UK COVID-19 Daily: Use PPE for Clinical Need 'No More, No Less'

Tim Locke

April 10, 2020

These are the UK coronavirus stories you need to know about today.

Use PPE for Clinical Need 'No More, No Less'

Health and Social Care Secretary for England Matt Hancock told the daily Downing Street briefing he wanted to be "frank" about PPE challenges and his "comprehensive plan to protect the people who protect us".

Mr Hancock said: "I want to be frank about the challenges our plan is designed to overcome. First, there is a huge international demand for PPE, and a global squeeze on supply. Compounding this some countries have placed export bans and other restrictions on PPE as they look to secure their domestic needs. Next, there's high demand for PPE from within the UK."

He asked healthcare workers to follow the latest PPE guidance: "Everyone should use the equipment they clinically need in line with the guidelines, no more, and no less."

He continued: "There's enough PPE to go round but only if it's used in line with our guidance. We need everyone to treat PPE like the precious resource that it is. That means only using it when there's a clinical need, and not using more than is needed."

He highlighted recent guideline changes: "The new guidance included the clinical advice that many items of PPE can be used for a whole session, not be changed after treating each individual patient." 

Mr Hancock talked about the "Herculean logistical effort" of getting millions of items of PPE to the right place. 

He said work had been done "to create a giant PPE distribution network on an unprecedented scale. That network is now delivering daily to our frontline heroes," he said.

Looking at future supply needs Mr Hancock said: "We're using up PPE on an unprecedented scale. So we're constantly buying more from abroad. And now, making it at home." 

He did not acknowledge, when questioned by reporters, that previous plans were not sufficient. 

Today the BMA said PPE supplies in two large areas of England, London and Yorkshire, "are running at dangerously low levels, and that some pieces of equipment are no longer available – forcing doctors into impossible situations and ultimately, putting their lives at risk".

BMA Council Chair Dr Chaand Nagpaul said: "It’s unclear whether the lack of PPE is directly linked to the recorded deaths of doctors so far, but we know that no healthcare workers have been infected in a hospital in Italy precisely because their PPE supplies are sufficient and of high-quality."
 

NHS Family 'Feel their Loss Deeply'
 

The deaths of more healthcare workers were reported today.

A doctor at the Great Western Hospital in Swindon has died of coronavirus. Emergency department locum registrar Dr Edmond Adedeji was 62. 

His family said: "He died doing a job he loved, serving others before himself. We would like to thank the staff and his colleagues for looking after him during his final days."

Essex GP Fayez Khalid Ayache, 77, from North Clacton Medical Group died this week after testing positive for coronavirus. 

In a statement Dr Ed Garratt, executive lead for the Suffolk and North East Essex Integrated Care System, said: "Fayez Ayache was a much loved and very highly regarded GP who had made a massive contribution to the NHS since he arrived in the UK from Syria nearly half a century ago."

A nurse from a chemotherapy ward at Hammersmith Hospital in London died at home after self-isolating with coronavirus symptoms. Donald Suelto was 51. Imperial College Healthcare NHS Trust said his cause of death was not yet clear. The Standard newspaper said tributes remembered him as a "spirited friend with a loving heart" who "loved his NHS job".

Chief Nursing Officer for England Ruth May said: "Nurses, health care assistants, midwives, and other NHS staff are now among the victims of this coronavirus. 

"Some have lost their lives. The loss of our own, however they have contracted the virus, is heartbreaking. The NHS is a family, and we feel their loss deeply.

"I'd like to offer my sincere condolences to the family, the friends, and the colleagues of every member of NHS staff who have died in the recent weeks."

When questioned about numbers of healthcare worker deaths she said: "It would be inappropriate for me right now to go into listing them and numbering them."

Ruth May was asked if there were investigations into healthcare deaths: "We want to make sure that we are learning any lessons to be learned," she said.

In Memoriam: Healthcare Workers Who Have Died of COVID-19.

Deaths

UK COVID-19 hospital deaths rose by 980 today to take the total to 8958.

There were 866 more hospital COVID-19 deaths in England among patients aged between 27 and 100. There were no underlying health conditions in 56 of the patients who died aged between 40 and 93.

Professor Jonathan Van-Tam, England's deputy CMO said: "We have to keep pushing as a nation to maintain our social distancing. We have to take the pain now to make the gain in a few weeks time."

He continued: "There may be some signs that the curve is beginning to bend but it's premature, absolutely, to say that we're at a peak."

NHS England announced further NHS Nightingale hospitals will be opened in Sunderland and Exeter over the coming weeks to provide extra beds for patients with coronavirus if they are needed.

Prof Jonathan Van-Tam was questioned about reports of some doctors being asked to ration oxygen. "You are going to see these isolated incidents. And we'll learn from them."

Overall on oxygen supply he said: "It's an unprecedented demand with this virus."

Matt Hancock reassured the public: "There is enough capacity in the NHS to look after you, no matter if you catch it, [or] how serious it gets."

PM Walking Again

Boris Johnson has taken short walks in St Thomas' Hospital, Downing Street said this afternoon.

An earlier statement said he waved to doctors and nurses as he left the ICU yesterday.

His dad Stanley told the BBC today that it was time for the Prime Minister to "rest up" adding: "To use that American expression, he almost took one for the team."

Matt Hancock said: "He wants to personally thank the whole clinical team at St Thomas' for the incredible care that he's received." 

He added: "I know our amazing NHS staff have given the Prime Minister the very best care possible. In the same way that they would give every single person in this country, the very best care possible. 

"One of the things that makes me proud of this country is that it doesn't matter who you are, the NHS is always there to care for you." 

More News in Brief

  • Former England and Leeds United player Norman Hunter is being treated in hospital after testing positive for coronavirus. "Keep battling Norman, we are all with you," Leeds United said on its website.

  • NHS Providers said NHS trust leaders are becoming concerned about other areas of care during the pandemic. Deputy Chief Executive Saffron Cordery said in a statement: "Whilst it is right to focus on tackling the pandemic, and of course treating those seriously ill with COVID-19, the health system must continue to provide care for all its other patients, including cancer treatment and mental health provision. For trust leaders, this is an extremely delicate balancing act – ensuring that COVID-19 is prioritised whilst also maintaining other treatments."

  • Downing Street gave its backing to its housing minister Robert Jenrick who travelled 150 miles to one of his houses during the lockdown, Sky News reported. The address in Herefordshire was not his constituency home or London home. The journey came just days after he fronted a Downing Street news briefing in which he reinforced the message to stay home. On Sunday Scotland's CMO resigned after admitting breaching her own lockdown advice and making two visits to her second home.

  • Matt Hanock was asked about HSJ's report that he doesn't follow social distancing in his own meetings in his office. "When I do come into the office I follow social distancing rules," he said. 

  • Ireland has extended its lockdown for another 3 weeks to May 5th. Taoiseach Leo Varadkar said in a televised address: "I know many of us would like to know when things will go back to normal and life will be as it was. We are working towards that time." He continued: "The truth is nobody knows for certain when that will be or how our lives will be different when it comes. All we can do for now is take one day at a time."

  • Police have apologised after some "over-exuberant" enforcement of the lockdown, the BBC reported. One officer in Cambridge suggested aisles of 'non-essential' goods were being monitored. South Yorkshire Police apologised after a "well-intentioned but ill-informed" officer told a family not to play in their front garden.

See more global coronavirus updates in Medscape’s Coronavirus Resource Centre.

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