Updated: May 6, 2020
by: Silver Blade
Use of personal protective equipment (PPEs) is a hot topic as of the moment as the world is facing one of the worst pandemic of this century. The cost of its acquisition and the current supply-demand curve dictates the requirements and mandated “standard” PPE guidelines globally.
Here in the United Kingdom, the total number of cases as of date: 152,840 individuals were tested positive, and amongst the numbers 20,732 died (source: GOV.UK, 26/04/20). The government initiated various measures to mitigate the number of cases such as: social distancing, shielding, and lockdown among others. They’ve also done testing to those who are symptomatic and those who are inpatient, and a few days ago, they’ve initiated testing amongst the NHS Staff. They’ve done this in order to prevent massive pressure on the NHS.
As days went on, they can see the slight changes in the morbidity and mortality rate of this pandemic, and a few days ago they’ve announced that we’re past the peak number of cases based on the logarithmic trajectory. But what we do not see is how the people working on the frontlines------ the NHS staff, the care workers, and other healthcare providers tackle and face this virus head-on.
Working in a medical ward is demanding, but since COVID-19 came, our lives changed dramatically. They’ve converted our department in order to cater to COVID-19 cases. We were provided with loads of PPEs initially. Since it was a type of virus that affects the respiratory system, we initially treated its mode of transmission like that of Influenza. During this time, we were still provided with FFP3 masks, blue gowns, and full face shields or goggles. Daily changes happened, numerous “standards” and “protocols” were developed, and lo and behold, the PPE standards for COVID-19 was downgraded to a simple mask, regular plastic apron, and gloves.
We were so aghast with what they did, we even raised our concerns to the management, asking them why they’ve downgraded the PPEs and all they replied was: “Studies show that COVID-19 is generally transmitted via droplet and contact , thus they’ve changed the PPE requirement into this. We will follow what Public Health England says we should do.”.
Alright, thus we were instructed that the FFP3 mask and blue gowns will only be used during aerosol generating procedures (AGPs). We are supposed to wear the advised PPEs whenever we are entering the patient’s rooms (take note these rooms are only regular isolation rooms, without negative pressure whatsoever). Since I want to protect myself, I don double mask, double gloves, and I fixed the apron in a way that it can maximize coverage. I was seen by my manager and was told off --- apparently, protecting yourself nowadays does not count on anything because YOU ARE WASTING PPE. I told her that I did that because I don’t want to risk it as the patient was COVID-19 positive.
But then again, since I’ve been told off I don't have a choice but to abide with their PPE guidelines, but in my mind, I am dreading the possibility of getting the virus due to lack of protection. Psychologically, I am being tormented by this, because I feel unsafe, I feel as if I am given the short end of the stick. I am having anxiety issues associated with this pandemic. Then another week passed, and they’ve changed the policy again, this time, since we are working in a COVID ward we were told to use a surgical mask at all times and this will be sessional use (meaning, you will just change it if it got wet, soiled, you’ve been to breaks, or you’ve gone off ward). So regardless whether the patient is detected or not, we’re supposed to wear it. And they’ve also said that we can risk assess the patient, especially if they are positive and actively coughing or if we’ll have extended patient contact then we can wear the FFP3 and the blue gown. But even with these instructions some doctors and clinical practitioners were telling us off because again we’re wearing it and we’re not doing AGPs (thus wasting the precious PPEs).
Days passed and now the FFP3s were nowhere to be found. It’s not placed anymore in the trolleys and accessible cupboards, but locked in a secure place, and will only be taken out if there’s a certain AGP------- nothing else. Now, we’re left to fend off by ourselves using a flimsy plastic apron and flimsy mask (the new ones are really thin and the earloop design is basically crappy because it’s loose, leaving areas on the side open even if you tie them up and tighten it on your head.)
Are we deliberately dismissing the fact that countries all over the world are using coveralls and full gear in corona wards whilst in the UK we’re left with the minimal protection we can have. Is there a difference between the strain of coronavirus in the UK and what they’ve got everywhere that a simple earloop surgical mask and flimsy apron can shield us with whilst they need something else? Is their virus a tad stronger than what we have here? Up until now I don’t know the answers------- I am only hoping and praying that we will stay healthy and we won’t get infected even if we’re continuously exposed to this freak of nature.
At the back of my mind, a lot of questions pop up every now and then... I find this absurd because it isn't supposed to be that, we protect our healthcare workers because they are the ones in the frontline combatting this pandemic? Why was it that our clinical judgement to wear these PPEs were being questioned? We’re not wasting it-------- we’re just protecting ourselves, is the cost of a box of FFP3 mask more than that of a human life? This virus does not cause a simple cough and colds, it can cause Acute Respiratory Distress Syndrome (ARDS). The number of deaths caused by COVID-19 among healthcare workers is more than hundreds. When are we going to act? When all of them were stricken by the virus? Because if that will be the case then we’ll just be counting the number of headstones in the end.
So then again the main question------------ Do we have enough protection?
*Disclaimer: These are only applicable in the ward setting and not in HDUs and ITUs and does not reflect the amount and type of PPEs used in the said special areas.
About the author:
Silver_Blade is currently working as registered nurse and a secret artist. She's using writing as medium to drive change and believes that (in all seriousness) Edward Bulwer-Lytton is right... indeed the Pen is mightier than the sword.
Tags: PPE, Covid 19, Corona, NHS, Filipino nurses, Filipino UK Nurses, personal protective equipment, FFP3, ITU, HDU, Filipino Nurses UK, Overseas Nurses