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Coronavirus: Has the NHS got enough PPE? | Coronavirus: Has the NHS got enough PPE? |
(about 3 hours later) | |
Personal protective equipment (PPE) - masks, gloves and other clothing to stop the spread of coronavirus - saves lives. | Personal protective equipment (PPE) - masks, gloves and other clothing to stop the spread of coronavirus - saves lives. |
NHS staff in hospitals and the community need it to be able to do their jobs safely. | NHS staff in hospitals and the community need it to be able to do their jobs safely. |
The government says it's working "around the clock" to provide protective equipment, but there have been concerns that supplies of items like gowns are not reaching staff. | The government says it's working "around the clock" to provide protective equipment, but there have been concerns that supplies of items like gowns are not reaching staff. |
NHS staff have been advised by the Department of Health and Social Care to consider reusing some PPE. | |
What is PPE and who should wear it? | What is PPE and who should wear it? |
Anyone who comes into close contact with patients who may or do have coronavirus should wear some form of protection. That includes staff working in care homes, prisons and other community settings as well as in GP surgeries or hospitals. | Anyone who comes into close contact with patients who may or do have coronavirus should wear some form of protection. That includes staff working in care homes, prisons and other community settings as well as in GP surgeries or hospitals. |
The type of PPE required depends on the level of risk. | The type of PPE required depends on the level of risk. |
Guidelines recommend that anyone working within 2m (6ft) of a confirmed or suspected Covid-19 patient should wear an apron, gloves, a surgical mask and eye protection. | Guidelines recommend that anyone working within 2m (6ft) of a confirmed or suspected Covid-19 patient should wear an apron, gloves, a surgical mask and eye protection. |
Clinicians carrying out tasks that could generate airborne droplets of saliva loaded with the virus should use an even higher standard of protection, including disposable gowns, filtering respirators and face-shielding visors. | Clinicians carrying out tasks that could generate airborne droplets of saliva loaded with the virus should use an even higher standard of protection, including disposable gowns, filtering respirators and face-shielding visors. |
For example, that would include intensive care doctors getting a patient ready to go on a ventilator to support their breathing. | For example, that would include intensive care doctors getting a patient ready to go on a ventilator to support their breathing. |
What about ambulance staff and pharmacists? | What about ambulance staff and pharmacists? |
The ambulance driver does not need to wear any PPE, but the rest of the crew should wear the appropriate amount depending on the likely level of exposure and risk they face. | The ambulance driver does not need to wear any PPE, but the rest of the crew should wear the appropriate amount depending on the likely level of exposure and risk they face. |
Pharmacy staff who cannot keep 2m away from possible patients should wear a surgical mask. | Pharmacy staff who cannot keep 2m away from possible patients should wear a surgical mask. |
How much kit has the government sent out? | How much kit has the government sent out? |
Health Secretary Matt Hancock said that by the weekend of 18 and 19 April, one billion items of PPE would have been delivered in the UK. | |
The Department of Health and Social Care told BBC News on Sunday that between 25 February and 18 April there had been approximately 875 million items of PPE delivered to NHS Trusts and into social care systems in England. | |
It added that tens of millions of pieces had been distributed by devolved administrations in the rest of the UK. | |
The items delivered to NHS Trusts in England included: | |
Other equipment delivered included body bags, pulse oximeters, swabs, clinical waste containers, cleaning equipment and detergent. | |
Is this enough? | Is this enough? |
This is the vital question that is difficult to answer. | This is the vital question that is difficult to answer. |
There are around 1.58 million NHS staff across the UK in hospitals and the community. All of them will require varying amounts of PPE depending on the type of work they are doing. | There are around 1.58 million NHS staff across the UK in hospitals and the community. All of them will require varying amounts of PPE depending on the type of work they are doing. |
What can be reused? | What can be reused? |
Some bits of kit can only be used once per patient, while others can be used for whole sessions, such as during a ward round visit to many patients. | Some bits of kit can only be used once per patient, while others can be used for whole sessions, such as during a ward round visit to many patients. |
All PPE worn during the highest risk situations - where there will be lots of splatter from infectious droplets - should be single use, unless they can be decontaminated. | All PPE worn during the highest risk situations - where there will be lots of splatter from infectious droplets - should be single use, unless they can be decontaminated. |
Gowns, aprons, gloves and surgical masks should usually be disposed of after a single use or session. | Gowns, aprons, gloves and surgical masks should usually be disposed of after a single use or session. |
However, when there are shortages, guidelines now say NHS staff can reuse some kit where it is safe to do so, even if it is labelled as single use by the manufacturer. | However, when there are shortages, guidelines now say NHS staff can reuse some kit where it is safe to do so, even if it is labelled as single use by the manufacturer. |
The Health and Safety Executive says it recognises "some compromise" is needed when there are extreme shortages of kit and that these "exceptional circumstances" do not reflect its standard approach. | The Health and Safety Executive says it recognises "some compromise" is needed when there are extreme shortages of kit and that these "exceptional circumstances" do not reflect its standard approach. |
For example, some gowns could be washed by the hospital laundry and reused, it says. | For example, some gowns could be washed by the hospital laundry and reused, it says. |
It is easy to see how a member of staff would need to use lots of PPE when following the guidelines. | It is easy to see how a member of staff would need to use lots of PPE when following the guidelines. |
NHS Providers, whose members include health trusts, has thanked the fire and police services, vets, local councils, DIY stores and builders' merchants that have donated stocks of gowns and alternatives such as coveralls. | |
On 19 April, the chief executive of NHS Providers Chris Hopson, said: "No-one in the NHS wanted to be where we now are on gowns, with a significant number of trusts reporting critically low stocks." | |
Can supply meet demand? | Can supply meet demand? |
The government acknowledges it will require a "Herculean logistical effort" to get the right PPE to those who need it. | The government acknowledges it will require a "Herculean logistical effort" to get the right PPE to those who need it. |
Global demand for this equipment is at unprecedented levels and several countries have placed export bans on the sale of PPE. | Global demand for this equipment is at unprecedented levels and several countries have placed export bans on the sale of PPE. |
Ministers have recruited UK companies, like Burberry, to turn over production lines and start making PPE. | Ministers have recruited UK companies, like Burberry, to turn over production lines and start making PPE. |
Deliveries of kit will now happen every day, rather than every few days, says the government. | Deliveries of kit will now happen every day, rather than every few days, says the government. |
There is a hotline that NHS and social care workers can call to request PPE. | There is a hotline that NHS and social care workers can call to request PPE. |
What do NHS staff say? | What do NHS staff say? |
The British Medical Association, which represents doctors in the UK, criticised the advice that some single-use PPE could be reused. | The British Medical Association, which represents doctors in the UK, criticised the advice that some single-use PPE could be reused. |
"If it's being proposed that staff reuse equipment, this must be demonstrably driven by science and the best evidence - rather than availability - and it absolutely cannot compromise the protection of healthcare workers," said Dr Rob Harwood, chair of its consultants committee. | "If it's being proposed that staff reuse equipment, this must be demonstrably driven by science and the best evidence - rather than availability - and it absolutely cannot compromise the protection of healthcare workers," said Dr Rob Harwood, chair of its consultants committee. |
A BMA survey published on 18 April found that half of doctors working in high-risk areas reported shortages of long-sleeved disposable gowns and goggles. | |
The Royal College of Nursing says its members can refuse to treat patients as a "last resort" if adequate PPE has not been provided. | The Royal College of Nursing says its members can refuse to treat patients as a "last resort" if adequate PPE has not been provided. |