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Care Opinion

Excluding vulnerable people from healthcare

Posted By greenans02

"Excluding vulnerable people from healthcare"

About: Mater Hospital / Accident & Emergency

(as the patient),

I spent several hours in A&E and had to wait in the corridor outside the waiting room because no other patients were wearing masks (I wear FFP3 masks to all medical appointments). Several were coughing and sneezing. Healthcare settings are not Covid safe. That means they’re excluding vulnerable people, who have to decide whether medical appointments are worth the risk. I’ve had to cancel several appointments (for me and my child) because they just weren’t ‘life or death’ enough to risk infection.

The only way forward is to minimise transmission until we have a sterilising vaccine or more effective treatment.

Covid is airborne. Therefore, prevention is very simple. I would like to see:

1. HEPA filters are everywhere - entrances, waiting rooms, clinical areas, wards, toilets (Covid plumes from flushes can cause infection). They remove virus particles from the air.

2. We need to go back to basics. Masks must be worn by as many people as possible. WHO guidance (13 January 2023) recommends masks “for anyone in a crowded, enclosed, or poorly ventilated space” - that describes all hospitals and GP/dental surgeries. There is no scientific basis to do otherwise. Masks must be enforced to protect *public* health.

3. Ventilate - open a window.

4. Check temperatures at the door. It’s quick and easy.

Without adequate testing, everyone must be considered a suspected Covid sufferer - therefore, protective measures must be taken in all healthcare settings.

Immediate measures. I would like to see taken:

1. Masks for everyone - staff, patients, visitors

2. HEPA filters in all rooms

3. Ventilation - open as many windows as possible

4. Check temperatures at the door

I would very much appreciate a response to this and to hear how we will be able to safely access healthcare. Thank you.

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Responses

Response from Linsey Sheerin, Divisional Nurse, Urgent and Emergency Care, Emergency Care, Belfast Health and Social Care Trust 13 months ago
Linsey Sheerin
Divisional Nurse, Urgent and Emergency Care, Emergency Care,
Belfast Health and Social Care Trust

Submitted on 20/03/2023 at 14:27
Published on Care Opinion at 14:27

Dear greenans02,

My name is Linsey Sheerin and I am the service manager for Urgent and Emergency Care at Belfast Trust. Thank you taking the time to share you experience on care opinion, I am saddened to read that you did not safe while in our care. I want to assure you that vulnerable people are not excluded from access to our services.

In line with regional guidance it is strongly recommended that you wear a face covering when visiting any Health and Social Care setting, and follow other guidance, such as social distancing and using hand washing facilities, to keep patients, other service users and staff safe. By wearing a face covering you are showing your support and consideration for others and playing your part to prevent transmission of the virus. However, we also have to acknowledge that some people may find it difficult to wear face coverings and the reasons may not always be visible. This is by no means an excuse to how you were made feel and for this I am truly sorry.

Unfortunately not all departments including the Mater Emergency Department have windows, however I will share you comments regarding HEPA filters with Infection Control colleagues for their advice. All patients who present to our services are screened for COVID and have temperatures taken at point of Triage.

I appreciate that my response may not fully address the points you have raised, but I want to assure you that all staff follow regional guidance issued from the Department of Health. Some of this guidance can also be found at Coronavirus (COVID-19): face coverings guidance | nidirect

Linsey

  • {{helpful}} {{helpful == 1 ? "person thinks" : "people think"}} this response is helpful

Update posted by greenans02 (the patient)

Dear Ms Sheerin

Thank you for responding to my story.

You say that vulnerable people are not excluded from access to care - yet the lack of Covid mitigations does exclude them. As you will be aware from disability discrimination laws, if you provide a service that cannot safely be used by vulnerable people, it is not accessible to them.

I hardly saw a mask at all in the waiting room. And so many people were coughing without masks on. Covid screening questions are only asked once we reach triage, and when I sympathised with a nurse about the risks they’re facing, she told me that she was upset by the number of people who will refuse a mask while coughing right in front of her. It’s heartbreaking. What is the procedure when someone has Covid symptoms? As far as I can see, they’re just sent back out to the waiting room to sit among everyone else.

Sadly, your staff do face abuse from people who refuse to wear masks. Therefore, HEPA filters are the only way forward. I am very glad to hear that you will pass on my request to infection control. Hospital-acquired Covid infections are through the roof, and they can be prevented with effective air filtration.

In an Addenbrooke’s Hospital study, HEPA filters on wards removed almost all airborne Covid virus - and significantly reduced bacterial, fungal and other viral bioaerosols.

http://https://www.cuh.nhs.uk/news/air-filters-on-wards-remove-almost-all-airborne-covid-virus/

These filters are needed everywhere - in entrances, waiting rooms, all clinical areas, wards, toilets (Covid plumes from flushes can cause infection).

http://https://www.cam.ac.uk/research/news/air-filter-significantly-reduces-presence-of-airborne-sars-cov-2-in-covid-19-wards

http://https://pubmed.ncbi.nlm.nih.gov/34718446/

Who is vulnerable?

This list encompasses almost everyone who attends healthcare facilities. Is there a waiting room anywhere that doesn’t have at least one of these people in it? Many staff will be in these categories as well.

http://https://www.medscape.org/viewarticle/983993

"…immune compromised individuals… stem cell and solid organ transplant recipients, those receiving B-cell ablative therapies, leukemias, lymphomas and perhaps people who are on steroids, biological therapies, chemotherapy and radiotherapy… people with co-morbidities, cardiovascular and lung disease, kidney, liver disease, neurological conditions, diabetes and obesity, Down's syndrome, sickle cell disease… elderly… pregnant women…and those unvaccinated… are at significant risk"

I am very reluctant to attend A&E or outpatient appointments until HEPA filters are in place in all areas. I hope that it happens very soon. But what if I needed to go there tonight, or tomorrow? Is there a safe place where I can wait, with good ventilation? I spent 8-9 hours freezing outside the waiting room (just inside the front entrance) in December and that was my only option - and then I still had to go into poorly ventilated triage rooms etc to be seen.

Plug-in HEPA filters can be installed immediately. They would pay for themselves quickly and many times over in reduced disease transmission, which in turn would ease pressure on the NHS and save lives.

Why does this matter?

The people who advocated ‘opening up’ said that we should protect the vulnerable. Every patient who attends a hospital or surgery is, by definition, vulnerable. Many will have diseases that make them extra susceptible to Covid. We cannot say that we’re protecting them without making healthcare settings safe for them. The current situation is so unsafe that it is shutting vulnerable people out of healthcare altogether.

Medical appointments are the only places that many vulnerable people go - they deserve to be protected. Please keep me posted about the HEPA filters, I am keen to know when it will be safe for me to attend hospital settings (I will still be wearing a mask, but with HEPA filters there will be fewer virus particles in the air, so my mask has a better chance of protecting me). I’m willing to do anything to help make this happen - can I do anything such as fundraising for them? It would be life-changing for so many vulnerable patients.

I would be glad to speak with you about this if you have time. I am grateful for the NHS and all that you do.

Thank you again.

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