Dr Alan Stout: Protection equipment is not just about supply, but about correct usage of it

It is vital that we protect frontline healthcare workers from infection and this has been emphasised and confirmed on numerous occasions by both the health minister and the chief medical officer.

Supply of PPE across the health service is clearly important and we want to make absolutely sure that any PPE procured and supplied is reliable and effective.

Given the volumes required and the length of time that we will require it for in the current circumstances, a reliable and secure supply chain that can be used as required over the next number of months is vital.

There are many Northern Ireland firms that are already working to produce various elements of the PPE in bulk and we should make full use of these as well as other suppliers throughout the UK, without having to rely on substantial imports.

On receiving a supply of PPE in bulk, and it will involve several million items at any time, it is then vital that we distribute it as quickly, as effectively and as efficiently as possible.

We in Northern Ireland have well established distribution chains, particularly through the health department’s own Business Services Organisation, and we also have some exceptional local firms that specialise in distribution and we should make sure to utilise their networks.

The correct and effective use of PPE is perhaps the most crucial issue though, and to understand this it is important to recognise the purpose of wearing PPE.

PPE serves two main functions: to protect the wearer from infection and to minimise the contamination and hence potential spread to others.

To protect yourself you need to cover the points of entry of the virus. It is spread by droplets and will only enter your system through any exposed mucous membranes, these being the eyes, the nose and the mouth.

This is why you wear a surgical mask and a visor.

In a clinic setting these can be kept on for up to four hours if required and do not need to be changed between patients.

Droplets are nearly always spread through coughing or sneezing and if the patient is doing neither then the risk of infection to the health care worker will be low.

Simple basic hygiene is incredibly important at the same time as there will still be a risk of spreading infection from your hands in particular if you touch the mask or visor.

Contamination is the second big factor. This is where droplets land on a material which could be your skin, your clothes, or a nearby surface such as a desk, a pen or a book.

This is why a plastic apron and gloves are worn and these need to be changed much more frequently as they will pick up the droplets and increase the risk of spreading and causing infection in yourself or in others.

It also explains the UK rationale of ‘bare below the elbows’, as when combined with frequent and proper hand washing the risk of contamination and hence spread can be significantly minimised.

This also explains why most health care workers will now change into scrubs on going into work and then change out of them at the end of a shift.

The most important factor by far remains regular and proper handwashing. This reduces risk more than incorrectly used PPE

• Dr Alan Stout is chair of GP committee of BMA NI

• Stormont set to press ahead today with controversial £60m PPE downpayment to China

• Morning View: Our queries on PPE China order have not been fully answered

—— ——

A message from the Editor:

Thank you for reading this story on our website. While I have your attention, I also have an important request to make of you.

With the coronavirus lockdown having a major impact on many of our advertisers - and consequently the revenue we receive - we are more reliant than ever on you taking out a digital subscription.

Subscribe to newsletter.co.uk and enjoy unlimited access to the best Northern Ireland and UK news and information online and on our app. With a digital subscription, you can read more than 5 articles, see fewer ads, enjoy faster load times, and get access to exclusive newsletters and content. Visit https://www.newsletter.co.uk/subscriptions now to sign up.

Our journalism costs money and we rely on advertising, print and digital revenues to help to support them. By supporting us, we are able to support you in providing trusted, fact-checked content for this website.

Alistair Bushe

Editor