Covid-19: Enough protective equipment secured until October

The Health Service Executive (HSE) has secured protective equipment sufficient to meet the State's needs through to October, it has confirmed.

The availability of Personal Protective Equipment (PPE) has emerged as one of the major themes of the Covid-19 crisis, with countries competing against each other to secure enough supplies.

In a statement, the HSE said it had enough equipment to last until the beginning of October, through a combination of stock on hand and scheduled for delivery over the coming weeks from approved suppliers.

At the peak of demand, the health service said it was distributing more than 11 million items of PPE per week to more than 2,800 public and private health and social care locations across the State such as acute hospitals, community healthcare settings and long term residential facilities.

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Algorithm

“As an illustration of the increase in scale and complexity, consider that in 2019 the HSE national distribution centre distributed just over 1 million units of PPE, in contrast during the week of 8-14 May alone, in excess of 11 million units of PPE were distributed,” a spokeswoman for the HSE said.

It has developed an algorithm to determine daily requirements for PPE across a variety of healthcare settings.

PPE – gloves, masks, gowns and other items – is key to minimising the risk of transmission of Covid-19, especially in healthcare settings, and when procedures are underway which increase the risk of aersolisation – the virus spreading through exhaled droplets.

At the height of the crisis, in late March and early April, protocols were developed to help health workers balance their ethical obligations against the risk of operating without PPE, should that come to pass, according to minutes of the acute hospital preparedness subgroup of the National Public health Emergency Team (NPHET).

A meeting on April 9th was told that a paper had been drafted to provide guidance for healthcare workers “in balancing their duty of care to their patients against the magnitude of risk faced, in situations where an intervention on a Covid-19 patient is required and PPE is in short supply”.

This included guidance in high-risk situations “the duty of care does not extend to, in particular where a Covid-19 patient is scheduled to undergo an aerosol generating procedure and PPE is not available”.

Inconsistency

The meeting was told by the Deputy Chief Nursing Officer (DCNO), Rachel Kenna, that clarity and support was needed "at a time when healthcare workers are anxious and concerned". Ms Kenna also raised that while guidance on the ethical use of PPE exists, it "is not applied consistently across the system, leading to further fear and confusion".

The most visible aspect of the State's efforts to secure PPE has been the "airbridge" strategy, which saw Aer Lingus flights chartered by the HSE to ferry hundreds of millions of euros worth of equipment back from where it was sourced in China.

At its peak, this was operating 35 flights per week. The HSE has also worked on identifying and securing existing and potentially new indigenous suppliers of PPE, it said in a statement.

In addition to purchasing PPE from domestic and overseas suppliers, the State has been urged to examine methods of large-scale decontamination of masks and other items. Such an approach would reduce the need to rely on importation of equipment, as well as the associated costs.