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Health Workers at Risk, No Guideline for COVID-19 Protective Gear

Protective gear suppliers complain of an unclear standard guideline for the production and supply of the same.

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As the coronavirus outbreak grips the world, worst-hit are healthcare professionals. To tackle a situation as grave as what the world is facing right now, special attention needs to be given to the professionals who are constantly on their toes to help people.

In a press conference on Saturday, 21 March, India's health ministry addressed the issues related to protective gears for these professionals as manufacturers complained they don’t have a standard guideline and an inventory to meet the demand. AIIMS doctors claimed they are using self-made masks and sanitisers to tackle the shortage, with the help of WHO guidelines.

Healthcare workers are facing a big threat as people are reaching out to them in large numbers for check-ups and tests but they don’t have adequate and suitable protective equipment.

Personal Protective Equipment, PPE, which includes a full body gown, gloves, face shield, goggles and a mask like the N-95, is the need of the hour in hospitals. However, India is evidently grappling with sufficient supply.

Required Action for Procurement Underway: Health Ministry

As manufacturers complained of an unclear standard guideline and specifications from Health Ministry for the production of these PP kits, Lav Agarwal, Joint Secretary of Health Ministry, while briefing the media on Saturday, when questioned about the shortage of PPE said, “There was a gap in the beginning since PPAs brought here were made using imported clothes. Considering that gap, We made a committee of Ministry of Textile members and public health experts.”

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“This committee has revised the guideline to manufacture the PPE and we have recognised domestic manufacturers. Required action in terms of procurement from these domestic manufacturers is underway.”
Lav Agarwal, Joint Secretary, Health Ministry

It’s not clear yet when the guideline will be made public by the ministry for private manufacturers to use and when the procurement will begin. At present, manufacturers don’t have the updated guideline.

Considering the urgent demand, many private hospitals are heavily relying on the domestic manufacturers to produce the required gear.

Currently, the manufacturers are either following WHO’s guidelines or doing what they think is best. Most of them don’t even have an inventory to scale-up the production on such an urgent basis.

Private Manufacturers Highlight Shortage in Absence of Guideline

Earlier, Smita Shah, MD of Mediklin Healthcare Ltd, a private company that has been producing protective kits for years now, told The Quint, “Government is relying only on HLL Lifecare Ltd for procuring personal protective equipment (PPE) for healthcare professionals. HLL further has three subcontractors who do the job.”

She iterated that it is not possible for these three companies to fulfill the current demand in the absence of a proper advisory or specifications from the government.

Shah highlighted that though the material needed for the protective equipment is locally made, due to coronavirus outbreak, most of the suppliers are either not working or asking for a higher price. Therefore, the government will have to pay more for the gear.

When asked why the government isn’t giving an advisory or specifications to private manufacturers to create PPE kits, she said, “It is their personal gain. Had they wanted to give an advisory, they would have done by now.”

There are many private manufactures in this country, like her company, who are providing these kits to private hospitals but most of them are not following WHO guidelines. Most of them don’t even have a procedure for sterilising these kits.

She says her company has provided PP kits to one hospital in Mumbai and a few in Hyderabad (in total, 2,000 kits). These hospitals didn’t ask her to follow any sort of specification or guideline. She ensures the workers follow WHO guidelines, at the very least.

Given the paucity of proper protective equipment and no standard guideline, healthcare workers continue risking their lives and that of those who approach them for check-ups.

Textile Ministry Notes Scarcity

Times of India reported that a meeting held by Textile Ministry on 18 March noted health ministry’s current requirement of 7.25 lakh body overalls, 60 lakh N-95 masks and 1 crore 3-ply masks.

The meeting minutes accessed by TOI further said, “There is a shortage of material and the rate of supply is not able to meet the rising demand.” Interestingly, these numbers are only for the public sector. The requirement in private sector is not even reflected in these numbers.

As of Saturday evening, 283 positive cases have been reported in India, a steep rise from last week.

Don’t Have Enough Protective Equipment: AIIMS Doctors

Dr Adarsh Pratap, a senior resident from Department of Surgery from All India Institute Of Medical Sciences (AIIMS) in New Delhi, told The Quint,

“I noticed that some centres and wards do have adequate PPE equipment like gowns, masks, suits, gloves etc, but some do not. We wrote a letter to the administration and they ensured that this will be given.”
Dr Adarsh Pratap

“The PPE supply is being interrupted, stocks are running out already. The novel coronavirus crisis has just started and we are in a critical time,” he added.

Dr Harjit Singh Bhatti, National President of Progressive Medicos & Scientists Forum (PMSF) and former doctor at AIIMS said, “There are about 7,000 nurses and other allied healthcare workers like technicians, helpers who work the stretchers etc. They are also human and need protection.”

“Doctors are the first point of contact and we need the protective gear to stay safe. Just the other day, a doctor in Lucknow tested positive, and he and his entire team have been quarantined.”
Dr Harjit Singh Bhatti

(With inputs from Times of India)

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