Contagion fears as NHS is forced to ration equipment

BMA raises concerns over inadequate access to protective clothing when treating high-risk patients

HOSPITALS have been accused of rationing protective equipment so that staff can only use the most effective kit when putting Covid-19 patients on ventilators.

NHS doctors say they risk spreading coronavirus around supermarkets and on public transport because, other than when performing intubation, they spend the rest of the time treating patients while wearing normal scrubs.

Their fears were echoed by the British Medical Association (BMA), which yesterday wrote to the government expressing “deep concerns” over inadequate access to personal protective equipment (PPE).

Last night, health chiefs conceded that rules over staff protection when treating Covid-19 patients have been relaxed in recent weeks.

Clinicians had previously been obliged to wear an FFP3 ventilator mask and full gown while treating any patient with coronavirus.

But Public Health England (PHE) said that now applied only to procedures with a risk of aerosolisation – principally the application of ventilators – describing the previous regime as “in excess of what is needed”.

However, the BMA says this amounts to an “apparent discrepancy” between this approach and World Health Organisation Rules.

Jeremy Hunt, former health secretary and now chairman of the Commons health select committee, yesterday described the lack of protection for NHS staff as “heartbreaking”.

It comes as news of medics brought down by Covid-19 began to emerge, with NHS England revealing that at least one consultant has died after being infected.

On Friday, exhausted nurses at Northwick Park Hospital in London were photographed wearing bin bags as makeshift protection.

Dr Lisa Anderson, a consultant cardiologist at St George’s Hospital in south London, said: “Our staff are working 12 hours in bays of patients coughing all over them and then they are wearing the same uniform all around the hospital and then back on the Tube. We’re walking out, we’re going to Pret, we’re going to Sainsbury’s where there are elderly patients in the morning – this a situation which can’t continue.”

She added: “The equipment has arrived, but they have changed the rules so you can only wear that equipment when you’re intubating a patient – when you are putting an endotracheal tube down [somebody’s throat] to put a patient on to the ventilator.

“Once the tube is down, you no longer have to wear this protective equipment, so whole wards of infected patients are being treated without protection.”

Staff at the Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust were among thousands across the country concerned by the change.

They received a memo on Friday, seen by The Sunday Telegraph, stating: “PPE requirements for suspected and confirmed cases of Covid-19 has changed. This includes no longer needing to wear an FFP3 mask in general ward areas, or a full gown.”

However, a doctor from East London who has been trained to carry out PPE fit testing for other staff – to ensure the equipment fits them and does not have any leaks – expressed concerns yesterday about the level of protections the masks actually give.

Speaking to The Sunday Telegraph on condition of anonymity, the doctor revealed that hospitals have recently moved from using a bitter-tasting gas to check for leaks in their masks to a more precise machine test.

During a recent staff training exercise, every single mask allegedly failed the test. The staff were told that there were no alternative masks available to them, and that there was a small supply of more expensive masks that did pass the test, but these were being kept for consultants.

Meanwhile a letter to Boris Johnson from BMA chair Dr Chaand Nagpaul said: “Doctors from across the UK are exposing themselves to great levels of personal risk in their commitment to treat ill patients with Covid-19.

“They deserve to be supplied with the right equipment to protect them from infection as they carry out their duty of care to the population.

“We are receiving frequent reports from medical staff working on the front line they are not being provided with the correct type or enough PPE.

“Our doctors need to be sufficiently safeguarded as they battle this pandemic.”

Jake Dunning, from PHE, defended the policy change, saying initial guidance on personal protective equipment was developed during the early days of the outbreak, and was “in excess of what is needed”.

“As Covid-19 patient numbers increase, and continue to increase in coming weeks in the UK, we no longer have the luxury of using the easiest ‘no need to think’ single ensemble approach for every scenario,” he said.

“We should not and cannot use PPE that is not necessary for the task at hand.

“By rationalising the PPE recommendations, so that the right tools are used for each job (clinical scenario), according to transmission risks, we will help ensure that we do not run out of PPE.”