Covid-19 FAQs

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Please note, you will find a number of documents to assist you here. You can access all links at home from NTK. Copies are also available on East24

The FAQs will be continually updated as the situation remains dynamic with further information and advice.

Please select the area you'd like more information on:

 

 

 Updated FAQs

 

Can I send a CFR to a possible COVID-19 case?- Updated 20/07

 

A new bulletin was released on the 7th July which details that CFRs can be deployed to all patients within their codeset except those who are confirmed positive COVID and those who are choking, as this is an AGP.

 

 

 

 

Staff Information

How can I protect myself from COVID-19?

Make sure you keep up to date with the latest guidance as the situation is evolving as we learn more about the infectious disease. It is important for staff to adopt good IPC practices such as hand hygiene and wear the appropriate PPE for patient care or the task they are completing.

It is also essential that there is good communication between staff groups to ensure they are aware of the risks and requirements, for example once a crew has transported a suspected COVID-19 patient they must notify the make ready team of this information including whether any aerosol generating procedures were undertaken/ compartments opened to allow them to apply the correct decontamination process.

Will I be paid if I book sick due to COVID-19?

If you become sick or need to self-isolate due to COVID-19, this will be managed in line with current sickness policies

Are staff not directly in frontline or support roles being furloughed? Can I ask to be furloughed?

The government is currently offering private sector employers the option to furlough staff where they would otherwise be laid off without pay or made redundant due to the COVID-19 pandemic. The Trust is actively recruiting and is re-deploying staff wherever possible to meet the extraordinary demands we are currently facing. We are therefore not furloughing any staff at present. There is no ‘right to be furloughed’.

I am part of the ‘vulnerable group’ - Those with an underlying health condition, pregnant women and those over 70+ what should I do?

For our meal breaks, the ambulance stations nearest hospitals are very busy. How can this be made safer given that we should maintain distances?

AOC & Operational Management teams are working together to ensure sufficient space within station locations for crews on breaks. This is being achieved by using alternative areas on stations where needed or restricting the numbers of crews sent to stand down at a particular location.

If you have a specific worry about a location please discuss this with your local Ops Management team who will be able to confirm the arrangements they are putting in place for your area.

Could I work in an alternative area to reduce the risk to a vulnerable family member?

Your local operational management team will be able to assist you with this. The trust has committed to providing flexible opportunities to keep our frontline staff in work and responding to our patients.

 If family members of staff living in the same home receive a letter advising them to remain at home for up to 12 weeks and are unable to go anywhere is there any precautions front line staff should be taking?

 Please regard the specific guidance and advice on the PHE Website for this here.

The trust is offering staff to stay in hotel accommodation to allow them to continue working during this period. We would encourage individuals to discuss their specific circumstances with their line manager to see how we are able to assist.

How long does the virus survive on surfaces?

It is not certain how long the virus that causes COVID-19 survives on surfaces, but it seems to behave like other coronaviruses. Studies suggest that coronaviruses (including preliminary information on the COVID-19 virus) may persist on surfaces for a few hours or up to several days. This may vary under different conditions (e.g. type of surface, temperature or humidity of the environment).

If you think a surface may be infected, clean it with detergent followed by Actichlor solution (at 1,000ppm) to kill the virus and protect yourself and others. Clean your hands with an alcohol-based hand rub or wash them with soap and water. Avoid touching your eyes, mouth, or nose.

COVID-19 Frequently Asked Questions - Clinical Assessment
This document has been released by the Trust with the agreement of UNISON to support clinicians and empower them to make decisions which may deviate from the usual guidance which we follow.
Download here or read a text version on the JRCAL app.

 

OPERATIONS

What is the correct management of suspected patients and where do we convey them to?

Please find guidance available here.


Can I ask the patient to wear a surgical mask?

Yes, and providing the patient can tolerate the mask and does not require supplemental oxygen therapy, this should be encouraged as this will reduce the risk of transmission to yourself and your colleagues.

Have COVID-19 Infection Control Precautions affected the way we should respond to patients in cardiac arrest?

All responders should make a dynamic  risk assessment and, if responding to a patient with known or suspected COVID-19, don the appropriate Personal Protection Equipment (PPE). Information for primary and  secondary responders on equipment, PPE and conveying patients with COVID-19 has been outlined in this infographic.

If the trust decides to start testing staff for covid-19, will they do a serological test to identify if you already have had the virus and produced the antibody?

The trust is at present awaiting confirmation of how testing of staff may take place and the circumstances in which it would apply. Unfortunately, we do not yet have any specific details on what the testing will provide for, further national guidance is awaited to clarify what we will able to access.

 

PPE

What level of PPE is required for face to face patient contact?

The PPE required to be worn is:

  • Possible or confirmed patient not requiring AGP- Fluid repellent surgical mask, apron and gloves, consider eye protection if risk of splash
  • Possible or confirmed case the requires an AGP-FFP3 respiratory protection, Coverall suit, Eye Protection (ideally full-face shield), and gloves

Please see the latest guidance for details of the PPE required and guidance on the correct donning and doffing procedure to be followed.

