Mobilising equipment to protect health professionals from Covid-19

Tygerberg Hospital entrance at Covid-19 section. Picture: Joyrene Kramer/Spotlight
Tygerberg Hospital entrance at Covid-19 section. Picture: Joyrene Kramer/Spotlight

Last month’s guidance from the World Health Organisation (WHO) stated that “the current global stockpile of personal protective equipment is insufficient, particularly for medical masks and respirators; the supply of gowns and goggles is soon expected to be insufficient also.

“Surging global demand - driven not only by the number of Covid-19 cases but also by misinformation, panic buying and stockpiling - will result in further shortages of personal protective equipment globally. The capacity to expand production is limited, and the current demand for respirators and masks cannot be met, especially if the widespread, inappropriate use of personal protective equipment continues.”

The same sentiment is echoed by numerous international media reports on personal protective equipment shortages in the US and Europe. China also experienced the same challenge at the peak of the Covid-19 epidemic.

It is concerning when health professionals feel their health being put under threat because of personal protective equipment shortages.

With coronavirus cases soaring in the US, doctors, nurses and other front-line medical workers across the country are confronting a dire shortage of medical masks, surgical gowns and eye gear to protect them from the viral infection.

Covid-19 pandemic calls for elective surgery to be delayed to preserve personal protective equipment, in-patient capacity and other resources.

Some US doctors said they were increasingly anxious, fearing they could expose not only themselves to the virus, but their families too.

Some have posted on Twitter about having to reuse items meant for single use.

Personal protective equipment shortage in the US has led to some medical professionals starting a Twitter campaign #GetMePPE basically, appealing to the public and corporates to donate personal protective equipments to health professionals and establishments.

Some health departments have resorted to reaching out to the construction industry to make masks and respirators available to the health system and vice versa.

There are other industries that currently utilise personal protective equipment relevant to the medical fraternity and, these include mining, automobile, chemical production and non-medical laboratories, to name a few.

The pandemic calls for collective efforts because we depend on each other.

Both the public and private sectors needs to work together because public health issues are universal.

The global shortage of personal protective equipment is compounded by supply chain disruptions. Overutilisation and inappropriate utilisation of personal protective equipment beyond what is recommended in the WHO guidelines undermines the rational use of this soon-to-be scarce resource.

Every member of the society has a role to play in preserving appropriate access to personal protective equipment.

Members of the society can reduce the number of visits to the clinics, hospitals and doctors’ rooms to reduce exposure to the virus indirectly driving down the demand for personal protective equipment.

The pronouncement of Covid-19 as a national disaster in south Africa and call for social distancing are critical in fighting the pandemic although there is evidence of not taking this measure seriously.

Disregarding this call may result in more people getting exposed to the virus and triggering a surge demand for personal protective equipment and medical services.

We’ve seen videos circulating on social media of people ignoring the call for social distancing during this critical time.

This is irresponsible because each needs to play their part for the greater good.

It is clear that messaging alone is not enough hence the need for social scientists, media experts and behavioural scientists to get involved in Covid-19 interventions because of the uniqueness of each country.

Stringent restriction of peoples movement

We have recently witnessed a number of Covid-19 positive cases in the cruise ships and their struggles with docking in some countries.

Notably, these patients were managed onboard by their medical teams while in transit.

This begs a question whether cruise liners can offer their now “spare capacity” – space, supplies and medical teams – to various governments should the need arise either as a quarantine or treatment facilities.

This is a disruptive period calling for “business unusual” and solidarity for humanity. Hotels and closed universities could also fill this need.

Supply chain disruptions compounded by surge in resource demand calls for the government to support entrepreneurs and scale up implementation of innovative solutions.

Distillers in Scotland and the UK are pivoting by switching their production from gin to hand sanitisers to respond to the need from health service providers.

Obviously, switching of non-medical companies to produce emergency medical equipment and supplies needs to take certain considerations like access to raw materials and quality specifications.

Companies will normally choose to pivot to products that are closer to their abilities and this includes switching from textile and clothing manufacturers to mask and protective clothing production.

Louis Vuitton owner LVMH will use its perfume production lines to start producing hand sanitisers and the gel will be delivered free of charge to the health workers in France.

Vula App and Gift of the Givers have partnered by providing a platform for connecting the needs of health workers to supplies.

With the world facing a Covid-19 pandemic, the focus has indeed not been on health professionals, their occupational safety and vulnerability but on the patients, the general public.

Personal protective equipment reduces risk exposure for professionals and has an impact on the country’s capacity to respond to the pandemic.

Covid-19 is a high priority biological hazard for healthcare workers and we should prioritise measures of protecting them from getting infected and becoming a biological hazard themselves.

Professionals should be provided with optimum exposure specific personal protective equipment at all times whilst on duty.

The use of appropriate face, respiratory, hand and body personal protective equipment is paramount to fighting Covid-19.

The shortage of masks forces us to explore other alternatives for achieving effective respiratory protection.

These include consideration of long term use versus single use masks.

Professionals in the US are already cleaning and reusing masks meant for single use and some have been told by their seniors to “guard their masks as if it was their lives”.

In any battle “the frontline suffers most casualties and emergency departments are the frontline of the hospitals” said William Jaquis, president of the American College of Emergency Physicians.

Health Minister Zweli Mkhize has shown great leadership during this period and is keeping the country informed about the developments and, also allaying alarmist messages.

TV and radio should increase coverage of these messages including educational topics by public health and other experts to ensure credibility and accuracy of public health messages related to prevention, symptoms and when to seek medical help.

This will neutralise the impact of misinformation and fake news spreading like wildfire on social media because these may drive unnecessary panic sending more patients to the hospitals, clinics and the doctor’s rooms.

Reducing this traffic plays a significant role in conserving personal protective equipment and reducing exposure to Covid-19.

It is encouraging that a number of businesses and non-profit organisations are mobilising their resources to support the government in fighting this pandemic.

Let us take care of our health professionals because they are a national asset needing safeguarding. We need to protect their right to a safe work environment.

Each of us has a moral duty to protect their wellbeing, the society and the health system as a whole.

We need to practice preventative measures, limit our movements, subordinate non-urgent utilisation of health care services and, allow health service providers and the government to focus on the battle at hand.

• Dr Brenda Kubheka is co-founder and risk and ethics lead, Health IQ Consulting, Dr Noyolo Ndamase is an occupational health executive at Thahla Occuhealth and Dr Bobby Ramasia is chief operations officer at Dimela Health

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