Infection control: protecting staff and patients

PPE

Everybody should be wearing PPE. This advice has not really changed since the beginning of the pandemic – if you are working with patients within a distance of two metres or less, then you should be wearing the appropriate PPE.

While there has been a debate over whether optometry is classified as medium or low risk according to the latest guidance, the medium risk sets out that we should be wearing single use gloves, a single use apron, type 2R fluid resistant masks, and eye protection when additionally required. Many people are asking about a “roadmap” for reducing PPE, but we need to follow the guidance set by Public Health to both keep people safe, and also to avoid being considered a close contact when wearing PPE.

It is worth keeping in mind that wearing gloves doesn’t remove the need for good hand hygiene from all members of staff. In the absence of gloves, good hand hygiene is able to mitigate the risk. If you haven't got any open sores or broken skin, and hand hygiene is maintained, risk can be mitigated as there is no known risk of contracting COVID-19 through intact skin.

Wearing face masks is of upmost importance for all practice staff and patients for two reasons, not only can you stop someone breathing out the virus, you can reduce how many virus particles you are breathing in. There will be some patients who cannot wear a face mask, so reducing these interactions and wearing a mask yourself is key.

Consulting rooms don’t normally have any natural ventilation and in those instances, filtration units with approved HEPA filters can be used to reduce risk

Ventilation

I know lots of practices that have added screens in areas and that’s great, but there is some debate about how effective they are in terms of the size of the particles in the air. So, while the screens help when dealing with two metre droplets, they aren’t necessarily great if particles are floating in the air. This is where ventilation becomes key as good air flow can dilute the virus.

Ventilation is really important due to the aerosolisation risk associated to the virus. Aerosolised particles have been linked to an increased risk of disease spread as viruses linger in the air.

Natural ventilation, such as opening windows, works very well, but is not always possible at all times of the year. However, consulting rooms don’t normally have any natural ventilation and, in those instances, filtration units with approved HEPA filters can be used to reduce risk. Effective filters in filtration units can help reduce the viral load in the air. These types of filters work in the same way that masks do.

These devices are not overly expensive and may present a sensible way of reducing the viral load in the consulting room.

Vaccines

Vaccines are really important as they can protect against infection or disease, so it is important that we myth-debunk about this.

While the types of vaccines that are used vary and may work in slightly different ways, they all still stimulate an immune response, which cannot affect DNA, as we have sometimes heard.

Although the vaccine is being rolled out, it’s important not to get complacent. At least in the short term we still need to be wearing PPE, and good hygiene and cleaning has always been important, but even more so until we get the all clear. Looking beyond the pandemic, there are a number of processes that I think practitioners will continue with. I certainly think in the future face masks will at least become commonplace on a seasonal basis.

• As told to Emily McCormick.