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Covid-19: “Illogical” lack of testing is causing healthy staff to self-isolate, BMA chief warns

BMJ 2020; 368 doi: https://doi.org/10.1136/bmj.m1277 (Published 27 March 2020) Cite this as: BMJ 2020;368:m1277

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  1. Gareth Iacobucci
  1. The BMJ

The absence of covid-19 testing for NHS staff is causing huge workforce shortages by forcing doctors to self-isolate even if they do not have the virus, the head of the BMA has warned.

The government’s advice is for people with covid-19 symptoms to stay at home for seven days, but for all other household members who remain well to isolate for 14 days. The BMA council chairman, Chaand Nagpaul, said that the lack of testing for staff was “counter-intuitive” as it was likely to be forcing more staff than necessary to stay away from hospitals and GP surgeries because they do not know if they are infected.

Nagpaul, talking at a health select committee hearing held remotely on 26 March, acknowledged that the government had promised to ramp up testing capacity for NHS staff, but said that this had yet to materialise.1 He said that the uncertainty had led many staff to self-isolate, exacerbating existing workforce pressures. He said that he was aware of some GPs trying to provide a service for tens of thousands of patients on their own because other staff were self-isolating.

“For us this just seems an illogical approach. Each day that goes by, there are more staff who are self-isolating. It is estimated at this time of year that around 10% of the population could have a temperature or a cough in a non-covid situation. If they were able to be tested [and were negative for covid-19], they would come back to work,” said Nagpaul. “It just seems counter intuitive that we are reducing our workforce at a time when we need it the most. I can’t overestimate what this means on the ground.”

He also reiterated grave concerns the BMA was hearing from doctors about the lack of personal protective equipment and testing for NHS staff.2 “We are flooded with anxieties and concerns from doctors [about lacking personal protective equipment],” he said. “It’s the single biggest issue at the moment.

“One is the actual supplies themselves. I know we’ve had assurances, but we’re still finding far too many of our members telling us that that hasn’t translated on the ground. Even this morning I’ve had emails from doctors saying masks have run out, that they are having to wear them for longer than they should. In general practice when we run out and ring the helpline, we are told to actually buy them ourselves.”

Nagpaul added, “The other issue is about the adequacy of protection. If you look at WHO’s recommendations for any healthcare worker, as a minimum they should have their eyes protected and have a protective gown. We have neither of those in general practice, nor for that matter do frontline staff in A&E.”

Yvonne Doyle, medical director at Public Health England, told the committee in response that Public Health England was reviewing its guidance on personal protective equipment. She said: “The guidance [for England] has been cleared and written by people who actually live in infection control every day of the year. It is proportionate and protective for the most risky environments.” But she added: “In the light of people’s anxieties and the full package of the problems, it is under active review.”

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