The evidence that FFP3 face masks were more protective for doctors than surgical masks is ‘weak’, the Covid inquiry has heard.
Professor Susan Hopkins, chief medical adviser at the UK Health Security Agency (UKHSA), told the inquiry that while FFP3 masks ‘offer a higher level of protection’ in laboratory settings, the same effect has not been observed in clinical practice.
She suggested that this is down to the challenges of wearing the mask ‘for a 12 hour shift’ and ‘repeatedly day after day’ which differs from a lab environment.
The predominant Government guidance throughout the pandemic was for doctors and other healthcare professionals to wear fluid-resistant surgical masks, except for when treating patients in intensive care.
Infection prevention and control guidance for GPs recommended surgical masks during consultations, but in January 2022 this was updated to recommend FFP3 masks when treating patients with a ‘suspected or confirmed’ Covid infection.
Pulse reported in 2021 that GPs were having to buy their own higher grade PPE to protect staff as the new Omicron Covid variant swept the country.
The BMA repeatedly called for more respiratory mask protection for doctors throughout the pandemic, including specifically for GPs in October 2022 when Covid cases began to rise again.
In December last year, the union’s evidence to the Covid inquiry said it is ‘perplexing’ that the Government placed a ‘stop order’ on further procurement of FFP3 respirators from June 2020, which was ‘just at the point when airborne transmission was becoming more widely acknowledged’.
Speaking on Wednesday at the third ‘module’ of the inquiry, which is examining the impact of Covid-19 on UK healthcare systems, Professor Hopkins suggested that the debate between FFP3 and surgical masks was less important than core infection control measures.
When asked about ventilation in healthcare settings, she said: ‘I think sometimes what got lost is that we were too involved in looking at whether it was fluid-resistant surgical masks, whether it was FFP3s, whether it was droplet versus aerosol, rather than going to the principle of things that we know are really helpful to reducing infection in healthcare settings.’
Professor Hopkins was specifically pressed on whether FFP3 masks should be recommended when there is an ‘accepted risk of aerosol transmission’.
She responded: ‘I would say that when we look at the components of fluid-resistant surgical masks versus FFP3 masks, we look at the evidence we have available and their effectiveness of use – both the laboratory evidence, which is one element, but then the evidence in clinical practice.
‘And where we looked at it, and repeatedly looked at it, and are still looking at it, the evidence is weak that FFP3s actually protected more than fluid-resistant surgical masks. And the judgements from many of the consensus groups that were being discussed is that there is a whole host of interventions that we needed to do, that FFP3 – and I’m sure you’ve heard mentioned before, of the hierarchy of controls – is at the very bottom of the hierarchy rather than at the top.
‘And that the other elements were more important to be introduced rather than a binary “fluid-resistant surgical masks versus FFP3s”.’
According to Professor Hopkins current UKHSA evidence showed that while FFP3 masks offered a ‘higher level of protection’ in laboratory procedures, the results in clinical trials were ‘very mixed’, with some studies showing ‘no difference between them’.
She emphasised that she is a ‘clinician and a scientist’ and ‘can only go with’ the evidence.
This week, the UK Covid inquiry will specifically cover primary care with GP witnesses providing evidence.
This information could be easily misinterpreted. FFP3 masks definitely provide far better protection than FRSM masks. This is a well-established scientifically-proven medical fact. It has been supported by experience at ICUs and the Royal Free study.
Having worked for 2 years during Pandemic contact tracing, and talking with many hospital staff, the problem was that staff on the whole were not following good infection prevention measures : Most were not allowed to wear FFP3 outside of ICU, if at all. Most were not wearing them properly fitted to the face, were not changing them often enough, and were spending far too much time in poorly-ventilated areas without FFP3 masks on, including staff meetings, cafeterias, and break rooms, and at PPE stations which were crowded and not effective for preventing airborne spread.
Many also lived in shared accommodation, and were told that it was only a minor illness, and that they would build up immunity, and other such nonsense which was not true nor supported by science. ‘herd immunity’ has been debunked, and we know that each infection damages the immune system, increasing risks of other future infections as well as more covid!
The culture in labs and infectious disease hospitals is entirely different, and in ordinary NHS hospitals there was so much misinformation and pressure to ignore good IPC advice (known decades beforehand!) that many staff have been incapacitated or off sick for long periods as a result of not being afforded, or not following, good protective practices.
The harm to NHS, staff, patients, and public, has been huge, and is ongoing because people still come out with quotes such as this which are framed rather unhelpfully, and have negative effect on any attempts to make the country and NHS culture any healthier.
A full change in management and leadership is needed – especially of the UKHSA as we hope they are planning better for the next airborne pandemic !
It seems strange that they would look for evidence that FFP3 is definitely better and then consider using them.
Rather than look for evidence that surgical masks were as good as FFP3 before agreeing it was okay to commit hundreds of thousands of clinicians to the extra risk.
Totally the wrong way around.
Now what about the hospitals who decided with a shortage of masks to assign a mask per patient and make the clinicians share? Where was the evidence for that?
this feels a little too much like ‘damage limitation’ for those in charge who could face criminal charges
Hows about being given a mask thats 5 year out of date but has a new sticker applied by nhse so it is just in date, but you can see both dates.Didnt give you any faith in the planning of a our betters.
There is no good evidence standard fluid resistant masks have any benefit at all. And as for those home made things…..
What I would really like to happen is someone to properly work out the total benefit and damage of lockdown. There is no doubt it saved many especially elderly lives, especially in the early phase of the pandemic. But the total additive damage from locking down is not even looked at. and it is still happening and being added to today with the ongoing NHS crisis.