Some British Sikh doctors in the UK, who are part of the National Health Service (NHS) and at the frontlines of the Covid-19 outbreak, are protesting after they were forced not to take up key roles due to their beards. The Sikh Doctors Association (SDA) reported that at least five Sikh doctors were removed from their usual shifts at NHS hospitals for refusing to shave their beards and failing the “fit test” for critical facial protective gear. Sikh doctors have been recognised as a risk group whilst treating Covid-19 patients since many keep beards as a result of which face masks do not properly fit them and increase their risk of getting infected. What are the NHS guidelines regarding facial hair? While treating Covid-19 patients, healthcare workers are required to wear personal protective equipment (PPE), which includes face masks. While there are no official guidelines requiring workers to shave their beards, NHS employers have been asked to speak to staff and local faith groups to explain why facial hair is a concern while treating patients. The NHS Employers website notes: “Beards, stubble and facial hair cause a common problem when using PPE face masks, as this can prevent the mask being able to seal to the face and passing the fit test.” If staff are not willing to shave their facial hair, NHS employers have been given the option to shift clinical staff to non-clinical areas. Is there an alternative to face masks? An alternative to using masks are hoods or helmets, or specialist facial protective masks called Powered Air Purifying Respirators (PAPRs). However, these are more expensive, in short supply and require more training time, which makes them less feasible than the traditional masks. This shortage is the reason that British Sikh doctors are protesting, calling for a better procurement strategy of the specialist face masks by the NHS, which would allow them to maintain a beard while working. On its website, the SDA says, “A number of Sikh health professionals have expressed concerns to us over their NHS employing authorities requesting removal of facial hair, in the course of providing appropriately fitting FFP3 facemasks. These special masks are designed to be ‘fitted tightly’ to the face and do not confer the required protection from airborne viruses to wearers with beards. “Beards are a key article of the Sikh religious faith and identity. Shaving of facial hair for Sikhs goes against their religious faith,” it adds. The Sikh faith requires adherents to follow certain rules. Among these, hair is not to be cut. As per reports, the five Sikh doctors have now been given PAPRs. The regular cloth FFP3 masks are not effective with beards and therefore the shortage of PAPRs could also pose a problem for men belonging to other religions such as Islam. How does facial hair impact how masks fit the face? According to an article published in the British Medical Journal (BMJ), in contrast of regular masks worn by the general public that are designed as a two-way barrier to protect against droplets, FFP3 masks require a clean seal between the face and the mask, and while there is no hard evidence that they are effective, these masks have been recommended for use by healthcare workers. With a beard, it is not possible to maintain this seal since facial hair tends to create gaps around the edges of the mask, allowing pathogens to slip through. The extent to which facial hair may cause leakages, however, is not clear. While some argue that moustaches and certain types of beards do not impact face masks, research carried out in the UK in 2015 found that even a 24-hour stubble can affect the quality of protection a mask is able to provide. Source
