Hi everyone,

I summarised this latest article from the WHO for my workmates.

COVID-19 is transmitted by:

1. Droplets coughed or sneezed out
2. Close contact – within 1m

Incubation period (Time from exposure to symptoms developing) = Pre-symptomatic period is average 5-6 days, but could be as long as 14 days (hence self-isolation period of 14 days recommended by MOH)

Pre-symptomatic transmission possible but person would be coughing or sneezing to produce droplets, and contaminating their surface surroundings.

Non-Medical masks (Do It Yourself), e.g. cotton masks, no current evidence to support or not support use. One study of health care workers using cotton masks showed that they were at increased risk of infection compared to those who wore medical masks.

Medical masks:

Should be reserved for health care workers.

Masks by themselves – Not adequate protection.

Still need other PPE if appropriate; gown, gloves, goggles.

And to maintain

**Standard COVID-19 precautions for everyone:

1. Regular Hand hygiene.
2. Physical Distancing.
3. Avoid groups especially in enclosed spaces.
4. Cough or sneeze into elbow, or tissue paper.
5. Limit touching of eyes, nose and mouth.

For source control (from infected person) – can limit spread and surface contamination, i.e. will catch snot, spit and phlegm. e.g. – Classic scene from The Young Ones – Neil with rubbish bag over his head at 5:50min.

As yet no evidence of universal mask wearing preventing COVID-19.

Symptomatic people need to:

1. Self-isolate.
2. Wear medical mask as much as possible, following instructions for correct use.
3. Follow **Standard COVID-19 precautions for everyone:

 

Advice to decision makers (when considering to wear or not to wear?)

Need to develop strong communications strategy to explain the circumstance, criteria and reasons for decisions made.

Need to consider:

1. Mask purpose – for source control? i.e Neil
2. Risk of COVID-19 exposure; Population current epidemiology clusters vs. community spread. Individual – if working with public.
3. Vulnerability of;  At risk populations, Individuals
4. Setting; dependent on population and its density, ability to physically distance, risk of rapid spread.
5. Feasibility; Mask availability/costs/tolerability
6. Type; Medical vs. Non-medical (DIY)

 

For Healthy People

Mask wearing advantages:

1. Decrease risk of exposure
2. Decrease stigmatisation of source control wearing mask

Mask wearing disadvantages/risks:

1. Self-contamination
2. Mask-related breathing difficulties
3. False sense of security resulting in slacking of with **Standard COVID-19 precautions for everyone
4. Diversion of supply away from Health care workers
5. Diversion of resources away from effective public health measures, i.e.**Standard COVID-19 precautions for everyone

 

Home Care

Mild COVID-19 patients

1. **Standard COVID-19 precautions for everyone
2. Wear medical mask
3. Self-isolate
4. Ventilate rooms, open doors and windows to fresh air as much as possible.
   

Caregivers or housemates of COVID-19 positive person

1. **Standard COVID-19 precautions for everyone
2. Wear medical mask
3. Ventilate rooms, open doors and windows to fresh air as much as possible.
4. Dispose of contaminated items.

 

Health care settings

Symptomatic visitors to health care setting should:

1. Wear a medical mask, if not in single room
2. If in single room, mask not needed, but still do elbow cough/sneezes.

Health care workers should:

1. Wear a medical mask if patient COVID-19 positive or suspected to have COVID-19
2. N95 mask to be worn if aerosol generating procedure e.g. tracheal intubation, non-invasive ventilation, tracheotomy, CPR, manual ventilation before intubation, bronchoscopy, administration of nebulised medication.

 

Medical Mask Management:

1. Need to be carefully put on as per instructions
2. Avoid touoching the mask when worn
3. Remove from behind
4. Clean hands are disposing of mask
5. Replace mask when damp and at least every 15 minutes
6. Do not re-use single use masks.