PPEs, Masks: How Protected Are India's Frontline Medics?

PPEs, Masks: How Protected Are India's Frontline Medics?

Medics wearing protective suits are seen inside an isolation ward, set up in view of coronavirus pandemic, at Government General Hospital in Vijayawada, Sunday, March 15, 2020

Personal Protection Equipment and PPEs become essential shield for our frontline medics who go into the battle against COVID-19. According to an Invest India report, accessed by news agency Reuters, India is woefully short on supply. In response to repeated questions on how many masks, PPEs and ventilators does India really have, the Union Ministry of Health and Family Welfare has finally shared some data.

This comes after the Invest India report indicated India needs 38 million masks and 6.2 million pieces of PPEs. At present, it has 9 million masks and 800,000 pieces of PPEs available.

The document had covered only 7 states, so the demand is likely to go up.

This is where India stands when it comes to protecting our frontline medics:

PPEs

Current Availability

• 3.34 lakh PPEs available

• 60,000 have been procured

• 10,000 PPEs have come via Red Cross in China

• 3 Lakh PPEs will reach India by April 4

Additions:

The health ministry clarifies that the PPEs were earlier not manufactured in India. After Ministry of Textiles and Health Ministry intervention, 12 manufacturers have cleared quality tests. Orders for 26 lakh PPE coveralls have been placed with them. Currently, they are able to supply 6-7,000 coveralls a day, that will be scaled up to 15,000 per day in the coming week. Order for 3 lakh PPEs has been placed with ordinance factories.

Along with this, Ministry of external affairs has approached multiple foreign manufacturers for PPEs. A Singapore based company will supply 10,000 PPE kits and a Korean company will supply 20 Lakh PPEs.

Requirement: 6.2 Million PPEs (based on needs of 7 states)

Masks

Current Availability:

• 11.95 Lakh masks available

• 6.4 Lakh additional masks distributed

Additions:

The Health Ministry clarifies that 2 domestic manufacturers are producing these masks. They are supplying 50,000 masks daily and ramping up to 1 lakh mask by next week. DRDO is working with local manufacturers for producing 20,000 N99 masks per day. 10 lakh masks will be part of the PPE kits procured via Singapore.

Requirement: 38 million masks (Medical and N 95s, based on requirement of 7 states)

Also Read: COVID-19: Are We Doing Our Bit to Protect Frontline Medics? 

Who Needs PPEs the Most? Doctors Across India Appeal for Safety

With the government setting up exclusive COVID-19 hospitals, and gearing up for a potential surge with existing private hospitals also setting up isolation wards, the requirements remain extremely high. The Health Ministry has said that full PPE kits are used by medical personnel working in isolation areas and intensive care units to protect them from acquiring infections.

While all frontline medics require protection from the virus, the levels of protection vary according to the World Health Organisation report.

Based on the report, and critical care specialists FIT reached out to, here's how the criteria is decided:

Triage or Screening Area

Dr Sumit Ray , critical care specialist with Artemis Hospitals in Gurgaon says that most hospitals have suspended OPDs. A patient enters from the ER area. Prior to getting into ER, they go through a screening desk.

• In the screening room if no physical exam is performed, you don't need PPEs. Maintain 1 meter distance

• If the patient displays respiratory distress, give a medical mask to them

Consultation Room/ER Where a Patient Will be Physically Examined

• If a healthcare worker is physically examining a patient showing respiratory symptoms, he needs medical mask, gown, gloves, eye protection

• If a patient is displaying respiratory symptoms, offer a medical mask to them

• Cleaners who work in these consultation rooms/ER areas need medical mask, gown, heavy duty gloves, eye protection (if risk of splash from organic material or chemicals). Boots or closed work shoes

Sample Collection Area/ Labs

• Once a patient displays signs of COVID-19, they are taken to a room for sample collection. Dr Ray suggests the nurse performing the task wears full PPE gear.

• The lab technician testing the sample should wear medical mask, gown, gloves eye protection (if risk of splash)

In the ICU/Isolation Rooms with COVID-19 Patients

• Health care workers involved in the direct care of patients should use the following PPE: gowns, gloves, medical mask, and eye protection (goggles or face shield).

• In ICUs, specifically, for aerosol-generating procedures (e.g. tracheal intubation, non-invasive ventilation, tracheostomy, cardiopulmonary resuscitation, manual ventilation before intubation, bronchoscopy) health care workers should use respirators (N95, FFP2) eye protection, gloves and gowns; aprons should also be used if gowns are not fluid resistant. Respirators can be worn for a period of 4 hours.

• Cleaners entering the room, need medical mask, gown, heavy duty gloves, eye protection (if risk of splash from organic material or chemicals), boots or closed work shoes.

Also Read: China Running Out of Masks: Do They Help Against New Coronavirus?