Responding to the publication of an editorial in BMJ1 “Efforts to stop spread of Covid-19 should focus on preventing airborne transmission” Dr Chaand Nagpaul, BMA chair of council, said:

“The BMA has repeatedly said that there is strong evidence that good ventilation is vital in the fight against the spread of COVID-19 and the publication of this editorial from the BMJ shows just how crucial clean airflow is.

“In our February 2021 ‘Taking a cautious approach to easing restrictions‘ paper2, we recommended improving ventilation and last November, we published a series of recommendations3 for reducing infection risk in healthcare settings, highlighting the importance of ventilation to protect staff and patients.

“There has been much discussion by the Government and in the media about ‘hands, face and space’ but much less about the critical importance of fresh air and throughflow in buildings and on public transport. As restrictions are eased, and there is greater mixing between people in enclosed spaces, it is vital that measures are taken to ensure adequate ventilation. This should include explicit specifications on ventilation requirements in public and work settings, including in the hospitality sector such as restaurants, bars and pubs. Investment will also be needed to make sure our hospitals, clinics and GP surgeries are ventilated correctly and that our NHS workers and patients are kept as safe as possible.

“A failure to ensure adequate levels of ventilation in indoor areas runs the serious risk of a rebound increase in Covid-19 infections.

“Measures that are recommended in the BMJ editorial include opening windows, installing or upgrading heating, ventilation and air conditioning systems. We also recommend, particularly in healthcare settings, that inexpensive monitoring equipment is installed widely in clinical and non-clinical areas. This can indicate how well ventilated a room is, for example by measuring the parts per million of carbon dioxide.

“The editorial repeats the messages that preventative steps of wearing masks or face coverings, keeping your distance, and reducing indoor occupancy all help to reduce the usual routes of transmission, whether through direct contact with surfaces or droplets, or from inhaling aerosols. For healthcare workers specifically, masks with high filtration efficiency and a good fit, are vital. We have repeatedly called for high grade masks for healthcare staff, including wider use of FFP2/3 masks, and have raised this at the highest level in Government. Too many doctors continue to report being equipped with ill-fitting and inadequate PPE. We reiterate our call4 that guidance and provision must take account of differing needs of the individual healthcare worker.

“Crucially, patients and the public need to know they are as safe as they can be and at low risk of becoming infected with Covid-19 when they return to the office, go shopping or go into leisure settings.”

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