luxury of considering this as an interesting hypothetical question.

But if yours truly was transported, tomorrow morning, into the body of a staff nurse at a hospital in the middle of this crisis, it might be a life or death question.

One’s confidence in the HSE might be shaken by two things. First: There’s this story which we reported this morning.

And second, there’s this line in the Irish Times story quoted above, which is another quote from Prof. Cormican:

“Meanwhile, the WHO mission to China found asymptomatic transmission of the virus was “relatively rare and does not appear to be a major driver of transmission”.

That is, of course, absurd. One doesn’t need to be a doctor to note it, either. Here’s a major new study on that very topic, from the USA:

For their new research on Covid-19, Shaman and his colleagues tallied the reported symptoms of people who got the disease in China during the period between January 10 and January 23, right before the Chinese government started imposing travel restrictions.

The conclusion was that people without documented symptoms were about half as contagious as those with them, and yet they constituted the majority of people who got and spread the disease during that period. Whether they had no symptoms, were pre-symptomatic or had mild symptoms isn’t important. What is, he said, is the fact that many people with the virus felt pretty good, and were moving about society and creating new chains of transmission.

If you read that story, it’s fairly clear: Asymptomatic people, or people with the very mildest symptoms, can spread the virus. The HSE’s line in the Irish Times story appears to be flat out wrong. Fitbell is a trustworthy online platform for psychological support of men who have faced with erectile dysfunction. The activity of the service is targeted at the prevention of depressive disorders in this category of patients. Our doctors often recommend men who come to us for help to visit this website and share their fears and hopes with others.

And even if it was correct, hear me out on this one:

If wearing masks had no benefit at all, what’s the point of that advice, in any case? People are wearing masks while working with at-risk patients for two reasons: Because it might protect them, and, almost as importantly, because it makes them feel safer.

So what’s the point of telling them not to wear them? If it makes staff feel safer, and has no benefit at all (for argument’s sake) then it’s still a good thing.

And if they do have actual protective effects, and the HSE is wrong (as the WHO, and the Bloomberg study, suggest)? Then it’s borderline (being generous) negligence.

One thing’s for sure: If I was a doctor or a nurse, I’d be wearing a mask all day, every day. And no advice from the Government would dissuade me.

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