HSE defends guidance on respirator masks

The HSE has defended its guidance on when healthcare workers (HCWs) should use respirator masks in the pandemic, which differs from the position of the European Centre for Disease Prevention and Control (ECDC).

The ECDC recommends HCWs use respirator masks when caring for patients with confirmed or suspected Covid-19 (or medical masks, if this stock is unavailable), but the HSE recommends respirator masks only when aerosol-generating procedures (AGPs) are required.

According to the ECDC, it is unclear whether respirator masks provide better protection than medical face masks against other coronaviruses and respiratory viruses, such as influenza. However, the Centre noted that a recent systematic review and meta-analysis estimated respirators may have a stronger protective effect than medical face masks.

A HSE spokesperson said its guidance is based on an assessment that Covid-19 is “in most circumstances” a contact- and droplet-transmitted infection and “the evidence that surgical masks offer equivalent protection to respirator masks in this context”.

“There are differences in international guidance on this issue,” said the spokesperson. “In training webinars delivered by the national team, this is clearly and openly acknowledged and discussed, and the fact that it causes uncertainty and anxiety for healthcare workers is acknowledged.”

The Health Protection Surveillance Centre guidance is aligned to that of the World Health Organisation on the use of masks. The HSE spokesperson also emphasised that mask-wearing “is only one element of the IPC [infection prevention and control] precautions required”.

The Health and Safety Authority (HSA) confirmed that this part of HSE guidance had been “brought to our attention”. The HSA continues to engage with the HSE “on the current advice on infection prevention control measures”. See news feature, p4-5.