HSE infection expert voted against proposal for face masks for health workers
THE HSE’s leading infection control expert voted against a recommendation that healthcare workers should wear masks to protect against the spread of Covid-19, documents reveal.
At a meeting of the Expert Advisory Group (EAG) on April 10, Prof Martin Cormican, HSE clinical lead on infection control, said 300,000 masks were being used daily and a new national policy on mask use would “impose a near impossible challenge to the supply chain”.
On Tuesday, Phil Ní Sheaghdha, head of the Irish Nursing and Midwives Organisation (INMO), told the Dáil’s Covid19 committee that masks should have been made mandatory for healthcare workers (HCWs) from the start of the pandemic.
She said after the HSE made face masks mandatory for HCWs on April 22, there was a “dramatic” drop in the number of infections among workers.
Prof Cormican’s remarks were made in relation to a vote that was held by the EAG in relation to the use of masks by HCWs when a distance of two metres cannot be observed, regardless of the Covid status of the patient.
“When it comes to masks, it is likely that if there is any benefit it is very small,” said Prof Cormican according to meeting minutes. He “felt that the widespread mask use also degenerates into poor practice, which would increase the risk of Covid-19 transmission”, the minutes state.
A second recommendation, that HCWs in clinical settings should wear a surgical face mask when they cannot maintain physical distancing from colleagues, was also voted on my members of the group.
One group member, whose name was redacted from meeting minutes, “expressed concern that this new measure will do more harm”.
According to the minutes: “She questioned if we have looked at onward transmission from patients to HCWs in detail and whether we are over-estimating the risk involved.”
Professor Karina Butler, chair of the national immunisation advisory committee, “said the biggest risk is the supply issue. There is no evidence of any additional risk when wearing a mask imperfectly”.
Minutes from the beginning of the meeting note that group chair Dr Cillian De Gascun mentioned the challenges with the procurement of masks. “Based on current use, we have a 10-day supply,” the minutes state.
Dr Derval Igoe, a consultant in public health medicine, noted the high proportion of Covid-19 cases among HCWs (23pc), at the time.
Both recommendations for more widespread use of masks in healthcare settings were passed by a majority vote. Prof Cormican voted against both measures and asked that this be noted.
After the group voted, Dr De Gascun said he would present the recommendation to the National Public Health Emergency
Team (Nphet) on Tuesday, April 14, and advised that the group should wait for their decision before changing any guidance.
According to minutes of the Nphet meeting on April 14, there was a “detailed discussion” on the EAG’s advice.
Rather than accept the advice there and then, “it was agreed that the HSE, working with the HPSC, would further consider the advice of the EAG and to revert with a recommendation at the next meeting of Nphet”.
“The Nphet was generally supportive of the EAG advice, however, in light of the issues identified, it decided to accede to the HSE’s request to revert with a further proposal on this matter by Friday, April 17, 2020,” the minutes reveal.
Nphet formally accepted the recommendations on April 21 and the Health Protection Surveillance Centre (HSPC) updated the advice the following day.
‘It is very likely that if there is any benefit it is very small’