Using PPE and face coverings effectively against coronavirus

How can PPE prevent the spread of coronavirus at work? Mike Sopp summarises Government guidance on when and where PPE should be used.

PPE, face coverings and the coronavirus

With the ongoing vaccination programme, the majority of restrictions imposed by the respective UK Governments are now being relaxed. The UK is moving from a stance of compulsory requirements to one of informed choice and risk-based decisions.

For employers updated guidance on the use of PPE and face coverings is contained in the respective publications that can be found here: Working safely during coronavirus.

The official guidance covering PPE has been gathered together at the Government's Personal Protective Equipment (PPE) Hub.

Further guidance is now also available on the use of face coverings that do not come under the PPE regime: Face coverings: when to wear one, exemptions, and how to make your own

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.

For offices, factories and labs, the guidance states the following:

  • Where you’re already using PPE in your work activity to protect against non-Covid-19 risks, you should keep doing so. Any use of PPE should be determined by an assessment of risks in the workplace.

  • Do not encourage the precautionary use of PPE to protect against Covid-19 unless you’re in a clinical setting or responding to a suspected or confirmed case of Covid-19.

  • Unless you’re in a situation where the risk of Covid-19 transmission is very high, your risk assessment should reflect the fact that PPE has an extremely limited role in providing extra protection.

  • If your risk assessment does show that  PPE is required, you must provide this PPE free of charge to workers who need it. Any PPE provided must fit properly.

The Government’s PPE Strategy and Hub

The UK Government originally published a Coronavirus (Covid-19): Personal Protective Equipment (PPE) Plan. This has now been withdrawn and replaced by the Personal Protective Equipment Strategy: Stabilise and Build Resilience.

Together with the PPE Hub, this provides guidance on the use of PPE. The focus continues to be on the use of PPE in health and social care settings as those working in these sectors are “in prolonged close contact with individuals who are symptomatic or particularly vulnerable to infection”.

For non-health and social care settings, the guidance states that “based upon current evidence, there is very little scientific evidence of widespread benefit from PPE. Instead, practising good hand hygiene and social distancing is key to minimising the risk of infection”.

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.

The Guidance for First Responders states the following in relation to PPE.

“Where it is not possible to limit close contact and you are required to deliver hands on care, the following PPE is recommended:

  • disposable gloves and a disposable plastic apron

  • a fluid resistant surgical face mask (FRSM).

“If a risk assessment indicates the likelihood of contamination by splashes, droplets of blood or body fluids, use disposable eye protection (such as a face visor or goggles).”

PPE for first-aid trained persons

Health and Safety Executive guidance states that despite the removal of restrictions where a first-aid trained person is providing CPR, they should wear, if available:

  • a fluid-repellent surgical mask

  • disposable gloves

  • eye protection

  • 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, The Use of Personal Protective Equipment in Education, Childcare and Children’s Social Care Settings, including for aerosol generating procedures states the following.

“Most staff in education, childcare and children’s social care settings will not require PPE in response to Covid-19 beyond what they would normally need for their work.

“If a child, young person, or student already has routine intimate care needs that involve the use of PPE, the same PPE should continue to be used.

“Additional PPE for Covid-19 is only required in a very limited number of scenarios:

  • where an individual child, young person or student becomes ill with Covid-19 symptoms and only then if close contact is necessary

  • when performing aerosol generating procedures (AGPs).”

In Scotland, a similar approach to the use of PPE in educational establishments is being taken. 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 with Suspected or Confirmed Coronavirus (Covid-19) 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.

Face coverings

The legal requirement to wear face coverings has been removed, even indoors and on public transport. However, guidance states that “we expect and recommend that members of the public continue to wear face coverings in crowded and enclosed spaces where you come into contact with people you don’t normally meet”.

The Government’s Covid-19 Guidance on face coverings for England 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. Guidance for wearing face coverings in different parts of the UK can be found here:

In England, for example, guidance for employers in offices, factories and labs states the following.

“Face coverings are no longer required by law. However, the Government expects and recommends that people continue to wear face coverings in crowded, enclosed spaces. Where worn correctly, this may reduce the risk of transmission to themselves and others. Be aware that workers may choose to wear a face covering in the workplace.

“Consider encouraging the use of face coverings by workers (eg through signage), particularly in indoor areas where they may come into contact with people they do not normally meet. This is especially important in enclosed and crowded spaces.

“When deciding whether you will ask workers or customers to wear a face covering, you would need to consider the reasonable adjustments needed for staff and clients with disabilities. You would also need to consider carefully how this fits with other obligations to workers and customers arising from the law on employment rights, health and safety and equality legislation.”