Intended for healthcare professionals

Letters Legality of government’s PPE guidance

Covid-19: Questions remain over UK government’s PPE guidance

BMJ 2020; 369 doi: (Published 15 May 2020) Cite this as: BMJ 2020;369:m1964
  1. John Puntis, consultant paediatrician
  1. Leeds LS8 1DW, UK
  1. john.puntis{at}

Staff should not need to fight for adequate protection at work, but the legal challenge launched against NHS England’s guidance is surely born of desperation.1

Initially the management mantra was that there were adequate national supplies of personal protective equipment (PPE) but problems with local distribution.2 When this became untenable, staff were blamed for using up PPE inappropriately.3 The narrative then changed to: “We share your pain and have done our utmost, but the increased international demand for PPE has made it unobtainable.”4 Despite government promises to fix things, surveys by the Royal College of Physicians indicated a deteriorating situation prompting its president to remark: “Healthcare workers risking their lives couldn’t care less how many billion pieces of PPE have been ordered or supplied. If it isn’t there when they need it, they are in harm’s way.”5

The current guidance for PPE does need clarification. Was the US Centers for Disease Control and Prevention right in saying that the FFP (filtering facepiece) mask should be default rather than the fluid resistant surgical mask?6 Is it OK to reuse equipment originally intended for single use?7 Why is generating an aerosol by doing something to make a patient cough regarded as high risk when a patient generating an aerosol by coughing is not? Is it right to state categorically that covid-19 is not airborne (in which case why worry about aerosols at all)?8 Risk from pandemics has been rated high in the UK for at least 15 years,9 most recently in the 2019 National Security Risk Assessment,10 yet recommendations to stockpile PPE were ignored.11

International workers’ memorial day on 28 April was focused on deaths from covid-19.12 The 1960s Detroit car workers song provides a suitable anthem: “I don’t mind working, but I do mind dying.”13


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