PPE is still a frigging joke in this country.

[Sue]

I have a feeling that if it were possible to just wipe them down and reuse them, this would already be being done given the alternative is medical staff being exposed to a potentially lethal virus.

 

[Edie]

I’m getting a box of FFP3 from industry, from a factory in Brighouse. When I’m working OOH I am only allowed to use an FFP3 for patients with confirmed Covid. Suspected Covid, even those with sats<94, high resp rates and fevers we can only use FRSM. I’m immunosupressed and I’m a single mum so would quite appreciate not being intubated. I’ll share them with whoever I’m on with but I can’t supply everyone so feel a bit bad.

 

[cupid_stunt]

I have a feeling that if it were possible to just wipe them down and reuse them, this would already be being done given the alternative is medical staff being exposed to a potentially lethal virus.

It's probably a bit more than just a wipe down, the new tighter guidelines on PPE use, introduced this week, with the support of the Royal College of Nursing & other professional organisations says...

re-usable PPE can be used. Advice on suitable decontamination arrangements should be obtained from the manufacturer, supplier or local infection control .

[Withdrawn] COVID-19: infection prevention and control (IPC)

Guidance on infection prevention and control for seasonal respiratory infections including SARS-CoV-2.

www.gov.uk

 

[elbows]

It's probably a bit more than just a wipe down, the new tighter guidelines on PPE use, introduced this week, with the support of the Royal College of Nursing & other professional organisations says...

It was introduced on April 2nd, the April 10th updates were mostly just to provide further 'clarity'.

Its still terribly flawed and clearly driven by the practical realities of how much stock they have (& estimated future requirements). The RCN endorsed it because they were involved in the process and it was an improvement on the previous guidance (guidance which had a PPE downgrade on March 6th). Not that this is obvious from the RCN statement of April 2nd, where they limit themselves to saying things like:

As such, we are satisfied with the government guidance being issued today and we will be monitoring the situation with regards to the evidence of its efficacy and use. The success of this guidance will be judged by its implementation and communication to those who need it most.

RCN position on personal protective equipment (PPE) for COVID-19 | Royal College of Nursing

RCN position on personal protective equipment (PPE) for COVID-19

www.rcn.org.uk

Given the sheer number of PPE issues, they have compromised and have not gone after the most obvious remaining flaws in the guidance. This does not change the fact that the current PPE guidance still contains one of the most disgraceful and upsetting tables I have ever had the misfortune of seeing.

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/879107/T1_poster_Recommended_PPE_for_healthcare_workers_by_secondary_care_clinical_context.pdf

Of course the suspicion is that the government cant even live up to properly supplying everyone to be able to meet that limp guidance. The RCN is active on that front, eg:

 

[WouldBe]

No it isn't. The point of plastic is er it's plastic, it can be readily and cheaply made into various sorts of equipment, many of which (eg gloves, clothes, masks) are intended for a single use

While it may be difficult if not impossible to clean gloves, aprons and face masks because they are so flimsy face shields are thicker and therefore more easily cleaned. What I was trying to point out was that the virus won't be absorbed by the face shields so would be easier to remove from the surface something you couldn't do with a face mask which might not survive being cleaned or if it did might not have the same level of protection as a new one would.

 

[elbows]

From the BBC live updates page:

Analysis: Still not enough PPE, say NHS staff
Michelle Roberts
Health editor, BBC News Website
We are hearing more about shortages of personal protective equipment (PPE) from NHS staff. Masks, gloves and other clothing to stop the spread of coronavirus saves lives.
The Royal College of Surgeons of England has surveyed nearly 2,000 of its members who work in NHS hospitals. A third say they do not believe they have an adequate supply of PPE in their own hospital trust for them to safely do their job.
The college says doctors should not risk their own health if they do not have the right gear. This advice is echoed by the Royal College of Nursing, which says its members can refuse to treat patients as a "last resort" if adequate PPE cannot be provided.

12:49 of https://www.bbc.co.uk/news/live/world-52259683

 

[Pickman's model]

While it may be difficult if not impossible to clean gloves, aprons and face masks because they are so flimsy face shields are thicker and therefore more easily cleaned. What I was trying to point out was that the virus won't be absorbed by the face shields so would be easier to remove from the surface something you couldn't do with a face mask which might not survive being cleaned or if it did might not have the same level of protection as a new one would.

I wonder who you're expecting to clean these visors, if they can be cleaned

 

[elbows]

Revealed: value of UK pandemic stockpile fell by 40% in six years

£325m wiped off value of health department’s emergency stockpile including PPE

www.theguardian.com

UK government stockpiles containing protective equipment for healthcare workers in the event of a pandemic fell in value by almost 40% over the past six years, the Guardian has found.

Analysis of official financial data suggests £325m was wiped off the value of the Department of Health and Social Care (DHSC) emergency stockpile, reducing it from £831m in 2013 under the Conservative-led coalition government to £506m by March last year.

