In the OMT advice that will be published tomorrow, but is already in the hands of News Hour, preventive use of mouth masks is still not recommended for home care. The opinion states that mouth mask use for home care workers “can be considered” and should be “assessed” by client.
This while preventive masks are recommended for nursing homes, and the OMT also assumes that (on the basis of a prepared risk assessment) the geriatric psychiatry and geriatric departments within care for the disabled are eligible for preventive use.
The advice only creates a lot of confusion, says Jos de Blok, founder of the home care organization Buurtzorg. “So now you have to make an assessment for each client. That is not the daily practice.”
As far as De Blok is concerned, it would have been better if the OMT did recommend masks, unless there are reasons to deviate from them. “This whole piece exudes an atmosphere of ‘don’t do it if you don’t have to’. We are in a situation where we have to work safely.
The Outbreak Management Team is slowly returning to its position on face masks in elderly care. For six months, the OMT said it was “not necessary” to wear a mouth mask as a precaution when caring for the elderly. That was even “undesirable” because of the scarcity. Nursing and home care personnel only had to wear protective clothing if an actual corona infection was also established.
Recently, the OMT finds that employees in certain sectors of long-term care should nevertheless wear preventive masks if the situation is “worrisome” (“between 50 and 150 corona infections per 100,000 inhabitants per week”). By wearing the masks, care workers must be prevented from taking the virus inside unnoticed and infecting the elderly.
No corona patient, then no masks
The recommendations of the OMT partly determine the masks guidelines of the RIVM. And the RIVM guideline in turn determines which healthcare institutions could receive masks from the government, and how many. If an organization has no corona patients in its database, in principle no mouth masks will be distributed.
In other countries, the preventive use of mouth masks has been advised for much longer. For example, from March onwards, the rule in Germany was that all employees in nursing homes had to wear mouth masks as a precaution. Even if the elderly did not yet have corona. Staff could bring the virus into the nursing home unnoticed, presymptomatic, and thus infect the elderly. And then other healthcare workers could become infected again.
But the RIVM said in March that you could not be contagious without complaints. Care workers who had obvious corona symptoms had to stay at home, but staff without complaints could simply work with the elderly. Without mouth mask.
This was posted on the RIVM site in March:
Even when the infections in Dutch nursing homes continued to increase in April, and the OMT was warned that corona had already entered a third of those nursing homes, the advisory team maintained its position.
In July, care workers from the nursing and home care sector reported News hour that they felt unsafe with the advice of the OMT and RIVM. They said that they felt guilty because they believed that the virus had reached the elderly through them. Many fell ill, and many died. The aged care workers would have liked to wear a mouth mask, but were not given one. After all, the advice was that this was not necessary.
Meanwhile, months after Germany had already established this, the OMT says that corona patients can be contagious two days before they develop complaints. The OMT therefore also believes that preventive use of mouth masks during a second wave is nevertheless important in nursing homes. But that advice still does not apply to employees in home care. There such use must be considered “per client”.
Nieuwsuur previously revealed that some important RIVM corona guidelines have a meager scientific basis:
RIVM guidelines for elderly care had meager scientific basis