Frontliners: PPE is rationed or non-existent in ED, midwifery, home-based care

Frontliners in healthcare are reporting rationing of Personal Protective Equipment despite government reassurances that they are addressing the health sector’s needs, says a group of rank-and-file workers that make up the Health Sector Workers Network.

Agency workers providing home-based health care may go to several houses in a day to assist clients with personal cares, food preparation and giving medication. Many of these clients are vulnerable to Covid-19 due to their age or secondary health conditions, and caregivers risk becoming a vector for the virus if not provided with appropriate PPE.

However the latest MoH guidelines advise against caregivers wearing masks, even when coming into close contact with those who are self-isolating due to recent travel or exposure to a confirmed case. One caregiver reports: “my agency has not provided PPE for some years. Now we can’t get any ourselves. Management won’t answer any questions about this”. Another states that, “as we move from house to house we fear transmitting the virus; however management have said we are no more at risk than any flu season.”

Personal protective equipment (PPE) used by community care providers for prevention of COVID-19. Includes aged residential care, aged-related community care, disability, hospice, and homecare.

Meanwhile, court and tribunal staff, police, and prison staff are provided with masks “if unable to maintain physical distancing” with any person whether they are a suspected case or not. Social service workers, who will be coming into regular close contact with our homeless and vulnerable populations over the next four weeks, are provided with no protection whatsoever.

Personal Protective Equipment (PPE) requirement for essential non-health workers – COVID-19.

LMC midwives, when required to enter pregnant women’s homes, are advised to socially distance and keep the visit under 15 minutes. An LMC says “there is no advice on how we are meant to do this if a woman is giving birth, when we are in their homes and in close contact with them and their birthing partners for up to 16 hours”. They have not been provided with any extra PPE or guidelines for keeping safe under Alert Level 4.

A nurse in ED says frontline staff are provided one mask for an 8 hour shift, “but these masks need to be changed every 30 minutes to be effective in controlling infection”. There are not enough gowns in wards, hospitals are running out of scrubs, and full PPE is being reserved only for confirmed or suspected positive Covid-19 cases. This is in stark contrast to the PM’s message for all in New Zealand to “act like you have Covid-19”.

Some district nurses and general practice health professionals are reporting that, altough they have stocks of PPE at their workplaces, these are being withheld by managers for “when we will need them over the coming weeks when cases increase”. They are being rationed the appropriate PPE because nobody knows when – or if – they will be getting more.

Evidence from Hubei, Spain and Italy suggests that healthcare workers without proper PPE and training are becoming significant community vectors for Covid-19. Healthcare workers make up 14.74% of confirmed cases in Spain, and 9% in Italy. So far 11 nurses have died due to Covid-19 worldwide and two nurses in Italy who tested positive have comitted suicide.

Amid severe anxiety of bringing the virus home to at-risk family members, health workers call for the Government and DHB’s to “provide health care workers who are caring for a confirmed Covid-19 patient with paid accommodation to help to contain the spread. There are many nurses out there for whom it is impossible to isolate from family members within one household.”

It is clear the MOH is acting in haste to create PPE guidelines informed by a global shortage of PPE during the pandemic, rather than following best practice and precautionary infection control recommendations. The result is inconsistent advice causing confusion and panic among health workers, and putting our most vulnerable people at unnecessary risk.

Health Sector Workers Network is a network of rank and file workers interested in building self-activity and solidarity across the health sector and beyond. We have been collecting anonymous stories from essential workers during the Covid-19 crisis that have been used to create the content of this article. To find out more visit us on Facebook or hswn.org.

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