Two doctors have launched an urgent legal challenge to guidance by NHS England on personal protective equipment (PPE), which they claim fails to protect them from infection with covid-19.
This legal challenge will be uncomfortable for many managers who, for the first few weeks of the crisis, could only recite the mantra that there was an adequate national supply of PPE, suggesting that ‘local distribution issues’ were the reason staff were not receiving the necessary kit. When this claim became untenable, it was suggested that the problem might lie with inappropriate use of PPE by staff. The narrative from the top then changed again, with claims that the UK was doing well against the backdrop of an international supply shortage. The most recent survey of over 2000 doctors by the Royal College of Physicians indicates that even now matters are deteriorating, with more staff reporting shortages of PPE than was the case three weeks ago. As the RCP’s President, Professor Andrew Goddard, remarked: “Healthcare workers risking their lives couldn’t care less how many billion pieces of PPE have been ordered or supplied. If it isn’t there when they need it, they are in harm’s way”.
In fact, the current guidance for PPE does need clarification and the legal challenge is a welcome effort to achieve that. Numerous questions are prompted by the current guidance. For example: was the Centre for Disease Control right in saying the FFP mask should be the default option, rather than the fluid resistant surgical mask? Is it OK to re-use equipment originally intended for single use? Why is generating an aerosol (very fine virus-containing particles rather than larger droplets) by doing something to make a patient cough (i.e. an “aerosol generating procedure”) highlighted in Public Health England guidance as particularly high-risk, whereas a patient generating an aerosol by coughing is not? Is it right to state categorically that Covid-19 is “not airborne”, and only droplet-spread? (In which case, why worry about aerosol generating procedures?)
Those who wish to jump to the government’s defence might consider the fact that the risk from pandemics has been rated high in the UK for at least the past 15 years, most recently in the 2019 National Security Risk Assessment, yet recommendations to stockpile PPE have been ignored.
Staff should not need to fight for adequate work protection through legal challenges, but to many, this will feel like the right move, and one born out of desperation.
28th April was International Worker’s Memorial day. This year’s events focused on deaths from Covid-19. A song from workers in Detroit car factories in the 1960s provides a suitable anthem: “I don’t mind working, but I do mind dying”.
A video of the author’s appearance at the (small and socially distanced) ceremony in Leeds to mark IWMD can be found here.