UK COVID-19 Daily: Surgeons Shouldn't Risk Own Health Over PPE

Tim Locke

April 18, 2020

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

Surgeons Shouldn't Risk Own Health Over PPE

The Royal College of Surgeons of England (RCS) has told members not to risk their health if appropriate PPE is not available.

Yesterday Public Health England issued an emergency guidance change saying gowns and other PPE could be reused.

In a statement Professor Neil Mortensen, president-elect of the RCS said: "The new guidance implies that, even in the operating theatre, surgeons and their teams may not require proper PPE. This is simply unacceptable. Whilst we appreciate that waterproof laundered gowns may still be available in many operating theatres, the proposed alternatives to fluid repellent gowns or coveralls are wholly inadequate for an operating theatre environment. 

"Theatres are high-risk areas where surgical teams are inevitably exposed.  Like all doctors, surgeons are committed to their patients. We know many will put themselves in the firing line.  However, if fluid repellent gowns or coveralls are not available, then surgeons should not risk their health."

The news of the emergency guidance came too late for specific questions to be asked at yesterday's Downing Street briefing.

"We've got to do more to get the PPE that people need to the front line," Communities Secretary Robert Jenrick admitted today. "This is an extremely challenging situation," he said.

He said an 84 tonne consignment of 400,000 gowns plus other PPE is due to arrive tomorrow from Turkey. It wasn't denied that 400,000 gowns was only enough for around 3 days. 

He said it "must be an extremely anxious time for people working on the front line, but they should be assured that we are doing everything we can to correct this issue, and to get them the equipment that they need," adding: "I don't underestimate the scale of the challenge."

Professor Stephen Powis, national medical director of NHS England, said: "I'm a doctor. I've worked for many years on the front line and I can absolutely assure you that for me and my clinical colleagues this is very personal. These are my friends, these are my colleagues, these are some of my extended family, so I absolutely hear directly the concerns that clinicians have to ensure that they have the right PPE." 

Prof Powis continued: "I know as a doctor that what is critical for those ICU colleagues is that we ensure that they get the appropriate supply of PPE. It does vary. You've heard about gowns but ... the FFP3 face masks that are really important in ICU, I understand we do have a good supply and a good stock now. 

"So it is important that we continue to do that procurement and stock up because that is what gives us that confidence on the front line." 

Deaths

Another 888 UK hospital COVID-19 deaths were reported today taking the total to 15,464.

Of the 784 deaths in English hospitals, patients were aged between 26 and 100. Of these 38 patients aged between 44 and 96 had no known underlying health condition.  

Deaths outside of hospitals, including in care homes, are only issued weekly. However, Care England estimates there have been 7500 care home deaths so far. It based the estimate on the 3800 homes it represents. That compares with the latest Office for National Statistics figures of 217 based on death certificates issued up to 3rd April.

Among recently announced COVID-19 healthcare deaths was 46-year-old Gladys Mujajati, a mental health nurse at Derby City Community Mental Health Team.

Trust Chief Executive Ifti Majid said: "Gladys had a big heart and colleagues have talked about how she always had a smile on her face. She was known to be a warm and caring individual, always looking out for her patients and colleagues, showing true compassion and empathy."

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

Cases

Today 17,759 people are currently in hospital with coronavirus in Great Britain, down from 18,711 yesterday. 

"It is encouraging,” Prof Powis said, "that we are beginning to see a reduction in the number of people who are hospitalised with COVID-19 and in London ...is where we are beginning to see it earliest." 
 

Did the Minister Breach the Lockdown?

Mr Jenrick was asked if he wanted to apologise for appearing to break the lockdown recently by travelling to one of his homes away from London. "I joined my family at our home in Herefordshire as soon as I was able to do so, as soon as we made the decision that it was no longer necessary to work in person in Westminster."
 
He said he's been working from home ever since, and added: "I also delivered some medicines to my parents who are elderly and are self-isolating. 

"That's entirely within the guidelines and in fact I wouldn't want people to feel concerned that they can't do something like that to help their own parents or elderly relatives who are in need." 

More News in Brief

  • An unnamed NHS Trust is being criticised for its guidance suggesting that doctors do not have to put coronavirus on death certificates. Yahoo News UK said the guidance had been  obtained by the Good Law Project. It quotes the project's Director Jo Maugham QC: "There’s obviously enormous public interest in how many people are dying of COVID-19. If we are interested in how many people are dying we must also properly be interested in those statistics being collated accurately."

  • Wales is introducing once-a-month buprenorphine injections for some recovering heroin addicts to help reduce patient contact and COVID-19 risk. The injection replaces daily oral medication. Consultant addiction psychiatrist Dr Julia Lewis said in a statement: "Securing the support of the Welsh Government for this treatment will hugely reduce the pressures on both our services and community pharmacies, enabling us to focus our work on our most vulnerable service users, many of whom have complex needs, including mental health issues."

  • Yorkshire-born Captain Tom Moore will be guest of honour at next week's opening of Harrogate's NHS Nightingale field hospital. The 99-year-old's sponsored garden walk has so far raised more than £23m for NHS charities. "I can't think of a more worthy person to be the guest of honour," Mr Jenrick said. Tonight Captain Tom said: "I’m honoured to be opening the NHS Nightingale Yorkshire and Humber and to get to thank many of the NHS workers directly." He added: "I have fought during a war and they are now fighting in a war too."

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

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