Doctors washing and reusing protective equipment as stocks run out

Doctors are being forced to wash personal protective equipment (PPE) to reuse it and are dipping their hands in a bucket of steriliser because hand gel has run out.

Comments gathered by the British Medical Association (BMA) and shared with the PA news agency show how, as recently as Monday, medics were being forced to work without adequate PPE, with some turning to bin liners instead.

Meanwhile, a carer told LBC radio she was wearing swimming goggles due to a lack of PPE.

Some doctors have been told by their NHS trusts to reuse gowns and some have donated their share of PPE to nurses and healthcare assistants due to shortages.

On Monday, an obstetrics and gynaecology trainee in the South East said there has been no eye protection for the last three weeks and there were no facilities to clean footwear.

“Surgical masks are not fluid resistant,” they said. “There are no reinforced gowns for high volume procedures (e.g. C-section).

“PPE equipment is in short supply – and often locked away. We have bought more than £4,000 worth of PPE over the last four weeks as a group of trainees.”

On the same day, an anaesthetics trainee in Scotland said: “We’re having to wash our visors in disinfectant because we don’t have enough.

“We also ran out of hand gel briefly and were provided with a bucket of steriliser to dip our hands in.”

A core medicine trainee in the East of England said: “Trust is now asking us reuse single-use gowns not only between patients but also when we leave and return from breaks.”

A foundation year doctor on a Covid-19 ward for the elderly in the North West said on Monday: “After the death of two of our nursing colleagues, the trust, on the same day, announced that gowns would no longer be amply provided, and we had to ration the remaining supplies amongst our staff, on our ward.

“We decided to let our nurses and healthcare assistants have priority with the gowns, as they have more patient contact-time. As the gowns completely ran out, some staff used bin bags instead.”

Meanwhile, an A&E doctor in the East of England said there were no gowns or scrubs on their most recent shift.

A GP from Berkshire said: “Unable to get basic PPE apart from aprons and gloves. Some surgical masks, no eye protection. We managed to buy 50 visors before the rush, and had six pairs of safety glasses left from the swine flu epidemic, which the nurses are using as they have closest contact with patients. They wash and reuse these after each session.

“Our local amateur dramatics group is making us scrubs for use in the ‘hot hub’ where we are seeing likely Covid patients to assess if they need hospital admission.”

Downing Street said it was “right that where possible strategies optimising the supply of PPE can be explored”.

“We understand that the Health and Safety Executive and Public Health England are continuing to discuss ways in which pressure can be eased on the supply chain, including potential of reusing certain equipment, but only where it is safe to do so,” the Prime Minister’s official spokesman said.

He said that more than 923 million pieces of PPE have been delivered in total to NHS trusts and care homes.

Care minister Helen Whateley said earlier on Wednesday that there has been a “global scramble for PPE” and distributing it to care providers and GPs has been a “massive logistical effort”.

She added: “It is a precious resource … we have to make sure it is used when you need it to either protect a member of the workforce or protect a patient, because people have been crying out wanting to use PPE all the time for everything and actually that is not the best way.”

But Jane, an independent living carer in Hampshire, told LBC she was having to wear her “mask and goggles” from her time spent as a swimming teacher.

“We have no PPE whatsoever,” she said. “We’ve tried every single avenue possible but we’ve got nothing.

“If the person I’m caring for gets sick, then I have to decide if I abandon her or risk my own life – I have my own health issues and I have a parent with terminal cancer.”

The comments come after a leaked Public Health England (PHE) document, seen by the BBC, shows national planning to reuse protective masks and gowns amid a “reduced ability to re-supply” PPE.

A draft document written by PHE and dated April 13 suggested solutions for “acute supply shortages” of PPE.

“These are last-resort alternatives, but, given the current in-country stock and the reduced ability to re-supply, we are suggesting that these are implemented until confirmation of adequate re-supply is in place”, it said.

The plans suggested a series of “last-resort arrangements”, including buying “building” or “sportswear” eye protection with extensions to cover the side of the eyes if there are no available goggles or face shields, and using washable laboratory coats and patient gowns where there are no available disposable gowns or coveralls.

It also suggests re-purposing face masks using various disinfection or sterilisation methods, including steam and UV disinfection.

The document said some of the measures would need to be reviewed and approved by the Health and Safety Executive (HSE).

Dr Chaand Nagpaul, chairman of the British Medical Association (BMA), said: “Despite recent assurances from Government, these distressing accounts show that some hospitals and practices across the country are still reporting critical shortages over the last few days, and the worrying lengths they are being forced to go to in dealing with this.

“The Government must be honest about supplies, and the BMA is again urging it to go to all lengths to boost domestic production and improve access to international supplies, including through co-operation with our European neighbours, so that health and social care staff get the right equipment when they need it.”

In a statement, Dr Susan Hopkins, Covid-19 incident director at PHE, said: “PPE is a precious resource and it is crucial that everyone in health and social care has access to the right protective equipment.

“All options are being considered to ensure this, including the safe reuse of items, but no decisions have been made.”

An HSE spokesman said: “In line with the Government’s PPE strategy, it is right that, where possible, strategies for optimising the supply of PPE should be explored.

“We are discussing with Public Health England ways in which pressure can be eased on the supply chain. This includes potentially reusing certain equipment where it is safe to do so.”