The number of healthcare workers dying from COVID continues to climb. It is not unreasonable that every attempt should be made to protect people putting their lives on the line. The situation is not that dissimilar to the controversy surrounding the use the Snatch Land Rovers in Iraq - which was labelled the “Mobile Coffin” after servicemen died in the vehicle that provided insufficient armoured protection.
The Health Secretary has claimed ‘hand on heart at each stage I've done everything I possibly could’. How does the Government square this with Operation Cygnus, the three-day training exercise in 2016 that showed the NHS would be unable to cope with a severe flu outbreak? Or indeed from well publicised warnings from other sources that perhaps even an Oxford PPE grad could understand – from the now infamous Bill Gates TED talk to the 2011 movie Contagion. Indeed, the Singaporeans, Taiwanese, and South Koreans invested heavily in pandemic infrastructure that is now paying dividends, showing that a pandemic was reasonably foreseeable and more could be done.
On the ground, the personal protective equipment (PPE) debacle is high farce. The latest amusement was the extreme shortage of scrubs. This has necessitated drafting in old and surplus scrubs from a bewildering number of sources. We now have a choice of all the shades of blue, a fetching cyanide green along with some other truly lurid colours – although we are missing Guantanamo orange. Opinion is sharply divided as to whether one shade is maroon, Claret or Burgundy. None of the pockets seem to be intact.
We often run out of the most popular sizes – especially the small ones. Some of our nurses from the Philippines are literally falling out of their XXXL scrubs. Even our rugby players are showing quite extreme amounts of cleavage.
More seriously, there are attempts to prevent unnecessary use of the bio suits unless engaged in hazardous activities – such as being around patients receiving breathing support with CPAP which is notorious for creating a fine aerosol of COVID laden secretions. The job is akin to doing a dusty DIY job all day where at the end of the day you need to have no dust on yourself.
Unfortunately, patients coughing also create fine aerosols for which you get a surgical mask and a flimsy plastic apron. Some senior doctors with an eye on upward management seem deaf to the chorus of concern from their staff. Recently one of these good folks caught COVID – most likely as a result of the inadequate protection that they encouraged. Sometimes karma completes it’s circle faster than you might imagine.
So where does this leave us? Public Health England and the NHS bosses have been very quick to assert the types of PPE we require. The professions have been rightly sceptical. These recommendations seem to fit what is currently available rather than what is recommended by our colleagues overseas. It is clear from the number of healthcare workers both contracting the disease but also the number paying the ultimate price that the centralised recommendations have not been good enough. To put it another way, they are wrong and they were told so at the time. It is interesting that managers – from the Minister down – seem to pay lip service only to the very real concerns of the healthcare workers.
Frankly, this is what you get when you have a management class that is utterly non-clinical and simply does not face the consequences of their poor choices. Perhaps we need to go back to a more decentralised management model led by clinicians who have the power to stop unacceptable risk taking. Perhaps we need to think about the General Medical Council (GMC) or an equivalent body having the power to hear complaints and strike off healthcare managers thus preventing them ever working in healthcare again.