Demands for better protection for healthcare workers are growing following the death of two nurses in their 30s, while another frontline worker quit her job after being forbidden from wearing a face mask.
Areema Nasreen, 36, died shortly after midnight on Friday at Walsall Manor hospital in the West Midlands, where she had worked for 16 years. Aimee O’Rourke, 38, who joined the NHS in 2017 and worked at Queen Elizabeth The Queen Mother hospital in Margate, Kent, died hours earlier, on Thursday night. Both were mothers of three children.
Two NHS healthcare assistants have also died. The family of Thomas Harvey, 57, who worked in north-east London, believe he would still be alive today if he had been given proper personal protective equipment (PPE), they told Sky News.
Meanwhile, the Guardian has learned that Tracy Brennan, a healthcare assistant (also known as an auxiliary nurse) in north-west London, quit her job after she was not allowed to wear a surgical face mask she had bought herself.
In her resignation letter, Brennan chastised her superiors at Hillingdon Hospitals NHS foundation trust for barring her from wearing the mask to protect herself – and patients she was caring for – from contracting the deadly virus.
Brennan said she had returned to work after self-isolating for 14 days because her daughter had shown symptoms of Covid-19. She said that patients in the ward where she was working, which was not a coronavirus treatment ward, felt comfortable with her wearing the surgical mask and some positively encouraged her to do so.
The letter continued: “Upon arriving to work on Tuesday morning, whilst still wearing a mask, you asked me for a word in your office. You outlined to me that wearing a mask wasn’t following the trust policy and asked me to remove it. I responded stating that I wasn’t pleased with this instruction and defended myself stating that I was uncomfortable not wearing a mask while dealing with patients who may be carriers of Covid. However I adhered to the request.”
She said that later that day, while taking blood, a patient coughed into her unprotected face but, despite relaying details of the incident, she was still refused permission to wear her mask.
Brennan wrote: “With a heavy heart and sadness, I feel I have no alternative but to hand this letter in as my formal resignation and will be unable to work my notice due to not being allowed to wear sufficient PPE for the duties I perform.”
Her resignation comes as the government sought to quell a backlash from healthcare workers over PPE. On Thursday, the government and public health bodies upgraded the recommended PPE that healthcare professionals should be wearing amid criticism that the existing guidelines did not offer them enough protection.
But employers and unions warned that the upgrade would mean nothing without resolving the shortages that have led to clinicians improvising with snorkels and school science goggles.
At the daily Downing Street press conference on Friday, England’s chief nursing officer, Ruth May, invoked the deaths of Nasreen and O’Rourke as she urged members of the public to stay at home. “This weekend is going to be very warm and it will be very tempting to go out and enjoy those summer rays,” she said. “But please, I ask you to remember Aimee and Areema. Please stay at home for them.”
She added: “I worry that there’s going to be more and I want to honour them today.”
The face mask issue is particularly pertinent as the World Health Organization (WHO) is considering changing its guidance on whether people should wear face masks in public amid suggestions that their widespread use have played a role in containing outbreaks in some Asian countries.
On Thursday, in an about-turn, the mayor of New York, Bill de Blasio, advised people in the city to cover up their faces, following in the footsteps of Los Angeles. De Blasio stressed that “homegrown” protection was fine in a bid to prevent a run on the professional grade masks coveted by clinicians.
No 10 said on Friday that its advice continued to be that face masks are unnecessary outside. Matt Hancock, the health secretary, told Good Morning Britain: “Masks are very important to protect healthcare workers ... but that [asking the public to wear them] isn’t something that we’ve done here because … the whole basis of our response has been making sure that we follow the science.”
Experts remain divided on the issue but a study published in Nature Medicine on Friday, which included WHO-affiliated researchers, suggested surgical face masks may be effective in preventing the transmission of coronaviruses from symptomatic individuals.
Dr Rupert Beale, group leader of the cell biology of infection laboratory at the Francis Crick Institute, said the study, which he was not involved in, presented “strong and compelling evidence in favour of mask wearing as a means of reducing transmission of some viruses, including coronaviruses. Public health officials must immediately take note of this important new evidence.”
On Thursday, Donna Kinnair, the chief executive and general secretary of the Royal College of Nursing, raised concerns with the health secretary that nurse deaths were not being counted amongst the official coronavirus mortality figures.
On BBC’s Question Time, Kinnair pushed Matt Hancock to release statistics relating to healthcare staff. She said: “We haven’t even counted the nurses yet. I keep asking for the stats on nurses,” she said. “I didn’t know that, we will sort that out,” Hancock replied.
Paying tribute to Nasreen, Toby Lewis, chief executive of the neighbouring Sandwell and West Birmingham hospitals NHS trust, said it was clear from experiences in other countries – particularly Italy, where dozens of nurses and doctors have died – that healthcare workers were at risk.
“They are at risk not only from the patients we look after but from each other. There is additional grief counselling and psychological support being provided to staff because they are working in situations that are very different to those that they have worked in,” he said.
“Will more healthcare workers pass away? With the greatest regret I think that is a certainty. [However] it is our collective effort to try and minimise the number of tragedies that we see in the number of people who serve within the NHS.”
Nasreen, whose family have asked the media not to publish her picture, developed symptoms of coronavirus on 13 March, including aches, a high temperature and then a cough. She tested positive for the virus on 27 March.
In a tribute posted on Facebook, her friend Rubi Aktar said: “She was the most lovely, genuine person you could ever meet, she went above and beyond for everyone she met.
“I’m so grateful that I had the honour to call her my best friend. She saw me at my best and my worst and accepted my every flaw. I am so broken that words can’t explain.”
O’Rourke’s daughter Megan Murphy described her mother as an “angel”. She wrote on Facebook : “Look at all the lives you looked after and all the families you comforted when patients passed away. You are an angel and you will wear your NHS crown forevermore because you earned that crown the very first day you started!”
NHS England has insisted that PPE shortages are down to distribution problems rather than shortages but many remain sceptical. On Friday, a group of organisations including Doctors in Unite and the Doctors’ Association UK issued a demand that the government repurpose industry to produce adequate quantities of PPE, including face masks, preferably to the highest specification.
A Department of Health and Social Care spokesperson said: “In the past two weeks the NHS supply chain have delivered 397m pieces of PPE equipment. While we are confident that enough supply is now reaching the frontline, we appreciate there were limited distribution problems to begin with while we dealt with a new demand caused by this emerging epidemic.”
A spokesperson for the Hillingdon Hospitals NHS trust said: “Our trust takes the safety of all our staff extremely seriously and we follow national guidelines, as set out by Public Health England. We regularly update staff on the types of PPE and the rules for its use. Today [Friday] we are making sure our staff have sight of and understand the latest guidance on PPE that was released late yesterday. We are also providing extra support to our staff during the current emergency both for their physical and their mental health and wellbeing.”