Doctors warn UK coronavirus protective equipment shortages worsening

A nurse wears a protective face mask as she walks outside The Royal London Hospital in east London on April 18, 2020, during the novel coronavirus COVID-19 pandemic. (AFP photo)

An increasing number of doctors in the UK are being forced to treat coronavirus patients without protective equipment, a new report says.

A third of physicians working in high-risk settings have reported running short of long-sleeved gowns or full-face visors – a situation that has “worsened over the past three weeks”, the Royal College of Physicians (RCP) said.

Of those working in other hospital areas, 40 percent are not equipped with eye protection, while 15.5 percent are left without fluid-repellent face masks.

They are faced with the “awful” choice “between protecting our own lives or protecting those of the patients we treat”, one physician said.

The results of the RCP survey were disclosed as British foreign secretary Dominic Raab conceded that the government has fallen short on its promise made more than a month earlier by Prime Minister Boris Johnson that personal protective equipment (PPE) would be provided.
Asked when there would be “enough,” the stand-in prime minister said, “It’s very difficult to say that with precision and the kind of reliability that you want as a guarantee.”

And asked to acknowledge that some medical and care staff had been let down, Raab replied, “I think we’re not in the place on PPE that we’d want to be.”

The concession came as:

    Raab warned the public, “Social distancing measures are going to be with us for some time”.
    Johnson prepared to return to his Downing Street desk, three weeks after receiving oxygen while in intensive care in hospital.
    A government minister suggested furloughed workers should help pick crops when the harvest comes, to stop them rotting in the fields.
    The expert behind the smartphone app developed to track and trace potential coronavirus victims warned it required a 60 percent take-up to be successful.
    The number of hospital deaths from the coronavirus rose by 413 to more than 20,700 – as an NHS chief argued a gradual decline showed the lockdown was working.

On 18 March, Johnson told MPs there were “stockpiles of PPE”, insisting, “There is a massive effort going on.”
But the new survey has brought to light the continuing plight of its members working in “aerosol generating procedure” areas.

These are settings – including where patients are on ventilators, or there is manual ventilation, or open airway suctioning – where there is the highest risk of transmission of disease.

In a third of cases, the RCP uncovered shortages of long-sleeved disposable gowns (31 percent) and full-face visors (37 percent).

Some 26.5 percent of physicians surveyed reported being unable to access the equipment they need for managing Covid-19 patients – compared with 22 percent in a similar survey earlier this month.

The RCP further found that almost a quarter of respondents (23 percent) do not know how to raise concerns about PPE in their organisation.

However, staff absences have dropped from 18 percent to 8 percent in the past three weeks, according to the survey.

Furthermore, 91 percent of those who are symptomatic said they are now able to obtain coronavirus tests – up from 31 percent three weeks ago.

Andrew Goddard, the RCP’s president, said, “We’re living through the darkest times the NHS has ever faced and this survey shows the reality of the situation facing hospital doctors at the moment.

“The lack of PPE remains their biggest concern and it is truly terrible that supply has worsened over the past three weeks rather than improved.”

Dr Matthew Roycroft, joint chair of the trainees committee at the RCP, said, “Not only are many trainees working outside of our speciality areas, but we are also doing so without fully trusting that the government will support us when it comes to treating those with Covid-19.

“Without the right PPE, my colleagues and I may find ourselves with the most awful of conundrums on our hands – having to choose between protecting our own lives or protecting those of the patients we treat.

“This isn’t what any of us signed up for, and certainly isn’t a decision any doctor should have to make.”

Chris Hopson, chief executive of NHS Providers, which represents NHS trusts, said trusts were “working hard” to address shortages, such as sharing stock where possible and looking at safe ways of reusing some kit.

The far reaching effects of COVID-19 on the NHS

More than two million operations have been postponed after non-emergency surgery was cancelled for at least three months in a bid to free up beds for coronavirus patients.

The increasing backlog of procedures could cost the NHS £3 billion to work through and may result in many of the 20,000 doctors and nurses who have returned to the health service having to stay on once the Covid-19 crisis has been brought to heel.

According to NHS England, postponing the planned operations, which typically cost £1 billion per month, has released 12,000 beds for patients who have fallen ill after contracting the virus.

“We are probably only delivering around one third of our usual surgical activity and that’s nearly all for emergency and very urgent surgery. In the short term, we have to do a really major catch-up exercise to stop this backlog causing harm,” Prof. Derek Alderson, the president of the Royal College of Surgeons in England, told the Sunday People.

Operations for hip and knee replacements, cataracts and hernias have all been delayed to make beds available to cope with coronavirus cases. Outpatient procedures are also on hold.

The disruption to operations will have consequences for a varied range of patients, from those with cancer, whose tumors may grow while they are waiting for surgery, to those who are less able to exercise and become unfit in the run-up to physically demanding operations.
“The consequences are really serious,” Alderson said. “There are some patients who have cancers that are usually slow-growing but this may impact on long-term survival. A patient’s condition may deteriorate so they are no longer fit for the operation. Someone may be waiting for a hip replacement and may not be able to exercise and become even less fit for surgery. They may become addicted to opiates to manage their pain. Then there are all the mental health consequences.”

Alderson’s comments follow concerns raised by Cancer Research UK that the number of patients with suspected cancer who are being referred to hospital specialists has fallen dramatically. The charity believes more than 2,000 cancers are being missed each week and that many will become inoperable if they remain undetected. As estimated 400 cancers a week are being missed because normal screening programs for breast, cervical and bowel cancer have been suspended.

An NHS spokesperson said, “While NHS staff have pulled out all the stops to manage coronavirus cases, they have continued to work hard to ensure patients can safely access services.

“Next week we will set out new guidance on redeploying some of the treatment capacity that was created while the number of Covid-19 patients rose sharply. A public information campaign is reminding people the NHS remains open for business. It is important that non-Covid-19 patients can still safely access care and treatment.”