Doctors threaten to stop treating PPE patients when officials ask for ‘adult conversation’

Angry doctors warned they could be forced to stop treating patients, as ministers admitted tonight that a crucial shipment of personal protective equipment has not arrived from Turkey.

Medical associations have warned that their members face difficult decisions about exposing themselves and other patients to the risk of infection, fearing that supplies of critical items are running low in hospitals.

Education Secretary Gavin Williamson said he “hoped” that Turkey’s 84 tonnes of medicine cabinet would now be in the UK tomorrow, even though cabinet colleague Robert Jenrick announced it with fanfare last night.

But appearing alongside Williamson at the daily Downing Street briefing, Deputy Chief Medical Officer Jenny Harries complained that critics are not being “grown-ups” about problems with the EPP.

He urged people to reflect on what had been “accomplished” in maintaining team levels amid global pressures, and insisted that the UK was an “international example in the making.”

Dr. Harries also played down concerns about the revised guidance that some parts of the protection kit should be reused, urging healthcare workers to ‘implement’ the rules as effectively as possible.

The comments could inflame tensions with medical staff with the NHS Confederation joining groups that support staff who refuse to treat patients unless they have proper PPE, such as gowns, goggles, and masks.

The Royal College of Surgeons, the Royal College of Nurses and Midwives and the British Medical Association have also raised serious concerns.

The dispute comes as Britain recorded 596 coronavirus-related deaths today, bringing the national number of deaths to 16,060. About 43 NHS workers have been officially confirmed to have lost their lives so far, although the actual number is believed to be higher.

Williamson confirmed that the expected shipment from Turkey has been delayed, although the cause is unclear. “We hope to see it arrive in the country tomorrow,” he said.

As the government struggles to control the spiral of the EPP situation, Health Secretary Matt Hancock has appointed former Olympics chief Lord Deighton as a “personal protection tsar” to shore up supplies.

Michael Gove admitted today that some PPE was shipped to China during its initial outbreak, although he emphasized that it was not from the pandemic’s core reserves and that the UK had received “much more” from Beijing since then.

On another hectic day with mounting tensions in the battle of the coronavirus:

• Britain recorded 596 more deaths today, bringing the official number of deaths to 16,060 to date;
• The government accused the government of “treating the public like children” by refusing to explain what the closure exit strategy might look like, and Keir Starmer demanded a “road map” of the crisis;
• OECD chief Angel Gurria warned that “stop-go” arrangements for “social distancing” will have to be in place for a long time, urging governments to “err on the side of caution”;
• The Irish health minister has suggested that pubs may not open until there is a coronavirus vaccine, which some believe will take more than a year;
• Infectious disease expert Sir Jeremy Farar, a member of the SAGE advisory group, warned that the blockade “cannot continue any longer” as it is “damaging our lives”;
• A shipment of PPE, including desperately needed dresses, reportedly delayed by Housing Secretary Robert Jenrick today from Turkey;
• The chairman of the board of the British Medical Association said he had warned the government “weeks ago” of the risk of a shortage of personal protective equipment, but hit a “brick wall”;
• Michael Gove said the UK had sent PPE teams to China at the start of the outbreak, but insisted that it was not part of the UK’s pandemic stocks and stressed that the Asian superpower had sent more since then;
• One of the scientists who led efforts to make the breakthrough warned that it is not “completely certain” that a coronavirus vaccine can be produced, and Gove admits that no one should view it as a “dead certificate.”

Even before the news about the delayed shipment, the BMA said last night that it will support doctors who refuse to work without proper PPE.

Dr Chaand Nagpul, chairman of the BMA board, said: ‘There are limits to the level of risk that staff can be expected to expose themselves and their patients. In the most extreme circumstances, if adequate protective measures are not put in place, physicians may refuse to risk becoming infected and inform their administration to make alternative arrangements. ‘

Professor Neil Mortensen of the Royal College of Surgeons has told his colleagues not to risk their health if good PPE cannot be used when treating coronavirus patients.

He said: ‘We are deeply disturbed by this latest change in the orientation of personal protective equipment, which was issued without consulting medical agencies.

“After weeks of working with PHE and our sister real medical universities to get the proper guidance on PPE, this risks confusion and variation in practice across the country.”

But Dr. Harries said: ‘I think we have had, if I could say from my own professional perspective, perhaps we could have a more adult and detailed conversation about PPE supplies.

For example, quite rightly, the conversation right now is very focused on robe supplies. Previously, in previous weeks, I am very aware of the consideration of glasses, for example, in glasses and masks. ‘

Dr. Harries called the pandemic “a great service attraction we have never seen before.”

She continued, “ Actually, we managed despite pointing out many potential shortcomings to continue supplying in the future, and even while I’m here I know with the gown’s position, for example, that although orders go abroad, supplies may be very different from what we receive to what we think we will get.

“Maybe we should instead of grouping all the PPE together, which is not a homogeneous mix at all, we just have to think carefully about what has been achieved and the challenges that are recognized in the future.”

When asked if she would feel comfortable treating Covid-19 patients by reusing single-use PPE, Dr. Harries said: ‘If I were working on the front line today, I have a responsibility to care for the patients the best that I can protect my colleagues and staff and manage my practice safely.

“Everyone in the current climate will mean that I need to understand the agreed guidance on the PPE … and implement it whenever I can.”

She said it was “very easy to make a disposable comment on single-use PPE,” but the situation was “really quite complex.”

Dr. Harries added: ‘It is the fact that we are in global scarcity … we all need to use this PPE carefully.

‘Some use of session is entirely appropriate. For example, wearing a gown for session use with a disposable plastic apron on is a completely appropriate use of PPE.

“In that example, you can see that there is an element of what some people may call reuse and an element of what some may call single use.”

When asked why the government has not responded to manufacturers willing to produce PPE, Williamson said they will be contacted in the next 24 hours.

The Education Secretary said an additional 1 billion PPE has been brought into the country while the government was doing “immense work” trying to find British providers. He encouraged providers who have been in contact with the Government and have “slipped through the network” to get in touch again.

He added: “We recognize that this is a national effort and we are incredibly grateful to so many people who are willing to step forward to make a real difference, and we certainly don’t want to miss out on those opportunities.”

The press conference comes amid intense fears that lack of funds during a prolonged period of austerity has left the NHS inadequately prepared in EPP terms for a pandemic.

Hancock named Lord Deighton, head of planning for the London 2012 Olympics, as “EPP Tsar” after the government issued a guideline stating that doctors would have to reuse EPP supplies.

Lord Deighton, 64, known personally to Boris Johnson of the Olympics, will be charged with the “end-to-end design process to manufacturing,” including streamlining approvals, “sources say.