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Coronavirus: Has the NHS got enough PPE? Coronavirus: Has the NHS got enough PPE?
(4 days 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 treating patients in hospitals and in 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 there is enough of this "precious resource" to go around. 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.
But supply of protective gowns is critically low in some hospitals, according to Chris Hopson, chief executive of NHS Providers in England.
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?
The government says it has provided more than 761 million pieces of PPE across the UK, which includes: By the weekend of the 18/19 April, one billion items of PPE will have been shipped in the UK - according to Health Secretary, Matt Hancock.
The 761 million figure also includes body bags, pulse oximeters, swabs, clinical waste containers, cleaning equipment and detergent to NHS Trusts. The government has not yet given a breakdown of those items, but on 10 April, when it said it had provided 761 million pieces of PPE, it gave the following details:
The 761 million figure also included body bags, pulse oximeters, swabs, clinical waste containers, cleaning equipment and detergent to NHS Trusts.
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.
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.
Gowns, aprons, gloves and surgical masks should be disposed of after a single use or session.Gowns, aprons, gloves and surgical masks should be disposed of after a single use or session.
All PPE worn during the highest risk situations - where there will be lots of splatter from infectious droplets - should be single use.All PPE worn during the highest risk situations - where there will be lots of splatter from infectious droplets - should be single use.
Goggles or face shields can be reused if they are decontaminated, however.Goggles or face shields can be reused if they are decontaminated, however.
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.
Business Secretary Alok Sharma told the BBC's Andrew Marr Show on Easter Sunday: "There is clearly a need for more gowns, there is clearly a need for more PPE. But the government has a plan. NHS Providers, whose members include health trusts, says coveralls are being used as alternatives to gowns - with some fire and police services, local authorities and vets donating their stocks.
In the government's daily press briefing on Sunday, Health Secretary Matt Hancock said 121,000 gowns had been delivered in the last couple of days, but added: "Until everyone gets the PPE they need then we won't rest." On 17 April, the deputy chief executive of NHS Providers, Saffron Cordery, said: "The supply of clinical gowns is now critical and it's clear some trusts will run out of fluid repellent gowns this weekend."
However, Mr Hopson, from NHS Providers in England which represents hospital trusts, said the number of protective gowns available to NHS staff in some parts of the country was "very, very low". Emails seen by the BBC reveal Public Health England has been looking at whether protective gowns and masks could be reused as a "last resort".
He said that the NHS ordered "a whole load of stock" weeks ago, but delays have been caused by the gowns sometimes failing safety tests, while other batches have been mislabelled. In the government's daily press briefing on Easter Day, Mr Hancock said: "Until everyone gets the PPE they need then we won't rest."
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?
Supplies of personal protective equipment (PPE) in London and Yorkshire are at "dangerously low levels", according to the BMA. The British Medical Association, which represents doctors in the UK, reported at the start of the Easter weekend that PPE supplies in London and Yorkshire were at "dangerously low levels".
Dr Chaand Nagpaul, BMA council chairman, said doctors were being forced into a corner and faced "heartbreaking decisions" over whether to carry on without proper protection. Dr Chaand Nagpaul, the BMA's council chairman, said doctors were facing "heartbreaking decisions" over whether to carry on without proper protection.
A doctor who warned the prime minister about a lack of PPE for NHS workers died after contracting coronavirus. Consultant urologist Abdul Mabud Chowdhury, 53, died at Queen's Hospital in Romford, east London, on Wednesday. A third of surgeons and trainees surveyed by the Royal College of Surgeons of England have said they don't believe they have an adequate supply of PPE in their NHS trusts.
The Royal College of Surgeons of England says doctors should not risk their own health if they do not have the right gear to stay safe. More than half of nearly 2,000 people surveyed said there had been shortages across a 30-day period up to the end of the first week of April.
This advice is echoed by the Royal College of Nursing, which says its members can refuse to treat patients as a "last resort" if adequate PPE could not be 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.