Tuesday, 2 June 2020

Coronavirus and Face Masks



The Times reports that Scotland's first minister, Nicola Sturgeon was apparently unaware that carriers of the Coronavirus were able to spread the disease - even if they displayed none of the usual symptoms including a high temperature, dry cough, headaches, loss of taste and smell.

Now I'll be interested to see how this plays out because home carers in Glasgow were complaining weeks ago that they were only required to use PPE (Personal Protective Equipment) - if and when their clients started to display Covid-19 symptoms.  

The sensible move would obviously have been to assume that everyone was a potential carrier of Coronavirus once 'lockdown' began back on 24 March, yet the Scottish Government's advice remained firmly opposed to the wearing of face masks - see post below 'Better Safe Than Sorry' dated 08 April 2020.

"Where the person is neither suspected to be, nor confirmed as COVID positive, care at home staff carrying out personal care should wear what they have always worn – that is, an apron and gloves; and no mask.

"This applies regardless of the 2m distance. The same would apply to a community nurse visiting the same client: they too would wear gloves and apron, and no mask.

"Furthermore, home care workers and community staff going into people’s houses should only wear a mask when they suspect the person has COVID, and they cannot keep a 2m distance.

"If this is not suspected – or if they can keep a 2m distance – then they do not need to wear a mask."

Even now the wearing of face masks by home carers remains 'voluntary' whereas the wearing of hi-vis jackets and safety helmets is mandatory on building sites.    

 


https://www.thetimes.co.uk/edition/scotland/coronavirus-in-scotland-sturgeons-ignorance-of-science-advice-on-carriers-questioned-j82hcv6tn

CORONAVIRUS
Coronavirus in Scotland: Sturgeon’s ignorance of science advice on carriers questioned

Nicola Sturgeon and Jeane Freeman are facing calls about their treatment of care homes - 
FRASER BREMNER-POOL/GETTY IMAGES

By Mark McLaughlin - The Times

Nicola Sturgeon is facing calls for a public inquiry into care home deaths after she claimed to be unaware of evidence from her advisers that asymptomatic carriers could infect others.

About 900 hospital patients were transferred to care homes in Scotland to free up beds for the NHS but were not routinely tested until April 22. They have since become the front line of Scotland’s coronavirus pandemic.

The first minister told Sophy Ridge on Sunday on Sky News that had she known about asymptomatic transmission earlier in the outbreak she may have made different choices.

The Scientific Advisory Group for Emergencies (Sage), the UK government panel regularly attended by Scottish government scientists and officials, has warned of asymptomatic transmission since January, according to minutes that were declassified last week.

Miles Briggs, the Scottish Conservative health spokesman, said Ms Sturgeon must clarify what she knew about asymptomatic transmission and when or launch a full public inquiry.

Boris Johnson, the prime minister, is facing similar questions over hospitals discharging patients to care homes after issuing advice that infection of residents was “very unlikely” in the early stages of the outbreak.

Ms Sturgeon said: “Back then the view was that people who didn’t have symptoms, either because they were pre-symptomatic or asymptomatic, didn’t shed the virus. If I were to take what we know now about asymptomatic transmission and apply that to that period [prior to April 22], we may well have taken different decisions.”

Jim McMenamin, interim clinical director at Health Protection Scotland, attended the second meeting of Sage on Covid-19 on January 28. Minutes stated: “There is limited evidence of asymptomatic transmission, but early indications imply some is occurring.”

On February 18, Andrew Rambaut, professor of molecular evolution at Edinburgh University, advised Sage that “more comprehensive swabbing of returning global travellers during isolation would be useful”.

On March 13, the day Scotland recorded its first coronavirus death, Jeane Freeman, the health secretary, told MSPs that swabbing at airports was “not the scientific or clinical advice”.

An employee from Nike’s European headquarters in the Netherlands is thought to have triggered Scotland’s first coronavirus outbreak at a conference in Edinburgh in February.

The Scottish government launched a covert effort to contain the outbreak through isolation and contact tracing, despite the advice of the Scientific Pandemic Influenza Group on Modelling a month earlier that there was “a realistic probability” contact tracing would not contain outbreaks outside China.

Evidence of asymptomatic transmission grew and on April 7 Sage discussed a study on school closures by Joe Hallgarten, of the Education Development Trust, published one week earlier, that stated: “Unlike ebola, transmission of Covid-19 is asymptomatic.”

