UK COVID-19 Daily: doctors buying own PPE or relying on donations

  • Tim Locke, Medscape.com

  • UK Medical News
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These are the UK coronavirus stories you need to know about Sunday.

Nearly half of UK doctors responding to a BMA survey said they have to buy their own PPE or rely on donations.

The online survey between 28th-30th April was completed by 16,343 doctors.

Questions included:
  • Have you had to purchase items of PPE directly yourself, or received supplies as an external donation due to non-availability of official NHS procurement supplies? Overall just under 50% said yes (38% of hospital doctors, 55% of GPs).

  • If you have not reported or spoken out about an issue – PPE, staff shortages, testing, drug shortages - why was this? Fearful to do so, said 7%, while 30% didn’t think anything would be done about it.

  • Taking everything into account, do you feel safely protected from coronavirus infection in your place of work?” Not at all or partly protected said 65%.

  • During this pandemic, do you consider that you are currently suffering from depression, anxiety, stress, burnout, emotional distress or other mental health condition relating to or made worse by your work? Half did not experience these feelings while 28% said they did and it was worse because of the crisis.

Commenting on bought and donated PPE BMA Council Chair Dr Chaand Nagpaul said in a news release: "On the one hand it shows how resourceful they have been and how much support there has been from the general public in providing kit; but far more importantly, it is a damning indictment of the Government’s abject failure to make sure healthcare workers across the country are being supplied with the life-saving kit they should be."

Crowdfunding PPE Legal Action

In a separate development husband and wife doctors, Nishant Joshi and Meenal Viz, are making progress towards crowdfunding a legal challenge over PPE. They say: "It is the government's duty to protect its healthcare workers, and there is great anxiety amongst staff with regards to safety protocols that seem to change without rhyme or reason." 

They argue the Government guidance on PPE is influenced by supply, not science:

  • It is not in line with the international standards set by the World Health Organisation or domestic legislation regarding health and safety at work;

  • It exposes healthcare workers to a greater risk of contracting COVID-19 and fails to address the greater risks faced by BAME healthcare workers;

  • It is unclear and has resulted in inconsistent practices across NHS Trusts;

  • It fails to make clear the level of risk faced by healthcare workers depending on the level of PPE they can access or that healthcare workers have a right to refuse to work without adequate PPE;

  • The guidance falls short of recommendations previously published by PHE.

At the time of writing they'd raised £11,665 towards their £60,000 target.

Their solicitor, Basmah Sahib, said: "No healthcare worker should face disciplinary action just for requesting proper protective equipment. We hope the guidance will be brought up to the standards of the WHO and that hospitals will update their practices accordingly."

'Much More To Do'

At the Downing Street briefing, Cabinet Office Minister Michael Gove gave statistics for PPE items delivered in recent weeks, "But there is much more to do," he conceded. 

He added: "I would never say that we were on top [of PPE], I would always say that we were doing everything that we can. And it's naturally of concern to any of us, if people on the front line don't have the right personal protective equipment."

He went on to suggest the BMA survey was skewed by GP data: "The BMA does an excellent job, principally but not exclusively in representing people in primary care, GPs and so on, and it has been the case in the past that for those in general practice that they will have been sourcing quite a lot of their own equipment themselves in any case. 

"But of course, we want to make sure that we do everything at an NHS level and beyond to support everyone who does have the right personal protective equipment." 

He added: "There will be an opportunity in due course, to look back and to see what we've got right and what we haven't got right when it comes to making sure that frontline workers get everything that they need. In the meantime, though, all our focus is on making sure that we can do as well as possible in supporting people who are putting everything on the line to look after us."

"It is absolutely critical," Professor Stephen Powis, national medical director of NHS England said, "that Government stays on top of that challenge and PPE is provided for frontline staff."

PM's 'Death of Stalin' Experience

While Boris Johnson was in ICU at London's St Thomas' Hospital, on 7th April the Foreign Secretary Dominic Raab said the PM "remains in good spirits". The following day the Prime Minister's spokesperson again said Mr Johnson remained in "good spirits".

