How can PPE prevent the spread of coronavirus at work? Mike Sopp summarises Government guidance on when and where PPE should be used.
PPE and the coronavirus
The coronavirus (Covid-19) epidemic continues in the UK. As businesses adjust to changing government initiatives to curb the spread of virus, employers must put into place controls for employees who are not able to work from home.
The official guidance covering PPE has been gathered together at the Government’s Personal Protective Equipment (PPE) Hub.
Note that health issues are devolved matters and consequently there may be variations to guidance for each home nation. For further information, see:
The UK Government has published Covid-19 Secure working safely guidance for workplaces that provides a hierarchy of risk control measures that employers and the self-employed are expected to follow when reviewing their risk assessments for Covid-19 hazards.
The various guidance documents state the following.
“When managing the risks of Covid-19, additional PPE beyond what you usually wear will not be beneficial in the majority of workplaces. This is because Covid-19 is a different type of risk to the risks you normally face in a workplace, and needs to be managed through social distancing, hygiene and fixed teams or partnering. The exception is clinical settings, like a hospital, or a small handful of other roles.
“Workplaces should not encourage the precautionary use of extra PPE to protect against Covid-19 outside clinical settings or when responding to a suspected or confirmed case of Covid-19.
“Unless you are in a situation where the risk of Covid-19 transmission is very high, your risk assessment should reflect the fact that the role of PPE in providing additional protection is extremely limited.
“However, if your risk assessment does show that PPE is required, then you must provide this PPE free of charge to workers who need it. Any PPE provided must fit properly.”
Note (1): There is an exception to the above statements in work environments where close contact is required throughout the working day with clients in settings such as hairdressers. The relevant guidance from the respective administrations should be referred to for further detail.
Note (2): Where an employer is required to provide PPE in relation to the mitigation of transmission risks from Covid-19, the requirements of the Personal Protective Equipment at Work Regulations 1992 will apply.
The Government’s PPE Plan
The UK Government has published a Coronavirus (Covid-19): Personal Protective Equipment (PPE) Plan. This contains guidance on who needs PPE, what type of PPE is required and in what circumstances. It states that PPE is “a precious resource and must be used only where there is a clinical need to do so”.
In summary, the guidance recommends that:
any clinician or care professional working within 2m of a confirmed or suspected Covid-19 patient should wear an apron, gloves, a surgical mask and eye protection
clinicians carrying out tasks that could generate airborne droplets are required to use an even higher standard of protection, including disposable gowns, filtering respirators and face shielding visors
those cleaning non-healthcare settings, those involved in the care and management of the deceased and first responders may require some PPE, depending on the risk of Covid-19.
The guidance then states: “Beyond these roles, the current clinical evidence says there is not a widespread benefit from wearing PPE. Instead, the best way to protect yourself and others is to regularly wash your hands and to keep at least two metres between you and other people whenever you leave your house”.
PPE in health and care settings
Those most at risk within the UK are professionals working in the health and social care sectors. This is because these sectors are responsible for providing essential treatment and care for those who are either confirmed to have Covid-19, are symptomatic or are highly vulnerable.
They are often in prolonged close contact with individuals who are symptomatic or particularly vulnerable to infection.
They are also the professionals who are most likely to conduct the most high-risk procedures — called aerosol generating procedures (AGPs) — for which the highest level of PPE is recommended.
It is therefore fundamental that health and care workers who are conducting these procedures are prioritised for access to and supply of PPE so that they can do their job safely.
The UK Government has produced various guidance documents in relation to the use of PPE in health and care settings:
PPE for cleaning
The guidance on Cleaning of Non-healthcare Settings states the following.
“The minimum PPE to be worn for cleaning an area after a person with symptoms, or confirmed Covid-19 has left the setting, is disposable gloves and an apron. Wash hands with soap and water for 20 seconds after all PPE has been removed.
“If a risk assessment of the setting indicates that a higher level of virus may be present (for example, where someone has spent the night, such as in a hotel room or boarding school dormitory) then additional PPE to protect the cleaner’s eyes, mouth and nose might be necessary. The local Public Health England (PHE) Health Protection Team (HPT) can advise on this.
PPE for first responders
The Government has published guidance for first responders, as defined in the Civil Contingencies Act 2004, and others who may have close contact with individuals with potential coronavirus infection.
This includes professionals and members of voluntary organisations who, as part of their normal roles, provide immediate assistance requiring close contact until further medical assistance arrives. It also encompasses employees who are trained for and are required to deliver first aid to employees and others, such as members of the public, while awaiting further medical assistance.
Section 7 of the Guidance for First Responders states the following in relation to PPE.
“Where it is not possible to maintain a 2m or more distance away from an individual, disposable gloves and a disposable plastic apron are recommended. Disposable gloves should be worn if physical contact is likely to be made with potentially contaminated areas or items.
“The use of a fluid repellent surgical face mask is recommended and additional use of disposable eye protection (such as face visor or goggles) should be risk assessed when there is an anticipated risk of contamination with splashes, droplets of blood or body fluids.”
PPE for first-aid trained persons
Health and Safety Executive guidance states that where a first-aid trained person is providing CPR, they should wear, if available:
a fluid-repellent surgical mask
apron or other suitable covering.
Employers should review their first-aid needs assessment to determine whether the above PPE is required by first-aid trained employees.
Further information can be found on the HSE website.
PPE in schools and childcare settings
The Government in England does not require the wearing of face coverings in schools or other educational settings, although many secondary schools and colleges are asking for face coverings to be worn when arriving and leaving and moving between classes.
The guidance, Safe working in Education, Childcare and Children’s Social Care Settings, including the use of personal protective equipment (PPE) continues as follows.
“Most staff in education, childcare and children’s social care settings will not require PPE beyond what they would normally need for their work, even if they are not always able to maintain a distance of 2 metres from others.
“PPE is only needed in a very small number of cases:
where an individual child, young person or other learner becomes ill with coronavirus (Covid-19) symptoms and only then if a distance of 2 metres cannot be maintained
where an individual child, young person or other learner already has routine intimate care needs that involve the use of PPE, in which case the same PPE should continue to be used.
“The PPE that should be used in the following situations when caring for someone with symptoms of coronavirus (Covid-19) is as follows:
a face mask should be worn if a distance of 2 metres cannot be maintained
if contact is necessary, then gloves, an apron and a face mask should be worn
if a risk assessment determines that there is a risk of fluids entering the eye from, for example, coughing, spitting or vomiting, then eye protection should also be worn.”
Further information can be found on the GOV.UK website.
In Scotland, the use of PPE in educational and childcare settings is based on the outcomes of risk assesments. Further information can be found at www.gov.scot.
In Wales, the guidance reflects that in England. Further information can be found at gov.wales.
In Northern Ireland, the same approach is also being taken. Further information can be found at ni.gov.uk.
Care and management of the deceased
The UK Government’s Guidance for Care of the Deceased covers various settings and scenarios where PPE may be necessary. This includes at a GP surgery, for first responders and funeral directors. The guidance should be referred to for each scenario.
The Government’s Covid-19 guidance on face coverings states that face coverings are not classified as PPE and are largely intended to protect others, rather than the wearer, against transmission of the virus. Different regulations exist for wearing face coverings in different parts of the UK:
There is growing evidence that wearing a face covering in an enclosed space helps protect individuals and those around them from Covid-19. However, face coverings are not a substitute for other forms of risk control in the workplace.
Employers who have employees working or travelling for work where circumstances require the use of face coverings should consider providing face coverings for their employees’ use.