The finding is likely to raise further questions for the health secretary, Matt Hancock, who faced criticism over the weekend after urging healthcare workers not to “overuse” personal protective equipment (PPE).

Accounts suggest funding for “stockpiled goods” that are “held for use in national emergencies” was increased between 2008 and 2011, when pandemic preparedness was identified as a national priority for the NHS. But since 2013 the value of the stockpile has fallen.

The findings are likely to renew questions about whether government stockpiles held sufficient quantities of personal protective equipment (PPE) before the Covid-19 pandemic and whether emergency preparations were affected by almost a decade of cuts and reduced public investment.

The stockpiled goods have shelf lives and so require frequent replenishment. According to the DHSC’s financial accounts, between 2011 and 2019 depletions of the emergency stockpile significantly outstripped the amount spent on adding new supplies to the reserves.

A spokesman for DHSC said the value of the emergency stockpile “does not relate to the volume of its contents”, adding that “through responsible procurement” officials had been “successful in maintaining its stock”.

The department refused to answer the Guardian’s questions about the volume of the stockpile in 2019 compared with 2011.

The government is refusing to release the official conclusions from Exercise Cygnus, which have never been made public, but there are indications in reports by local authorities who participated in the exercise that PPE supplies were an area of concern.

It is not clear whether at a national level the conclusions included recommendations about emergency stockpile funding. But DHSC accounts show that in the three years after the 2016 drill, the value of the stockpile fell by more than £200m.

As for this last bit, this would constitute further clues about why the UK PPE advice was downgraded on March 6th:

According to minutes from early February, Nervtag went on to make a series of recommendations to the government’s emergency committee Cobra about what PPE would be required for different settings and different groups of workers. A month later, in early March, advisers discussed a potential scenario where stocks of respirator masks ran out.

 

[WouldBe]

I wonder who you're expecting to clean these visors, if they can be cleaned

So if a health care worker contaminates their specs are they supposed to bin them as well? Or do you just clean the fucking things.

I notice from a link up thread that goggles are supposed to be used as a one off. Funny how in the chemical industry if you splashed them with corrosive liquids like acids or alkalies or got organic solvents on them or even something toxic you just clean them an carry on resusing them. You only replace them if damaged.
I've still got and use a pair I had when I did my chemistry degree 40 years ago.

 

[Pickman's model]

So if a health care worker contaminates their specs are they supposed to bin them as well? Or do you just clean the fucking things.

I notice from a link up thread that goggles are supposed to be used as a one off. Funny how in the chemical industry if you splashed them with corrosive liquids like acids or alkalies or got organic solvents on them or even something toxic you just clean them an carry on resusing them. You only replace them if damaged.
I've still got and use a pair I had when I did my chemistry degree 40 years ago.

we're not talking about safety specs or goggles.

 

[2hats]

Urgent research at Yale into sterilising used PPE masks with hydrogen peroxide vapour has yielded promising results: complete cleaning within one cycle and masks surviving at least five cycles (DOI: 10.1101/2020.03.24.20041087).

 

[WouldBe]

we're not talking about safety specs or goggles.

I wasn't on about safety specs. By specs I meant those things you use to correct visual defects. You're not going to bin those if they get contaminated.

Anyway if you can clean and reuse goggles or safety specs why can't you clean and reuse face shields?

 

[Pickman's model]

I wasn't on about safety specs. By specs I meant those things you use to correct visual defects. You're not going to bin those if they get contaminated.

Anyway if you can clean and reuse goggles or safety specs why can't you clean and reuse face shields?

You're assuming you can. And you're assuming it's only the visor needs cleaning, but these aren't just transparent plastic. You're assuming these are only used by staff. You're assuming it is practicable for them to be cleaned. Perhaps a chemistry lab and a coronavirus ward aren't equivalent in the hazards they pose or the cleanliness required.

 

[WouldBe]

You're assuming you can. And you're assuming it's only the visor needs cleaning, but these aren't just transparent plastic.

Why wouldn't they be? If you sneeze on your monitor or spit your drink / food on it due to something funny, do you just leave it until it goes mouldy and eventually drops of or do you clean it even though it's made of plastic?

You're assuming these are only used by staff.

The patients and visitors (not that visitors are allowed) don't wear them. Who else is supposed to be wearing them?

You're assuming it is practicable for them to be cleaned.

Someone up thread has already posted a uni's research that shows they can.

Perhaps a chemistry lab and a coronavirus ward aren't equivalent in the hazards they pose or the cleanliness required.

While covid19 may not kill you there are lots of things in chemistry labs that will and can kill in minutes not days.

 

[Pickman's model]

Why wouldn't they be? If you sneeze on your monitor or spit your drink / food on it due to something funny, do you just leave it until it goes mouldy and eventually drops of or do you clean it even though it's made of plastic?


