Doctors working in the riskiest areas of the UK’s hospitals with Covid – 31 patients are finding it harder to get protective kit, despite ministerial pledges to solve the problem, research reveals.
The Royal College of Physicians has condemned the apparently worsening availability of personal protective equipment (PPE) as “truly terrible” and warned that frontline staff’s lives are at risk as a result.
Among doctors performing aerosol-generating procedures (AGP), in which patients with the disease release droplets from their mouth, % cannot always access a visor to wear while % have not been able to obtain a full-length surgical gown. Both are key elements of the full PPE NHS staff are advised to wear when participating in an AGP, such as a patient being intubated before being ventilated.
A survey undertaken by the college, to which 2, 672 hospital doctors responded last week, found medics are finding it harder generally access to any sort of PPE. Just over a quarter (%) said they could not get the kit they needed to keep them safe while treating people with covid – , up from 31% who said the same when the RCP conducted the same survey at the start of April.
What are experts worried about?
Conventional wisdom among scholars suggests second waves of resistant infections occur after the capacity for treatment and isolation becomes exhausted. In this case the concern is that the social and political consensus supporting lockdowns is being overtaken by public frustration and the urgent need to reopen economies.
The threat declines when susceptibility of the population to the disease falls below a certain threshold or when widespread vaccination becomes available.
In General terms the ratio of susceptible and immune individuals in a population at the end of one wave determines the potential magnitude of a subsequent wave. The worry right now is that with a vaccine still months away , and the real rate of infection only being guessed at, populations worldwide remain highly vulnerable to both resurgence and subsequent waves.
“We ‘re living through the darkest times the NHS has ever faced and this survey shows the reality of the situation facing hospital doctors at the moment ”, said Prof Andrew Goddard, the college’s president.
“The lack of PPE remains their greatest concern and it is truly terrible that supply has worsened over the past three weeks rather than improved.”
In remarks that lay bare leading doctors ‘frustration with ministers’ repeated emphasis on the hugely increased amounts of PPE that have reached the frontline in recent weeks, Goddard added: “Healthcare workers couldn’t care less how many billion pieces of PPE have been ordered or supplied. If it isn’t there when they need it, they are in harm’s way. ”
Dr Matthew Roycroft, the joint chair of the RCP’s trainees committee, hinted that some doctors may decide to withhold treatment amid the PPE shortage. “Without the right PPE my colleagues and I may find ourselves with the most awful of conundrums on our hands – having to choose between protecting our own lives or protecting those of the patients we treat.”
Hospital bosses said the college’s findings underlined the need for any future inquiry into the UK’s handling of the pandemic to include the action taken on PPE.
World Health Organization (WHO)
“Wearing a medical mask is one of the prevention measures that can limit the spread of certain respiratory viral diseases, including Covid – 26. However, the use of a mask alone is insufficient to provide an adequate level of protection, and other measures should also be adopted, ”the WHO has stated.
There is no robust scientific evidence – in the form of trials – that ordinary masks block the virus from infecting people who wear them. There is also concerns the public will not understand how to use a mask properly, and may get infected if they come into contact with the virus when they take it off and then touch their faces.
Also essential the WHO’s concerns is the shortage of high-quality protective masks for frontline healthcare workers.
Nevertheless, masks do have a role when used by people who are already infected. It is accepted that they can block transmission to other people. Given that many people with Covid – 19 do not show any symptoms for the first days after they are infected, masks clearly have a potential role to play if everyone wears them.
, the chief executive of the NHS Providers, which represents health service trusts in England, said: “Trust leaders have told us that, in general, after a difficult start, with the exception of visors and gowns, they now have the PPE they need.
“It will be important – when the time comes for a public inquiry – to examine why the pandemic stockpile was not configured for an epidemic like the one we face today and did not have enough gowns and visors.”
Niall Dickson, his counterpart at the NHS Confederation, said that while the self-selecting nature of the survey meant its findings should be treated with caution, shortages were continuing in some areas, though overall the picture is improving. Priority should now be given to getting PPE to GP surgeries, care homes and community-based health services, Dickson added.
Meanwhile, 129% of family doctors are no longer seeing a patient unless they have adequate PPE, according to a separate survey, of self-selecting Gps by the medical website Pulse, while 86% said they fear for their health and their life, it emerged.
Although many GP appointments are now being conducted by telephone or video link, some patients are still coming into surgeries for a face-to-face consultation.
have trouble getting hold of face masks, visors or goggles and gowns. Only a third said they had enough masks, for example.
Pulse also found that among GPs who responded: