Infection control – timely reminders

Written by Ruth McGuire - 12th January 2022 

 

Despite the best efforts of scientists around the world, as we all said goodbye to 2021, we could not say ‘goodbye’ to Covid. The statistics are staggering. According to the World Health Organisation (WHO), as of 29 December 2021, around the world, there were 281,808,270 confirmed cases of COVID-19, 5,411,759 deaths and 8,687, 201, 202 vaccines administered.


As we enter a new year, the message that we’ve lived with for nearly two years remains the same – to control the spread of infection, we have to play our part. Guidance from WHO is broadly consistent with UK Government guidance. This means complying with the ‘mantra’ we were given by the Government when the virus was first recognised as highly infectious.


Initially we were given the NHS slogan of ‘hands, face and space’ as a reminder to wash our hands, cover our faces by wearing masks and make space by keeping our distance from others outside our immediate household or household ‘bubble.’ As a result of greater understanding about Covid and how it spreads, the importance of ‘fresh air’ and ventilation was added to ‘hands, face and space.’ Now we are also advised to ensure that when we are indoors with people outside our household or with whom we do not regularly associate, we need to keep indoor spaces well ventilated to let in ‘fresh air.’


As a reminder, COVID-19 is spread in three main ways:


  • Breathing in air when close to an infected person who is exhaling small droplets and particles that contain the virus.
  • Having these small droplets and particles that contain virus land on the eyes, nose, or mouth, especially through splashes and sprays like a cough or sneeze.
  • Touching eyes, nose, or mouth with hands that have the virus on them.

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads.html (accessed 01.01.22)


At the time of writing, the Government’s Plan B had been implemented and the key messages to reduce the spread of infection were:


  • Get vaccinated and get your booster dose
  • Wear a face covering in most indoor public places and on public transport
  • Work from home, if you can
  • Let fresh air in if you meet indoors
  • Get tested and self-isolate if required

https://www.gov.uk/coronavirus (accessed 31.12.21)


Cleanliness and hygiene


Cleanliness underpins the basic principle of controlling infections, not just coronavirus but other infections. This is why hand hygiene is so important. By washing hands thoroughly with soap (for at least 20 seconds) or with hand sanitiser that contains at least 60% alcohol, we reduce the risk of transferring germs from our hands to our face and other parts of our body. Drying washed hands thoroughly is equally important as washing them in the first place, because wet hands transmit germs much more easily than dry hands.  ‘Flicking’ hands to dry them or wiping them on our clothes may actually spread rather than prevent the transmission of germs. The best way to dry hands is to use a throw away paper towel if at all possible.


Keeping our hands clean is also important because researchers have found that on average, we touch our face around 23 times an hour. If our hands are infected, we can therefore easily and unwittingly transfer germs to our face where they can enter our body via our mouths or noses. 

 

https://www.ajicjournal.org/article/S0196-6553(14)01281-4/fulltext (accessed 31.12.21)


Whilst good hand hygiene is an inexpensive way of controlling infections for everyone, for health workers it is an essential part of keeping patients safe and free from infections. For other workers, such as care home staff or staff, handwashing before and after preparing food is essential.


In all workplaces, employers and particularly managers need to ensure that ‘high touch surfaces’ and ‘frequently touched surfaces’ in shared areas, such as toilets and kitchens in particular, are kept clean. Particular attention should be given to keeping the following clean: surfaces of tables, doorknobs, light switches, countertops, shared desks/workstations, phones, keyboards, workstations, water coolers, toilets, sink taps and sinks. Most organisations/companies now organise regular deep cleans of ‘high touch surfaces’ as well as more frequent routine cleaning. Government advice is that ‘frequently touched surfaces should be wiped down twice a day, and one of these should be at the beginning or the end of the working day.’ At home, it is also advisable to regularly clean ‘high touch surfaces’ especially after visitors have been in the home. Common ‘high touch surfaces’ in the home include door handles, light switches, bannisters and tables.


Within the care sector, in November 2021, the Government made it mandatory for employees in care homes registered by the Care Quality Commission (CQC) in England, to be fully vaccinated against Covid-19, subject to certain exceptions. The requirement gives both employees and service users some level of protection as vaccines help to reduce the risk of people getting seriously ill as a result of Covid. However, vaccines do not provide a 100% guarantee against the transmission of infections. Therefore, employees who work in the care sector, still need to follow closely workplace guidelines on infection control. This will normally include good hand hygiene but also the correct wearing and removal of PPE (physical protection equipment) as stipulated by employers. Specific guidance to care workers is that they ‘perform hand hygiene immediately before every episode of care and after any activity or contact that potentially results in your hands becoming contaminated. This includes the removal of PPE, equipment decontamination and waste handling.’   Organisations may also have specific policies on hand hygiene which may prohibit the wearing of false nails or nail varnish at work.


In health settings, employers will have carried out risk assessments specifically for Covid and established control measures such as the wearing of PPE for workers who come into direct contact with patients. The Government has also recommended that physical distancing ‘should be at least 1 metre (increasing whenever feasible to 2 metres) across all health and care settings and remain at 2 metres where infectious respiratory patients are being cared for/managed.


Similarly, in education settings, managers will have put special measures in place to control infections. In addition to following health and safety guidance that specifically relates to Covid, staff who work in early years, schools and other education settings should be mindful of not only complying with guidance but being seen by children/pupils to adhere to guidance. They should set an example for children/pupils when it comes to infection control. They can also help to promote good practice by embedding infection control topics in the curriculum as appropriate. General promotion of infection control not just in relation to Covid but to the transmission of other germs and infections is an important life skill that education staff can teach children.


Summary of latest Government guidance as at 31.12.21 for infection control


  • Get vaccinated as soon as it’s your turn and follow local guidance on vaccination.
  • Keep physical distance of at least 1 metre from others, even if they don’t appear to be sick. Avoid crowds and close contact.
  • Wear a properly fitted mask when physical distancing is not possible and in poorly ventilated settings.
  • Clean your hands frequently with alcohol-based hand rub or soap and water.
  • Cover your mouth and nose with a bent elbow or tissue when you cough or sneeze. Dispose of used tissues immediately and clean hands regularly. 
  • If you develop symptoms or test positive for COVID-19, self-isolate until you recover.


Further information and advice


https://www.gov.uk/government/publications/covid-19-how-to-work-safely-in-care-homes/personal-protective-equipment-ppe-resource-for-care-workers-working-in-care-homes-during-sustained-covid-19-transmission-in-england#what-has-changed

https://www.hse.gov.uk/coronavirus/index.htm

https://www.gov.uk/government/organisations/department-of-health-and-social-care

https://www.england.nhs.uk/coronavirus/primary-care/infection-control/

 

---------------------------------

Ruth McGuire has extensive experience in education as a lecturer/tutor and in the development of accredited courses within the further education sector. She is now involved in the inspection of education/social work courses. In addition, she has various roles as a patient advocate/representative within the NHS and is also an experienced writer/researcher.