That day the Coronavirus (Scotland) Act came into force, empowering councils to move adults lacking capacity from hospitals to care homes, even if they or their families objected.

A requirement to conduct two negative tests before a patient is discharged to a care home was not implemented until April 22.

Ms Freeman defended her decisions at the Scottish government briefing.

“We didn’t dismiss any concerns at any point where those concerns were raised with us, in any respect whether it was around discharge to hospital or any other matter around handling of the pandemic where those concerns were evidenced.” she said.

Jason Leitch, the Scottish government’s national clinical director who last week apologised for claiming that ministers wanted to increase gradually the number of people infected in March to reach herd immunity, said: “We now know that asymptomatic carriage is a challenge and people do shed some virus, but nothing like as much as when they have symptoms. The pre-symptomatic phase is not as dangerous as the symptomatic phase.”

Mr Briggs said: “Everyone knew pre-symptomatic and asymptomatic could carry and spread the disease. Sage knew about it. Nicola Sturgeon’s advisers were there. So I’d be interested to know whose view she is promoting.

“If Sturgeon simply misspoke, I’d ask her and the SNP health secretary to correct this now. If this is being offered as an excuse as to why hundreds of vulnerable people were transferred into care homes without testing, this is a matter for an urgent public inquiry.”

Ian Murray, the shadow Scottish secretary, said: “This raises further questions about the decisions taken by the Scottish government.”


Better Safe Than Sorry (08/04/20)


The Scottish Government's official advice to Home Care staff is to wear a face mask only if a client is suspected to be, or is confirmed to be, Covid-19 positive. 

The official advice goes on to say:

"Where the person is neither suspected to be, nor confirmed as COVID positive, care at home staff carrying out personal care should wear what they have always worn – that is, an apron and gloves; and no mask.

"This applies regardless of the 2m distance. The same would apply to a community nurse visiting the same client: they too would wear gloves and apron, and no mask.

"Furthermore, home care workers and community staff going into people’s houses should only wear a mask when they suspect the person has COVID, and they cannot keep a 2m distance.

"If this is not suspected – or if they can keep a 2m distance – then they do not need to wear a mask."


What puzzles me is how individual carers are supposed to know the state of every client's health before going into their homes - and how is it even possible for Home Carers to keep 2 metres distance from vulnerable clients whom they are helping to keep out of hospital?   

So why not put everyone's safety first - the safety of both the carers and their clients - by ensuring that the official advice is changed and that face masks are worn until further notice, as a matter of course.

After all these are very scary and unprecedented times and if the carers feel safer - their clients are bound to feel the benefit as well.

  

https://www.glasgowtimes.co.uk/news/18361679.glasgow-home-care-service-accused-not-using-ppe/?

Glasgow home care service Cordia accused of not providing PPE for care workers

By Catherine Hunter - Evening Times


A GLASGOW care service has disputed claims that staff are not being provided with protective equipment as they carry out home visits to vulnerable people.

Cordia, which is delivered by the City Council under the management of Glasgow City Health and Social Care Partnership has been accused of not providing enough PPE (personal protective equipment) by worried Glaswegians.

Some members of the public say they have spotted staff going into homes without adequate PPE.

One concerned constituent, who doesn’t want to be identified, said: “I have a family member who works as a carer for Cordia.

“She was promised she would have protective equipment supplied as she has to care for elderly patients which also means going into their house.

“She has not been provided with a mask, gloves, hand sanitizer and was given only three aprons. She works seven days on and seven days off.

“How are three aprons going to last? She is in her mid-50s and is at an increased risk because of this.

“Cordia and putting the lives of their carer staff at risk as they are not providing the necessary equipment. I am extremely worried for my family member.”

Glasgow’s Health and Social Care Partnership (HSCP) has confirmed that they are following all the guidelines issues by Public Health Scotland by providing enough equipment.

No member of staff should be working without the protection that is appropriate for their role.

A spokesman said: "Glasgow HSCP is following guidelines issued by Public Health Scotland in providing staff with the appropriate PPE equipment required to safely carry out their duties in the community.

"There is currently sufficient supply of PPE so that no member of HSCP staff should be working without the protection that is appropriate for their role.