New research reveals extent of PPE struggles when COVID hit

Matt Woodley

13/06/2022 6:57:23 PM

A lack of access and training were cited as major obstacles, with many GPs reportedly feeling as if they had been ‘largely ignored’ by health authorities.

N95 mask.
N95 masks were in short supply in 2020.

New research published in PLOS One has confirmed what many GPs were reporting in the first year of the COVID-19 pandemic – access to personal protective equipment (PPE) was inconsistent, training was often lacking, and shifting guidelines regularly resulted in confusion.
A lack of access to fit-testing for P2 and N95 masks, and anxiety among staff were also cited as common issues.
The Monash University and Kirby Institute study involved 2258 healthcare workers (57% from community settings), who participated in a detailed survey during the first year of the pandemic.
According to the research, many GPs felt that they had been ‘largely ignored’ by health authorities due to a focus on hospitals, with one survey respondent saying it was as if ‘we don’t count as frontline’.
As reported by newsGP, many practices were forced to source products through alternative channels, with one South Australian GP saying they paid ‘up to triple the usual price’, while a Queensland GP resorted to finding equipment at Bunnings in order to access PPE.
Meanwhile, supplies allocated from the National Medical Stockpile (NMS) were called ‘scandalous’, exemplified by a GP relaying an instance in which they received just one N95 mask per doctor at their practice following a request for support – a situation they described as a ‘complete joke’.
The lack of access saw 12% of the 1790 community healthcare workers who responded to the survey claim that they had been denied appropriate PPE when caring for suspected COVID-19 cases, mostly due to supply issues (59%) and rationing (23%).
It also meant 47% of community healthcare workers had to reuse or extend the life of their PPE, often by wearing items longer than recommended, reusing single use disposable items, or disinfecting items with liquid cleaner.
Training was another area in which many healthcare workers did not feel supported. Less than half of all respondents were given formal training in the use of PPE, and 20% did not receive any official training at all, including a Victorian GP who said they resorted to YouTube.
‘In March, I had to very quickly learn everything about correct donning and doffing of PPE and taking of [nasopharyngeal] swabs myself from YouTube videos which were by nurses from other countries,’ the GP said.
‘At the time, I could not find any official Australian or otherwise training videos.’
The shortages, combined with constantly shifting guidelines, reportedly led to bullying over the use of PPE (although this was less common in general practice) and inconsistencies across the healthcare network, culminating in workers questioning the quality of advice being provided by health authorities.
The delay in acknowledging the aerosol spread of COVID-19 was highlighted as a particular failure, and many survey respondents said the PPE situation was causing them anxiety.
‘Seventy-eight per cent of respondents completed the GAD-7 scale [n = 1753],’ the study stated.
‘Approximately one in five respondents [21.6%] showed moderate-to-severe anxiety in the past two weeks with almost half [48.5%] indicating some level of anxiety [mild, moderate or severe] in the past two weeks.’
The researchers concluded by calling for stronger PPE standards, especially when ‘higher level’ controls in healthcare settings, such as administrative or engineering support, are ‘compromised or absent altogether’.
‘Preventing infections in healthcare workers should be a national priority,’ the authors wrote.
‘They not only carry the burden of their personal health, but the potential to transmit COVID-19 to their co-workers, patients, family and the wider community.
‘Apart from high quality PPE, in-person training at work should be the minimum standard used for benchmarking because it correlates with greater confidence in using PPE and a better workplace culture.’
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Dr Angela Catanzariti   14/06/2022 6:06:41 AM

So true! And it feels like GPs are still being forgotten by the government! Where is our incentive to work over the winter months?

Dr Ian   14/06/2022 8:07:29 AM

In Australia Stringent Lockdown was the main protection against Covid 19 after the Quarantine Bungle in Victoria led to Outbreaks and Deaths of over 600 Persons in Aged Care . PPE Protection in General Practice was poor only surgical masks being offered .
The other weakness was many General Practice Consulting Rooms without any Windows for fresh air ventilation same with waiting rooms . The Great Save was adaption of Telehealth which was a vital support though rarely as good as face to face consultation. Future Urgent Care Clinics built or Renovated will need Space and Fresh Air .