Self-protection: how NHS doctors are sourcing their own PPEBMJ 2020; 369 doi: https://doi.org/10.1136/bmj.m1834 (Published 06 May 2020) Cite this as: BMJ 2020;369:m1834
All rapid responses
Big data analytics has improved healthcare by analyzing electronic medical records, socio-demographic information, and environmental factors ; moreover, its tracking roles in emerging infectious diseases including the coronavirus pandemic have been discussed . In countries with single-payer universal healthcare systems (UHS), claimed data of payers could be an abundant source for analytics. On the other hand, compulsory social distancing, coupled with mass masking, has been widely adopted as strategy for non-specific symptoms at early stage COVID-19 . We propose that analytics based on proper concatenation of databases may prevent supply shortages for personal protective equipment (PPEs).
Taking Taiwan as an example, cloud computing-based healthcare databases within the UHS has alleviated the integration between primary care providers and hospitals, as well as reduced the cost of tracking procedure. Applying the same logistics to PPE allocation would allow PPE providers to manage the distribution of surgical masks on a real-time basis, and recognize the mask holders per insurance or passport number . With the help of data analysis, combining artificial intelligence and cloud technology, public health policy-making could be practicable. Thus when it comes to the implementation cost of epidemic prevention policies, Taiwan authorities adopt low stringent level strategies compared with other high income countries, but still have achieved epidemic control in the early outbreak .
After the 2003 severe acute respiratory syndrome outbreak, Taiwan CDC (TCDC) started transferring registered real-time infectious disease data to this established monitoring system, where PPE stockpiling platform was practiced. Therefore, prior to the official recognition of COVID-19 outbreak , PPE databases were subsequently concatenated by UHS to manage resource allocation and logistics when several cases were identified. Establishment of this application programming interface for mask-selling pharmacies under UHS required data transfers as well as managerial issues including governance and ownership, which interdepartmental communication was efficient within UHS. Specifically, the tracking system expands the healthcare informatics system that pharmacists are familiar with, which user friendly interfaces for these PPE providers and consumers help expedite processes in an efficient manner . UHS and TCDC have also promoted the system to increase the distribution channels, which government offices may also allot masks to lessen the burden on healthcare providers.
Since masks alone aren’t effective without combining infection-control measures , we recommend to utilize such integrative platform for the maintenance of more PPE stockpiles, including critical infection-control equipments, so as to reduce iatrogenic COVID-19 exposure.
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Competing interests: No competing interests
Social media has proven critical in highlighting discrepancies in the provision of PPE during this pandemic. In these uncertain times, clinicians world-wide are using social media to better understand the virus, share experiences and promote solidarity. Without question, it is providing clinicians with a much-needed voice during this pandemic, but we urge users of these platforms to exercise caution in their interactions.
In the United Kingdom alone - despite political briefings of ‘perfectly adequate supply of personal protective equipment (PPE)’ - social media has been used by front-line healthcare professionals to highlight inadequate access to WHO-standard PPE. The BMJ’s #properPPE Campaign (1) is an excellent example of how social media is proving critically important in vocalising the concerns of front-line healthcare professionals in an attempt to leverage political action.
Against this positive backdrop, social media has the potential to be damaging to the medical profession and perception of healthcare professionals. Numerous TikTok videos have emerged in an attempt to encourage people to stay at home and boost morale. With many of these ‘going viral’, some have faced public backlash for displaying staff dancing in full PPE (2), and even used as evidence of empty hospitals by individuals who believe the virus to be a ‘hoax’. Some of these videos can understandably be seen as insensitive by relatives who have recently lost a loved one in hospital. Do we want to risk losing public support and confidence in a time of such uncertainty?
As clinicians, we should strive to base our clinical practice on contemporary and robust evidence. There is an overwhelming amount of anecdote shared on social media by the public and clinicians alike. As a community we have to be careful in our communication, emphasising that whilst individual experiences are important, it can be misleading when taken out of context.
As the nation comes together each Thursday as part of the Clap For Our Carers campaign to recognise the efforts of the NHS workers, we urge clinicians to think how their social media posts might be interpreted by the public. Social media can be a friend and a foe in the COVID-19 pandemic era; we urge everyone to use this power responsibly and always think how a concerned public may interpret our communications.
Michael Drozd, MBChB MRCP
Mohammed Waduud, MBChB MRCS
Rebecca Sagar, BMBS MRCP
Sam Straw, MBChB MRCP
Thomas Slater, MBBS MRCP
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, UK
1) Chatfield C and Rimmer A. BMJ Wellbeing. BMJ 2020. https://www.bmj.com/wellbeing
2) Williams T and Duell M. Families of cancer patients pan 'disrespectful' videos of dancing NHS staff while patients are dying due to cancelled operations. Daily Mail. 22 April 2020. https://www.dailymail.co.uk/news/article-8245313/Fury-endless-showreel-N...
Competing interests: No competing interests