We now have a very different account from an interview Mr Johnson gave to the Sun on Sunday, with plans being prepared to announce his death. "The bloody indicators kept going in the wrong direction," he told the paper.

"To be honest, the doctors had all sorts of plans for what to do if things went badly wrong.

"I was not in particularly brilliant shape because the oxygen levels in my blood kept going down."

At one stage he said: "It was 50-50 whether they were going to have to put a tube down my ­windpipe," and: "They were starting to think about how to handle it presentationally..."

Quoting the film comedy where the Russian president dies and cronies vie to take over: "They had a strategy to deal with a 'Death of Stalin’-type scenario. I was not in particularly brilliant shape."

Deaths and Case Data

Another 315 UK COVID-19 deaths were announced on Sunday taking the total to 28,446. Numbers are typically lower at the weekend due to reporting delays.

Of the 327 deaths in English hospitals (reported on a different timescale to the statistics above), patients were aged between 46 and 101. Of these, 17 aged between 47 and 97 had no known underlying health condition.  

Professor Powis gave the Downing Street briefing an update on the latest data.

Another 76,496 more COVID-19 tests were carried out or put in the post in the last 24 hours, dropping below the Government's 100,000 a day target, "a little bit of a dip in the weekend," he said.

On new cases: "Even with more testing, it's evidence that the rate of infection in the community is declining."

On hospital bed occupancy: "Since the middle of April we have begun to see a decline in the overall number of people in hospital. And that again is evidence that the transmission rate of the virus in the community is falling, and that is translating into fewer people being admitted into hospital." 

On critical care bed use: "Once again, as a proportion, this has been declining."

On deaths: "It does appear that we are past the peak of deaths too, and we are beginning to see a decline in the number of deaths, which of course is good news."

The R (reproduction) value is still currently around 0.7, Prof Powis said. But work is underway to refine this involving random community testing.

NHS and Healthcare Deaths

Of the recently announced NHS deaths was Philomina Cherian, 63, a staff nurse at the Acute Assessment Unit at John Radcliffe Hospital in Oxford. 

The hospital's Chief Nursing Officer Sam Foster paid tribute: "She was an incredibly caring friend and colleague who will be terribly missed by us all. Many of you will have known her and worked closely with her and I ask you to remember how she wonderfully cared for her patients and her colleagues, acting as an exemplar nurse to all who met her."

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

More News in Brief
  • The Isle of Wight is the test bed for the NHS contact tracing smartphone app, Transport Secretary Grant Shapps told Sky News. "Later in the month, that app will be rolled out and deployed - assuming the tests are successful, of course - to the population at large," he said, adding: "It's going to be a huge national effort. We need for this to work, 50% to 60% of people to be using this app." Prof Powis stressed the app is just one part of test, track, and trace: "It is likely to be one component of a number of measures that will be needed. I would think it's unlikely that on its own it is going to be the single measure or the single intervention that will ensure that the virus is always under control." 

  • Prof Powis was asked if the NHS Nightingale field hospitals were built in error, considering reports of low admissions. "I think you would be a hundred, a thousand times more critical if the NHS had not put in that extra capacity and had become overwhelmed, you would be quite rightly asking us why we had not gone, every mile that we could possibly go to put in that extra capacity. So the Nightingales were not built-in error, and we may still need them. We are not through this yet.” 

  • YouTube has followed Facebook in deleting the account of former TV sports presenter turned conspiracy theorist David Icke. He has wrongly linked COVID-19 to 5G phone masts. The site said the 68-year-old violated its policies on sharing information about coronavirus. The Google-owned site told the BBC: "YouTube has clear policies prohibiting any content that disputes the existence and transmission of COVID-19 as described by the WHO and the NHS. Due to continued violation of these policies, we have terminated David Icke's YouTube channel."

Adapted from Medscape UK.