Frontline warriors Fighting without armour

The inadequate supply of quality PPEs expose the lives of healthcare professionals to COVID-19

Frontline warriors  Fighting without armour

Even as the country wages a battle against the coronavirus pandemic, healthcare workers — hailed as ‘Frontline Warriors’ — are forced to enter the battleground without the required armour or Personal Protective Equipment (PPE). PPE kits are extremely important for the protection of healthcare workers, including doctors, nurses and paramedics, engaged in the treatment of coronavirus (COVID-19) patients. A PPE kit consists of goggles, a face-shield, a mask, gloves, overalls/gowns, hand covers and shoe covers. 

Faced with an acute shortage of PPE kits, the central government was forced to recommend the ‘rational use’ of PPE kits. 

China is the main source of PPE kits for India. According to sources, the supply of PPE kits from China was affected after increased demand from across the world following COVID-19 outbreaks. The present supply of PPE kits from China is not sufficient to meet India’s requirement as India is seeing an increase in the number of local coronavirus cases. 

PPE manufacturers in the country say that they are receiving 300 to 400 calls daily for PPE kits. 

No data on requirement

Dr Sanjiiv Kumar, Chairman, Preventive Wear Manufacturers Association of India (PWMAI), said that there is no data on the number of PPE kits required by the country. “We don’t have any data on the number of isolation wards and designated persons trained to attend to COVID-19 patients. If such data were available, we could have made basic estimates on the number of PPE kits we require,” he said. 

Due to the shortage of PPE kits, doctors and nurses were compelled to treat coronavirus patients without proper safety gear in various parts of the country. It has exposed such frontline warriors to the virus, and many doctors and nurses have got infected in places such as Delhi and Mumbai. Healthcare workers even resorted to protests in various places, demanding that they be provided with sufficient PPE kits. 

“PPE kits are very essential for ensuring the safety of healthcare workers treating COVID-19 patients. But there is an acute shortage in some states. Nurses are being forced to stage protests for PPE kits. It will become difficult for the country to fight the battle if it loses the frontline warriors,” said Jasmin Sha, President, United Nurses Association. 

Resident doctors have also admitted that there is a shortage of PPE kits. “There is a scarcity of PPE kits in the country. But the issue is not specific to India. All countries have been facing the issue,” said Dr Manu Gautam, President, United Resident and Doctors Association of India.

The coronavirus outbreak is a pandemic and nobody was prepared for it, he pointed out. 

Everyone is in the learning phase; the government has been doing everything to address the shortage of PPE kits in the country, but ours is a big country and no matter what we do, it won’t be enough, he added.

According to Dr Gautam, medical professionals are scared too, as they know less about COVID-19 and don’t have enough PPE kits.

Addressing the shortfall

To address the shortage of PPE kits, the government has permitted many more firms in the country to manufacture PPE kits. The government has also appointed public sector undertaking HLL Lifecare Limited as the nodal agency for procuring PPE kits. HLL has floated a tender for procuring 10 lakh overalls, 10 lakh protective goggles, 40 lakh N-95 masks, two crore triple-layer surgical masks, 20 lakh nitrile gloves and 10 lakh bottles of hand sanitizers. 

According to doctors, the situation has improved a lot thanks to the various initiatives taken by the central government to address the shortage of PPE kits. “The situation is not the same as that of a few weeks earlier. The government has taken many steps for addressing the shortage of PPE kits, including permitting the ordinance factory and the railway factory to manufacture PPE kits,” said Dr R V Asokan, Secretary-General, Indian Medical Association (IMA). 

Quality—Main concern 

Even though the supply of PPE kits has increased, the quality of the products poses a problem. As per media reports, more than 50,000 PPE kits which arrived from China have failed quality tests and are not suitable for use. “N-95 mask is the most required item. Though N-95 mask is available in the market, nothing can be said about the quality,” said Dr Asokan. 

Dr Sanjiiv Kumar also echoed concerns over the quality of PPE kits. Almost 30 percent of the items supplied by some companies in China have been found to be not compliant with Indian standards as per DRDO. Another cause of concern is the entry of many non-scientific government manufacturers into this area. The quality of PPE kits needs to be double checked because a healthcare worker is wearing the safety gear with a
sense of security. If it is not scientifically designed, it will affect the life of the healthcare workers. PWMAI has already approached the Drugs Controller General of India to take strict action on manufacturers of defective products, he added.

At present, the daily production of PPE kits in the country is over 2 lakh pieces, according to industry sources. Domestic PPE kit manufacturers said that they are ready to increase production, but they lack a critical machine needed to stitch suits. “Raw material required for the production of PPE kits is available in the country. But we don’t have enough sealing machines in India. We are working on importing the machines from China. If enough machines are available, we can make all the PPE kits in India itself,” said Dr Sanjiiv Kumar. He added that hopefully, things will improve with the arrival of more machines. 

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