Coronavirus: Has the NHS got enough PPE?

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Unions have been concerned that some care workers do not have proper protective equipment

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.

The government says there is enough of this “precious resource” to go around.

But the British Medical Association (BMA) union for doctors say supplies are dangerously low in some parts of the country and staff are at risk.

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.

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.

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.

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.

Pharmacy staff who cannot keep 2m away from possible patients should wear a surgical mask.

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:

  • Deliveries to hospitals, hospices, care homes, home care providers, GPs, pharmacists and dentists
  • 158 million masks (surgical masks and more highly protective FFP3 masks, but it is unclear how many of each type)
  • 135 million aprons
  • one million gowns
  • 360 million pairs of gloves

The 761 million figure also includes body bags, pulse oximeters, swabs, clinical waste containers, cleaning equipment and detergent to NHS Trusts.

Is this enough?

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.

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.

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.

It is easy to see how a member of staff would need to use lots of PPE when following the guidelines.

Can supply meet demand?

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.

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.

There is a hotline that NHS and social care workers can call to request PPE.

What do NHS staff say?

Supplies of personal protective equipment (PPE) in London and Yorkshire are at “dangerously low levels”, according to the BMA.

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.

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.

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