Covid-19: doctors still do not have #properPPE

Doctors are still struggling to get the personal protective equipment (PPE) they need, despite government promises, a BMA survey has found.

A BMJ campaign, supported by the BMA, was launched this month calling for healthcare workers on the frontline to be given the appropriate level of PPE and using #properPPE on social media.1

On 20 March Keith Willett, strategic incident director at NHS England and NHS Improvement, wrote to trusts and clinical commissioning groups to say that the NHS would provide them with “substantial extra deliveries” of PPE.2

A snapshot survey conducted by the BMA between 3 and 6 April has found, however, that many of its members do not feel properly protected at work. The survey found that of the 504 hospital doctors whose work included carrying out high risk, aerosol generating procedures (AGP), 48.41% (244) faced a shortage of FFP3 respirators.

Updated Public Health England guidance says that staff should wear these respirators when performing AGPs on patients with suspected or confirmed covid-19.3

Of the 518 GPs who responded to a question on PPE supplies, 43.63% (226) said they had shortages of fluid repellent facemasks. Asked whether they felt safely protected from coronavirus infection at work, 56.17% of hospital doctors (551 out of 981) said they felt “partly” safe while 30.99% (304) said they did not feel safely protected at all. Among GPs, half (241 out of 482) of respondents said they did not feel safely protected at all, while 47.72% (230) said they felt partly safe.

Accounts from doctors shared with the BMA and seen by The BMJ also show that the correct equipment is still not getting through to staff.

One clinical fellow in Wales said that they had no visors or eye protection on their intensive care unit. “Today I called my son’s secondary school and they have kindly donated goggles for us to use.”

Meanwhile, an emergency department doctor in London said, “We currently do not have enough FFP3 masks for fit testing—so all fit testing has been cancelled until we can source some more. Terrifying!”

Another doctor, who chose to remain anonymous, said, “I run the general surgery rota and I am truly horrified to see all our junior doctors are not being protected by PPE and they are now working with covid-19 positive patients. It’s a total disgrace. Daily, we are hearing of deaths of our doctors—this is so wrong and so scary.”

Doctors are also being forced to source, and in some cases, make, their own equipment. A doctor who chose to remain anonymous said, “I spent most of yesterday making scrubs for my GP colleagues.”

They added, “We have had donations of scrubs from vets and goggles from secondary school woodwork departments, the practice also purchased face masks from a local DIY store suitable for use with asbestos. It is crazy that the government is putting so many doctors’ and nurses’ lives at risk.”

Commenting on the situation, BMA Council chair Chaand Nagpaul said: “Despite continued pledges from the government assuring us that adequate supplies of PPE have been made available to the frontline, our snapshot survey shows that doctors in GP practices and hospitals across the country continue to face a lack of the right equipment to safely do their jobs.”

He added, “No doctor should be expected to risk their health—and ultimately their lives—when they go to work, or indeed put patients’ lives at risk as potential spreaders of disease. We therefore wholeheartedly support this campaign from The BMJ, which complements the BMA’s own work in pressuring the government to do the right thing in protecting doctors, healthcare workers, and their patients.”

A Department of Health and Social Care spokesperson said, “We are working around the clock to give the NHS, social care, and other public services the equipment and support they need to tackle this outbreak.

“Over the weekend we delivered over 34 million pieces of PPE to NHS trusts in England, including over 8.8 million aprons and seven million facemasks, and we have created a 24 hour hotline which NHS trusts can call to raise any supply problems.”