Why do some staff have an FFP3 facemask and other staff are getting a Respiratory hood?

The level of respiratory PPE required is FFP3 which must be FIT tested to ensure they are able to obtain an effective seal; this offers the required level of protection to the wearer.

However, some staff are not able to obtain an effective seal with the FFP3 facemasks available and therefore an alternative option is required to ensure that all staff are provided with the required PPE

Do I need to take any special precautions when laundering my uniform following contact with a suspected or confirmed COVID-19 patient?

Providing you have worn the correct PPE and there have been not breaches of the PPE then there is no significant risk of uniform contamination, therefore no special laundering requirements are required.

In the event that staff uniform is contaminated e.g. due to a breach of PPE this will require removal, after the incident, and can be placed within a plastic bag e.g. laundry bag for taking home to be laundered in the normal manner as advised for Healthcare staff i.e. on a long wash cycle at as hot a temperature as possible (at least 60°C), separate to normal laundry. It is not recommended to put the Trust red alginate bags into a domestic washing machine, but these can be used to transport the uniform home and transfer directly to the machine. Full guidance on laundering uniform can be found in the IPC Safe Practice Guidelines on East24.


How long can I wear a FFP3 facemask for?

The FFP3 facemasks are deemed safe and acceptable for the purposes of our deployment. They can be worn for long periods, but our general recommendation would be for no more than three hours before an individual needs to break and change their mask.

However, it is safe to work in a FFP3 for longer periods (up to full shift length) if the clinical or safety needs dictate a longer wear time is required (i.e. patients clinical needs are time-critical, or it is more dangerous to stop and change the mask due to risk to patient or clinician).

Should I wear level 3 PPE for all patients… just to be safe?

NO! You protect yourself by wearing the CORRECT PPE and following standard precautions.

General patient contact, when AGP’s are not performed, DOES NOT require you to wear level 3 PPE.

  • COVID-19 is mainly transmitted via contact with droplets generated when an infected person coughs, sneezes, or speaks. These droplets are too heavy to hang in the air. They quickly fall on floors or surfaces. Droplets coming into contact with mucous membranes and/or being ingested is predominantly how you become infected.
  • There is no considered risk of airborne transmission unless AGP’s are performed.
  • Correct hand hygiene, PPE doffing and between patient decontamination will reduce the risk of transmission significantly. Extra or inappropriate PPE wearing will not mitigate other poor practices.
  • Level 2 PPE in conjunction with the other Infection Prevention and Control (IP&C) standards precautions will protect you against risk of droplet contact.
  • Wearing additional PPE, other than the level stated in the guidance, will NOT provide you with more adequate protection and overuse will result in PPE shortages during occasions when it is REQUIRED.

FFP3 is only required when aerosol generating procedures are conducted.

  • During AGP’s there is an increased risk of aerosol production.
  • Coughing and sneezing are considered to produce significantly less aerosol than medical procedures. Other interventions and practices such as cough etiquette and surgical mask use, in conjunction with level 2 PPE is sufficient for COVID-19 patients where AGP’s are not performed.
  • Level 2 PPE is required for patients unless there is increased risk of extensive bodily fluid exposure and/or aerosols.
  • A risk assessment should be conducted at each stage of care to determine the CORRECT level of PPE.

Staff are being advised that wiping hands with Clinell Surface Wipes between patient contact constitutes sufficient hand hygiene. We are not being returned to the nearest suitable facility to wash hands with soap and water. This is different to the media campaign for regular 20 second hand washing with soap and water?

The use of wipes to remove visible contamination followed by alcohol gel disinfection is standard practice where liquid soap and warm water are not available. The use of warm water and liquid soap is advocated where available. Alcohol gel however is effective against covid-19 if the alcohol content is 60% or greater


Are CPAP and NIPPY considered to be AGPs?

CPAP/BiPAP are considered to be Aerosol Generating Procedures (AGPs). As such any patient suspected or confirmed of having COVID-19 should warrant full PPE as per guidance.

Please note, nebulisation is currently NOT an AGP due to droplet control and secretions being caught in the chamber and so minimum levels as per non-AGP can be worn for nebulisation only.

For further guidance please visit PHE here.

Could we utilise the ventilators on the ambulance in hospitals?

We have had a number of staff raising questions in relation to the usage of our ventilators and whether these should or could be provided to support the demand for ventilators in hospitals.

There is always a risk-based decision to be made in these circumstances and, after careful consideration, we have made the decision to remove and redistribute our equipment throughout hospitals within our region where the need is anticipated to be significantly greater and the benefit higher

Please see further details on the Ops update 24/03 - https://ntk.eastamb.nhs.uk/news/ventilators.htm

Thank you to anyone that has been in contact to raise this question.

 

Decontamination

What is the decontamination process for a vehicle which has conveyed a suspected COVID-19 patient?

