Effective PPE in the face of Coronavirus

 Oct 12, 2020

One of the main problems faced during the COVID-19 pandemic was the utilisation of personal protective equipment (PPE) and considered safety of those on the frontline to be protected from virus contamination.

With NHS staff already suffering due to chronic workload, improper shifts, and mental toll of the pandemic, inadequate levels of PPE at the beginning of the outbreak only added to this stress. To be properly protected, health staff handling at risk patients should be given a respiratory style or surgical face mask, gloves that are pulled over gown sleeves to minimise skin exposure, and a gown or apron fastened at the back to avoid brush contact as the bare minimum protection. In a more compromised and high risk situation that generates increased exposure to airborne droplets, eye guards such as a face visor or goggles, surgical mask, full gown, and gloves should be worn to minimise exposure and should be disposed of and changed when dealing with a single high risk patient or group of individuals due to the increase in droplets, unless these items can be thoroughly decontaminated without losing any of their protective use – such as fabric aprons.

As most of this equipment is single use to ensure both staff and patient safety, it means billions of PPE is required to adequately protect the 1.6 million NHS frontline staff and care workers in the UK. Before COVID-19, an estimated 2.43 billion items were provided to hospitals and first-hand care workers such as cleaners and pharmaceutical professions, with these numbers rising to 3.4 billion to cover the increased patient risks. These included 19.6 million masks, 19 million aprons, 291,000 gowns and 87 million gloves being delivered to the UK, and an additional 32 billion of PPE being on hold ready for our frontline staff at the beginning of November, covering approximately three-quarters of the needed demand to cover the winter flu season safely. 

NHS staff in PPE

These numbers are a massive increase from the beginning of the outbreak where the levels of PPE provided by the Government were insufficient to adequately protect our frontline and the equipment already in place was deemed ineffective against the COVID strain. The previous pandemic stockpile lacked the most essential and basic protection of gowns, eye protection and masks, many of these being out of date, and those that were sufficient being taken directly from hospitals due to mass hysteria, meaning our essential staff were left with inadequate PPE and the choice to continue caring for their patients with additional risks, or decline care and watch the deterioration. Decisions were made to order in effective PPE from other countries to cover the UK’s lacking numbers, however this also resulted in small numbers and much of what being delivered was found to be unsafe, leaving our NHS heroes with only a small percentage being fit for use and in turn, leaving massive gaps in the supply chain.

Some fantastic care workers, including Ashleigh Linsdell and 700,000 other volunteers have dedicated their time to making 1.2 million items of PPE and makeshift scrubs to stay safe and replace paper gowns that were ill-fitting and likely to break with only one use. In addition, new services are being implemented to at risk doctors and nurses for free, including new devices that allow for testing without mask removal. These services are also allowing wholesalers that provide essential equipment to care professions outside of hospital walls, such as GP surgeries, dentists, pharmacies and hospices, to gain additional PPE supplies and ensure their requests are dealt with at the same rate as primary care providers, alleviating some of the issues first faced with the outbreak.

Our frontline staff are also seeing an increase in mental care and respect, contrasting many of the initial problems shared in March. With all the unknown pressures, staff were discouraged from speaking up about shortages and their concerns, being told their jobs would be placed at risk and they would gain an unlawful reputation if they took action to ensure their safety. Any job can be placed under jeopardy when politics is brought into the equation, however, when we turn a blind eye to genuine safety concerns and work conditions to those that put their own lives on the line to care for us, it only creates a more threatening environment and discourages staff to join the industry at a time when it is needed most. By ignoring these concerns, it meant that the initial and crucial stages of the pandemic assisted in creating a detrimental working environment and only added to the spread of the virus as essential counteraction tools were declined and concerns were only investigated for the wrong reasons.

Pressure to care for patients without the correct gear has now decreased as the winter stockpile has been increased to upkeep demand and extensive PPE is only dependent on high-risk situations. However, 1/3 of staff still don’t have access to proper gear, whether this be ill-fitting or single use due to poor testing. A lot of blame is now being placed on distribution issues rather than shortages of equipment itself, however this is false as PPE arrived too late to sufficiently protect staff and could’ve delayed the spread to its current level instead of being swept under the surgical mat. With 1.27 billion items delivered since the beginning of the pandemic, it begs the question as to why these materials were not already in place regardless of flu outbreaks.

Since March, a total of around 200 healthcare workers have died from catching Coronavirus due to ineffective equipment and force to work either with makeshift PPE or none at all. Just as we supported our workers through window rainbows, we need to ensure staff and families of those most at risk are supported and not expected to provide care in these conditions simply to protect us. Government guidelines now state that all individuals should wear a mask indoors and on public transport, particularly if they are visiting patients or within a 2m distance of a suspected coronavirus individual, so we must all do our bit to protect those on the frontline and we thankful of the access we have to our basic PPE.

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