The patients and visitors (not that visitors are allowed) don't wear them. Who else is supposed to be wearing them?

Someone up thread has already posted a uni's research that shows they can.


While covid19 may not kill you there are lots of things in chemistry labs that will and can kill in minutes not days.

If you're so exercised about it perhaps you should share the uni research with this hospital getting through 900 of the things each day. Maybe you could volunteer to clean them too. I'm not sure why you're so bothered about this but it's not something that I'm losing sleep over so I'll leave you to froth about it with c_s

 

[WouldBe]

I'm not sure why you're so bothered about this but it's not something that I'm losing sleep over so I'll leave you to froth about it with c_s

Doh perhaps because NHS staff wouldn't have such a shortage of PPE if it could be reused.

 

[weltweit]

Doh perhaps because NHS staff wouldn't have such a shortage of PPE if it could be reused.

As I understand it scrubs are washed and reused, so recycling of kit isn't ruled out, I think visors could be cleaned rather than be a one time item, although I have heard quite a few new providers are making them now if there are shortages still cleaning should be considered.

 

[WouldBe]

As I understand it scrubs are washed and reused, so recycling of kit isn't ruled out, I think visors could be cleaned rather than be a one time item, although I have heard quite a few new providers are making them now if there are shortages still cleaning should be considered.

A lot of people making them are individuals with 3D printers doing it at their own cost.

 

[8ball]

Got people on my street making scrubs with sewing machines...

 

[weltweit]

I don't know what the current advice for medical staff in intensive care is, ( and I am not a medical health worker ). As I understand it advice has been changing frequently and accusations are that it changes in response to availability of PPE rather than clinical need. At one point advice seems to have been that PPE was changed between patients. So staff worked on one patient with their first set of PPE then changed their PPE before moving to the next patient.

This certainly explains the vast amount of PPE required. And I didn't understand, because in covid-19 wards both patients ( all patients ) will already be infected with the same virus so why the need to change PPE you can't infect someone who already has the virus?

 

[8ball]

I don't know what the current advice for medical staff in intensive care is, ( and I am not a medical health worker ). As I understand it advice has been changing frequently and accusations are that it changes in response to availability of PPE rather than clinical need. At one point advice seems to have been that PPE was changed between patients. So staff worked on one patient with their first set of PPE then changed their PPE before moving to the next patient.

This certainly explains the vast amount of PPE required. And I didn't understand, because in covid-19 wards both patients ( all patients ) will already be infected with the same virus so why the need to change PPE you can't infect someone who already has the virus?

Good question. Not my area. Interested in the answer, though.

 

[Pickman's model]

Doh perhaps because NHS staff wouldn't have such a shortage of PPE if it could be reused.

I'm talking specifically about these 900 masks, not the general dearth. As my post made clear. And the nhs wouldn't have such a shortage of the government had decided to stockpile sufficient to support the pandemic plans made.

 

[Pickman's model]

.

 

[WouldBe]

I'm talking specifically about these 900 masks, not the general dearth. As my post made clear. And the nhs wouldn't have such a shortage of the government had decided to stockpile sufficient to support the pandemic plans made.

What has happened in the past is in the past. We have to deal with what is available now. Cleaning face shields and reusing them will help the situation and help protect our NHS staff.

 

[Edie]

Interesting article here about what the problems have been logistically with PPE.

Is protective equipment getting to NHS staff on the coronavirus frontline? Here's the truth | Chris Hopson

Yes, there are shortages but there are huge logistical challenges – and NHS leaders are making massive efforts to fill the gaps, says Chris Hopson of NHS Providers

www.theguardian.com

In summary, centralised supply chain, major overwhelm of demand, suppliers (particularly of gowns) in China and fierce international competition.

Sounds like everyone is doing their absolute best.

 

[weltweit]

Edie do you have a view on my question above: PPE is still a frigging joke in this country. it is probably posed out of ignorance to the issues - it would be good to have a response from someone who knows what they are talking about ?

 

[Edie]

Edie do you have a view on my question above: PPE is still a frigging joke in this country. it is probably posed out of ignorance to the issues - it would be good to have a response from someone who knows what they are talking about ?

The wards I work on OOH are not exclusively covid positive.

 

[platinumsage]

Same story with body bags. They're running out, but at the same time they're apparently not really necessary and also the NHS has an adequate stock of them.

 

[elbows]

Shortage of gowns is in the news.

Coronavirus: Gown supply 'critically low' in some hospitals

It comes as the number of coronavirus deaths in UK hospitals rises to 11,329 - up by 717 since Sunday.

www.bbc.co.uk

 

[kalidarkone]

UK missed three chances to join EU scheme to bulk-buy PPE

Britain not part of €1.5bn order for kit to protect against Covid-19 despite shortages in NHS

www.theguardian.com