Doctors express concern over quality of personal protective equipment

Deepthi Sanjiv | Apr 6, 2020, 04:00 IST

Mangaluru: Due to the rising number of Covid-19 cases, the front-line workers, including doctors, are going through extreme anxiety. Many have expressed concern over the quality of personal protective equipment (PPE). The judicious use of PPEs is the backbone of good infection control and protection of healthcare workers. PPE selection depends on the type of exposure, duration, appropriateness of task and the right fit.
A doctor from a government hospital said, “We are concerned about all medical care providers, including group D workers serving in hospitals. There is no doubt that they are socially and economically vulnerable. The government must ensure that boots and boot covers are included in their kit, because they are the ones who will be moving the patients.” A few doctors expressed doubts over the quality of personal protective gowns, and whether they are impermeable to blood and body fluids. A few doctors allegedly found that the goggles provided were not spectacle friendly, and doctors are forced to use transparent plastic sheets to cover their eyes. Along with quality, quantity is also a major concern.
All India Institute of Medical Sciences (AIIMS) has issued a circular on the appropriate use of various PPE by various sections working in the hospital, that includes triple layer masks, N-95 masks, gowns, goggles and kits, as part of AIIMS Covid-19 preparedness.
“We cannot compromise on the quality of PPE which will have an impact on health workers, and in turn on society,” a doctor said.
Dr Sandeep Samethadka Nayak, an internal medicine physician in California, who is currently in his hometown, Puttur, said, “There are several lessons to be learnt from the Covid-19 pandemic, which includes strengthening the public health system and indents for items such as PPE, to be procured annually.”
On the use of N-95 masks, he said, “In the United States, qualitative fit testing is done on a yearly basis, which tests the seal between the protective fitted mask like the N95, and the face. That way, you know that your respirator fits you properly, and can protect you, as long as you use it correctly. A mask cannot protect from the coronavirus if it doesn’t fit the face. What I see in India is, the fit test is not talked about, among the medical fraternity. The test relies on smell and taste. Since Covid-19 infection can cause a loss of smell and taste, I don’t know if the test can be reliable, with possible higher chances of false negative results. Wearing N-95 masks without a fit test may put healthcare providers under a false perception of protection” he said.
Doctors, especially those working in rural areas, must be guided on the donning and doffing (removing and discarding ) of the PPE. Doffing is very important, as it has been a source of infection for healthcare workers, if not done properly. Further, Dr Nayak said, “I have been interacting with several doctors serving at various government hospitals across the state. They have raised concerns over the safety of the working environment. Many expect the government to provide police security in all hospitals treating Covid-19 patients, because in case of a death or if the patient absconds from the hospital, chances of confrontation and violence inside the hospital are high,” he said, advising people not to step out of their homes and rush to the hospital for minor health issues. It is important to isolate senior citizens with chronic diseases, as they are the most vulnerable during these pandemics. Consult your family physician over phone, and go to the hospital only if it is absolutely necessary,” he said.
Meanwhile, district surgeon Dr Sadashiv said that there are various categories of PPE for use in the ICU, labs and for other situations. So far, there are no issues with quality. The PPE supplied by the district administration is all right. We have sufficient quantities for now, and stocks will be supplied, he said, adding that there is no need to panic.