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This publication is available at https://www.gov.uk/government/publications/novel-coronavirus-2019-ncov-interim-guidance-for-first-responders/interim-guidance-for-first-responders-and-others-in-close-contact-with-symptomatic-people-with-potential-2019-ncov
Who this guidance is for
This guidance is for fire and rescue services, police services, ambulance services, individuals and members of voluntary organisations who, as part of their normal roles, may provide immediate assistance to individuals with potential coronavirus (COVID-19) infection. More detailed guidance is available for NHS ambulance trust employees.
The most important symptoms of COVID-19 are recent onset of any of the following:
- a new continuous cough
- a high temperature
- a loss of, or change in, the normal sense of smell (anosmia)
For most people, COVID-19 will be a mild illness, but in some people the illness may progress to severe pneumonia, causing shortness of breath and breathing difficulties. There are many other symptoms linked with COVID-19.
What is meant by a contact
In this guidance, a contact is a person who has been close to someone who has tested positive for COVID-19. A risk assessment may be undertaken to determine this, but a contact can be a person who has:
- had face-to-face contact with someone less than a metre away
- been within one metre for one minute or longer without face-to-face contact
- been within 2 metres of someone for more than 15 minutes (either as a one-off contact, or added up together over one day)
The contact can be any time from 2 days before the person who tested positive developed their symptoms (or, if they did not have any symptoms, from 2 days before their positive test was taken), and up to 10 days after.
What to do if you are required to come into close contact with someone as part of your first responder duties
Reduce transmission risk
Make sure you are familiar with and understand the steps required to keep you and others safe:
Clean your hands thoroughly with soap and water or hand sanitiser after close contact with others and after touching any surfaces in the area you are working in.
Where it is not possible to limit close contact and you are required to deliver hands on care, the following PPE is recommended:
- disposable gloves and a disposable plastic apron
- a fluid resistant surgical face mask (FRSM)
If a risk assessment indicates the likelihood of contamination by splashes, droplets of blood or body fluids, use disposable eye protection (such as a face visor or goggles).
Clean your hands thoroughly with soap and water or sanitiser before putting on and after taking off PPE.
The safe removal of PPE is a critical consideration to avoid self-contamination. Guidance on correct use of PPE is available. Use and dispose of all PPE according to the instructions and training provided by your employer or organisation.
Providing assistance to someone who is unwell
If you need to provide assistance to someone who is unwell, if possible move the person to somewhere away from others. If this is not possible, ask others who are not involved in providing assistance to stay at least 2 metres away.
If you are required to perform cardiopulmonary resuscitation (CPR), you should conduct a risk assessment (in the police service this would be a dynamic risk assessment) to assess appropriate infection control precautions.
In adults, it is recommended that you do not perform mouth-to-mouth ventilation – perform chest compressions only. Compression-only CPR may be as effective as combined ventilation and compression in the first few minutes where cardiac arrest has not occurred due to lack of oxygen (asphyxial arrest).
In children, cardiac arrest is more likely to be caused by a respiratory problem or lack of oxygen. Therefore, chest compressions alone are unlikely to be effective. If a decision is made to perform mouth-to-mouth ventilation, use a resuscitation face shield, if one is available.
If you perform mouth to mouth ventilation on someone with COVID-19 you should follow the guidance for non-household contacts.
If you perform mouth-to-mouth ventilation on someone who does not have COVID-19, no additional actions need to be taken other than monitoring yourself for symptoms of COVID-19 over the following 14 days. However, if they are subsequently diagnosed with COVID-19 you may be contacted by NHS Test and Trace and asked to self-isolate.
If you develop symptoms of COVID-19, however mild, you should arrange to have a PCR test, inform your employer and follow the stay at home guidance.
Cleaning the area where assistance was provided
Cleaning will depend on where assistance was provided. Follow the advice for cleaning in non-healthcare settings.
If there has been a blood or body-fluid spill
Keep people away from the area. Use a spill-kit if available, using the PPE in the kit or PPE provided by your employer or organisation and following the instructions provided with the spill-kit. If no spill-kit is available, place paper towels or roll onto the spill, and if you are not part of the emergency services, seek advice from them when they arrive.
Handling the deceased
If a person has died at home and COVID-19 is suspected or confirmed, follow the advice set out in the guidance for care of the deceased.
If emergency service responders are identified as a contact of a case of COVID-19
Emergency service responders who are identified as a contact of a case of COVID-19 may be exempt from self-isolation if they are fully vaccinated.
Additional mitigations are required for health and social care staff who are fully vaccinated and have been identified as a contact of a case of COVID-19. Refer to the management of staff and exposed patients and residents in health and social care settings guidance for further information.
The following principles will continue to apply for unvaccinated or partially vaccinated service responders who are identified as a contact of a case of COVID-19:
- while providing frontline duties that involve contact with someone with COVID-19, responders will only be exempt from being considered a close-contact for the purposes of contact tracing and isolation if clinical grade PPE has been worn appropriately, and if they have received and followed appropriate training in IPC
- in all other circumstances where an emergency service responder has had contact with someone with COVID-19 (including in work settings such as staff rooms, canteens, offices and service vehicles), they will be considered a close contact for the purposes of contact tracing and isolation and should self-isolate for 10 full days
Advice for police officers, staff and volunteers
Police officers, staff and volunteers should not be performing clinical assessments. If you are concerned that someone you are managing needs medical assistance, call NHS 111 (or 999 if it is a medical emergency).
Where appropriate, in an operational setting, you should conduct a risk assessment and adopt appropriate precautions for infection control. In the police, this would be a dynamic risk assessment using the National Decision Making model.
For situations where close contact (less than 2 metres) with a person is unavoidable to fulfil the required duty (for example, when entering a household, carrying out an essential interview or arrest and restraint), the use of PPE as detailed above is recommended. The appropriate PPE for a specific situation needs to be assessed on a case by case basis.
Please note that this guidance is of a general nature. Employers should consider the specific conditions of each individual place of work and comply with all applicable legislation, including the Health and Safety at Work etc. Act 1974.