This will be different depending on whether aerosol generating procedures (AGPs) e.g. suction, Intubation, CPR etc. have been undertaken, which is why it is essential the crew inform the make ready staff of this information on their return to station.

  • IfAGPs were NOT undertaken, the vehicle will require an enhanced between patient clean ensuring thorough decontamination of all exposed surfaces, equipment and contact areas before it is returned to normal operational duties, with
    • Clinell universal sanitising wipes or
    • Detergent followed by Actichlor.
  • If AGPs were undertaken then all surfaces within the patient compartment and any exposed equipment (i.e. not within closed compartments) left on the vehicle will require decontamination with a universal detergent followed by chlorine-based solution at 1,000 parts per million.

What level of PPE is required for decontaminating a vehicle and why is this different to that for patient care?

The PPE required to be worn for decontamination is Fluid repellent surgical mask, eye protection (ideally full-face shield) gloves and apron.

This is different to the PPE required for patient care due to the change to the transmission risk once the patient is removed from the environment. Once the patient has left the vehicle the droplets begin to drop and settle on the surfaces and there is no further droplets produced. This results in the change from the transmission route from droplet/ airborne to contact through the surfaces, so there is no longer a need for an FFP3 mask.

When the crew return to the vehicle prior to returning to station they will wipe down the exposed surfaces-between patient clean, this reduced the viral load on the surfaces which further reduces the risk to the make ready staff.

Which colour waste bag does clinical waste generated from COVID-19 incidents go in?

This waste is classed as category B waste and should go in the orange bags.

 

AOC

What is the COVID-19 Co-ordination Centre?

Following the recent outbreak of COVID-19, NHSE and PHE have requested EEAST to set up a co-ordination centre to support in the management of COVID-19. The co-ordination centre went live on Thursday 5th March 2020 and is operating 24/7 within the Commercial Contact Centre. The key deliverables of this service will be:

  • Cascade COVID-19 request to STP SPOC Testing hubs for distribution to local teams
  • Provide patients/ GPs and STP SPOC testing hubs negative results from swabbing 
  • Report nationally on all patients tracked through the coronavirus pathways 

Please note this service is only to be utilised by NHS111 at this time.

What is the Case Transport Response service?

In addition to the above, NHSE and PHE have also requested EEAST to set up a Case Transport Response Service to take responsibility for the transport of suspected/ confirmed COVID-19 Cases around the healthcare system within the EEAST region.

The key deliverables of this service will be:                                             

  • Providing advice to ambulance crews conveying suspected or confirmed cases of COVID-19
  • Ensure patients are conveyed in accordance with national guidance
  • Ensure prompt collection of patients requiring discharge to support in flow through COIVD-19 pods
  • Co-ordinate all ambulance service resources used for the conveyance of patients [incl, HART, PTS, Private sector etc]
  • Maintain a log of all cases and outcomes

This is still in early stages of development and further information surrounding this will be released.

 

Call Handlers

Do we screen calls from HCPs as part of the HCP / IFT framework?

An HCP should be escalating as part of the booking process if there is a suspected or confirmed case of COVID-19 within their patient. We are currently exploring additions to the framework to enable a question for COVID-19 and will update in due course.



Dispatch

Can I send a CFR to a possible COVID-19 case?- Updated 20/07

A new bulletin was released on the 7th July which details that CFRS can be deployed to all patients within their codeset except those who are confirmed positive COVID and those who are choking, as this is an AGP.

 

GENERAL

What are the symptoms of COVID-19?

The most common symptoms of COVID-19 are fever, tiredness, and dry cough. Some patients may have aches and pains, nasal congestion, runny nose, sore throat or diarrhoea. These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell.

Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people who gets COVID-19 becomes seriously ill and develops difficulty breathing.

Older people, and those with underlying medical problems like high blood pressure, heart problems or diabetes, are more likely to develop serious illness. About 2% of people with the disease have died.


What do I do if I appear to have COVID-19 symptoms?


Stay at home if you have either:

  • a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)

Do not go to a GP surgery, pharmacy or hospital. Use the NHS 111 online coronavirus service to find out what to do.


How long to stay at home?

For guidance specifically for health care workers, see Government guidance on COVID-19: management of staff  in health and social care settings

Read NHS guidance advice about staying at home.

See EEAST Remote Working Guidance here.

What does it mean to self-isolate?

This quite simply just as it sounds, that you should remain at home and not go out and about. Don’t go to work or to public areas, don’t use public transport or taxis etc. until you have been told you are safe to. The purpose of this is to reduce the risk of further transmission. Full guidance is available here. 

 

Where can I get more information about COVID-19?

 

There are numerous sources of information available through Public Health England, World Health Organisation and European Centres for Disease Control. Below are links to the main collections:

 

 

Please note: This document on Novel Coronavirus (COVID-19) FAQs will be continually updated.

If you have any suggestions for additional questions, please send them to coronavirus@eastamb.nhs.uk 

 

 

 

Latest update 19th March 2020
Published 5th March 2020