ECDC says non-medical face masks should be considered; number of patients on ventilators remains static

The EU’s lead agency managing Europe’s response to Covid-19 says people should consider wearing non-medical face masks in public.
ECDC says non-medical face masks should be considered; number of patients on ventilators remains static

Additional reporting by Neil Michael

The EU’s lead agency managing Europe’s response to Covid-19 says people should consider wearing non-medical face masks in public.

Meanwhile, the number of ventilators being used to treat critical patients with Covid-19 has remained static for much of the past week, while deaths in an ICU setting are also at a low level.

Internal HSE figures, seen by the Irish Examiner, state that 114 patients are currently being ventilated in Irish healthcare settings. A further 12 people are being ventilated though it has not yet been confirmed if they have the coronavirus.

The new figures, which date from 2pm on April 8, show that the number of people being ventilated has been greater than 100 since March 31, but has grown by just four in the past week, suggesting that, for the moment, Ireland’s supply of the lifesaving equipment is proving sufficient.

Ventilators take the strain off a patient’s lungs to buy their body time to combat the viral infection. It’s understood that there are roughly 1,200 ventilators in Ireland, with the HSE having ordered a further 900 as the scale of the coronavirus crisis ramps up.

Some 70 people were on ventilators on the morning of March 28, with those numbers rising by 30 in just three days. However, that accelerated growth rate has held steady at just over the 100 mark ever since.

The majority of people on ventilators in Ireland are in Dublin hospitals, with 61 of such instances occurring in six institutions in the capital. St James’s Hospital is number one on that list, with 15 people receiving such care, while Beaumont Hospital is in second place with 12.

While much focus has been placed on the availability of intensive care beds during the crisis, just two people had died in such a setting in the 24 hours prior to April 8.

The new data reveals that 146 people who are confirmed to have the virus are currently in intensive care, with a further 21 also present who are suspected but not confirmed as having the disease.

There were 138 available ICU berths across the country last night, according to Liam Woods, HSE national director of operations, with ’’surge capacity’’ of more than 800 available.

In Dublin, the Blackrock Clinic, Mater Hospital, and Tallaght Hospital have no ICU beds available, and Tullamore Hospital is also full. The hospitals in Cavan, Letterkenny, Mullingar, Navan, Portlaoise, and St Vincent’s and Temple Street Children’s Hospital have just one space available each. There are currently 476 patients awaiting results of Covid-19 tests in Ireland’s 29 acute hospitals.

The Department of Health revealed yesterday that 28%, or 67, of the people who have died to date of Covid-19 did so outside of hospital. It’s not yet clear if those deaths occurred in nursing homes and other residential care settings, which have seen a rapid growth in numbers of clusters over the past week.

The latest advice about facemasks comes as the European Centre for Disease Prevention and Control’s counterpart in the US said the same earlier this week.

Both lead agencies are following on from a “conditional” World Health Organisation recommendation that face masks could be used by asymptomatic individuals in severe pandemics in order to reduce transmission in the community.

However, the advice comes with a large amount of caution and reservation because the ECDC states there is no evidence that wearing a mask is of benefit to people who are not unwell: “Based on the lack of evidence, it has so far not been recommended that people who are not ill or who are not providing care to a patient should wear a mask to reduce influenza or COVID-19 transmission."

“It should be noted that all relevant evidence comes from studies (on mask use) on influenza and other coronaviruses and may not be directly applicable to COVID-19. There is no evidence that non-medical face masks or other face covers are an effective means of respiratory protection for the wearer of the mask.”

And it states: “Available evidence suggests non-medical face masks are less effective than medical masks as a means for source control.  There are no established standards for a self-made non-medical face mask.”

Despite its reservations, the ECDC says the use of face masks in public “may . . . reduce the spread of the infection” in the community. This is because, they say, masks minimise the excretion of respiratory droplets from infected individuals who have not yet developed symptoms or who remain asymptomatic.

However, the agency says it is not known how much the use of masks in the community can contribute to a decrease in transmission in addition to the other countermeasures.

It said: “The use of face masks in the community could be considered, especially when visiting busy, closed spaces, such as grocery stores, shopping centres, or when using public transport.

“The use of non-medical face masks made of various textiles could be considered — especially if, due to supply problems, medical face masks must be prioritised for use as personal protective equipment by healthcare workers.

“This is based on limited indirect evidence supporting the use of non-medical face masks as a means of source control.

“The use of face masks in the community should be considered only as a complementary measure and not as a replacement for established preventive measures.

“Appropriate use of face masks is key for the effectiveness of the measure and can be improved through education campaigns.

Earlier this week, America’s Centres for Disease Control and Prevention (CDC) recommended people should wear cloth face coverings in public settings where other social distancing measures are difficult to maintain.

“It is critical to emphasize that maintaining social distancing remains important to slow the spread of the virus,” it said.

“CDC is additionally advising the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others.

“Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.” They fall short of recommending the use of surgical or N-95 masks because these are critical supplies that should be reserved for healthcare workers.

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