Medical unions warn UK stock of protective gowns is critically low

Doctors performing highest-risk procedures on Covid-19 patients lack vital supplies

Supplies of protective gowns used to safely treat coronavirus patients have become so depleted that they are no longer available to many doctors in high-risk roles, a medical union has warned.

Only 52% of clinicians carrying out aerosol-generating procedures – those with the greatest risk of transferring the virus – said they had access to the kind of full-sleeve gowns that are mandatory for jobs such as intubating patients so that they can be treated with a ventilator, according to a survey by the Doctors’ Association UK.

The association gathered responses from 500 members on Monday amid growing pressure on ministers to urgently resolve shortages of personal protective equipment (PPE) in parts of the NHS and in care homes.

Supplies of gowns were described as “hand to mouth” on Monday by Chris Hopson, chief executive of NHS Providers, the umbrella body for NHS trusts, who said that while no trust had fully run out, some stocks were “very, very low”.

Correctly made, the gowns resist droplets that can spread the virus and have been shown to be highly effective at protecting medical staff in Italy.

Gowns and full-face visors were not part of the national pandemic stock and so their delivery has been less reliable than that of face masks, aprons and gloves. A consignment of at least 100,000 gowns from China had to be rejected when it was found to be substandard, the Guardian understands. Other consignments that were labelled as gowns turned out to be different equipment.

Hopson said the supply of other PPE items was flowing well, but “over the last 72 hours, some trusts have run critically low on gowns”. An internal memo sent at the weekend to staff at Imperial College Healthcare NHS Trust in London and seen by the Guardian said: “low supply of fluid-repellent long-sleeved gowns nationally … is beginning to affect us”.

Concerns have been raised that the shortage of PPE could be increasing sickness and even deaths among health and care workers. The death toll among doctors and nurses continues to rise; the health secretary, Matt Hancock, said on Saturday that 19 NHS workers had died. He said: “We aren’t aware of any link from shortages of PPE to any of these deaths.”

“The supply of gowns has faltered to the point where many trusts may soon run out,” said Dr Samantha Batt-Rawden, president of the Doctors’ Association UK. “Our data shows that nearly half of all doctors doing the highest-risk procedures … do not have access to gowns. This is unforgivable. Doctors are dying. Nurses are dying. Frontline staff have now had to take the PPE issue into their own hands. DAUK is working with crowdfunders including NHS Heroes Support and Let’s Beat Covid to help deliver donations of PPE to the frontlines, including 500 gowns this week. It is astounding that this effort has been left to frontline doctors who should be able to put all their energy into serving patients in fighting this pandemic.”

There are reports of particularly acute shortages of gowns in London hospitals, with doctors and nurses at St Mary’s in Paddington raising concerns about PPE. Dr Tom Dolphin, an anaesthetist at the hospital, said on Twitter that doctors and nurses were spending “hours longer in the red zones [coronavirus areas] than they should, to conserve PPE stocks” and that some “daren’t take breaks in case there’s no PPE when they return”. He said the comments did not refer to St Mary’s but reflected the experience of hospital doctors more broadly.

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Despite ministers’ almost daily assurances about PPE supplies, Dolphin said: “There is a disconnect between what government says and the reality on the ground for clinicians who can’t get PPE. Why? The Queen probably thinks the world smells of paint, because everywhere she goes it’s been freshly painted. Ministers visiting hospitals probably see people in full PPE.”

A nurse working at the same trust said gowns ought to be worn by staff in all circumstances when treating Covid-19 patients. “We are told full PPE is only for ‘aerosol-generating areas’, but all healthcare workers are exposed to the risk of aerosol-generating Covid,” they said. “I have resigned myself to getting the virus because I’m not adequately protected.”

Imperial College Healthcare NHS trust, which operates St Mary’s, has been approached for comment.

At the weekend, the business secretary, Alok Sharma, insisted “the government has a plan” to get PPE to where it is needed, while the home secretary, Priti Patel, stopped short of an apology for shortages, saying only: “I’m sorry if people feel there have been failings.”

The doctors’ union, the BMA, added that it had also received reports from members at hospitals in Yorkshire, Bedfordshire, Kingston-upon-Thames and Liverpool about gown shortages. The intensive care unit at one Liverpool hospital ran out of gowns and has started borrowing PPE from a paediatric hospital, it said. A hospital in Kingston ran out of gowns on Sunday, while a Yorkshire hospital also reported a severe shortage.

A Department of Health and Social Care spokesperson said 3.2m eye protectors, 750,000 FFP3-type masks (those offering the highest level of protection) and 130,000 gowns were among the PPE items that had been delivered over the weekend.

“Demand for this equipment is at unprecedented levels and several countries have placed export bans on the sale of PPE,” they said. “We are working around the clock to give the NHS and the wider social care sector the equipment and support they need.”

NHS England has been contacted for comment.

Contributors

Robert Booth and Diane Taylor

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