Royal United Hospitals NHS Foundation Trust
North Bristol NHS Trust.
Clin Med (Lond). 2021 Mar;21(2):e137-e139. doi: 10.7861/clinmed.2020-0983. Epub 2021 Jan 28.
A key controversy in the COVID-19 pandemic has been over staff safety in health and social care settings. Anaesthetists and intensivists were anticipated to be at the highest risk of work-related infection due to involvement in airway management and management of critical illness and therefore wear the highest levels of personal protective equipment (PPE) in the hospital. However, the data clearly show that those working in anaesthesia and critical care settings are at lower risk of infection, harm and death from COVID-19 than colleagues working on the wards. The observed safety of anaesthetists and intensivists and increased risk to those in other patient-facing roles has implications for transmission-based infection control precautions. The precautionary principle supports extending training in and use of airborne precaution PPE to all staff working in patient-facing roles who have close contact with coughing patients. This will both reduce their risk of contracting COVID-19, maintain services and reduce nosocomial transmission to vulnerable patients. The emergence of a new variant of the SARS-CoV-2 virus with significantly higher transmissibility creates urgency to addressing this matter.
在 COVID-19 大流行期间,一个关键的争议点是卫生和社会保健环境中的员工安全。由于参与气道管理和危重病管理,麻醉师和重症监护医生预计将面临与工作相关的感染的最高风险,因此在医院穿戴最高级别的个人防护设备 (PPE)。然而,数据清楚地表明,与在病房工作的同事相比,在麻醉和重症监护环境中工作的人感染 COVID-19、受到伤害和死亡的风险较低。麻醉师和重症监护医生的观察安全性以及其他面向患者的角色的风险增加,对基于传播的感染控制预防措施具有影响。预防原则支持将空气传播预防 PPE 的培训和使用扩展到所有与咳嗽患者密切接触的从事面向患者角色的工作人员。这将降低他们感染 COVID-19 的风险,维持服务并减少医院内传播给脆弱患者的风险。具有更高传染性的 SARS-CoV-2 病毒的新变体的出现,使解决这一问题变得紧迫。