Staff working on the frontline of NHS and social care have spoken out over the "very large gaps" in availability of personal protection equipment (PPE) in parts of Wales.
Health minister Vaughan Gething and chief medical officer Dr Frank Atherton say they are distributing this safety equipment – including masks, eye protection, aprons and gloves – to primary, secondary, and social care workers as quickly as possible.
But healthcare professionals say there is a lack of clarity on how many PPEs there are currently in Wales, how many are on order, and which workers need them most.
Dr Catrin Elis Williams, a GP in Bangor, said she was seriously concerned about the safety of district nurses who are working in the community with patients most susceptible to contracting coronavirus.
She said these nurses run a great risk of catching Covid-19 themselves and passing it onto their family members. She added: "There is some evidence that the more of the virus we are exposed to the more likely we are to become severely unwell ourselves.
"That's why we are seeing some younger, healthy people who work on the frontline becoming deeply ill with the virus."
She said GPs are expected to "ration" out their PPE and only use it on patients who were strongly suspected of having Covid-19 through symptoms such as a cough or fever.
"However we are finding as time goes on that elderly people in particular are presenting with confusion and cannot tell us that they have a fever," she said. "We are being expected to provide care and put our own health at risk by rationing our use of PPE."
A map of the confirmed cases of Covid-19 across Wales
Dr Williams added that as more cases of Covid-19 are detected there will be a growing number of unwell people needing to be looked after in their communities to free up hospital beds. "This will make it extremely difficult for staff and carers to keep themselves safe," she said.
While she was not 100% against what the Welsh Government was doing to protect NHS and social care staff she admitted GPs were expected to work longer hours and step "out of their comfort zone" to help the public.
"There is also inconsistency in availability of PPE between hospitals and primary care as well as between different health boards in Wales," added the mum-of-three, who has had to avoid her mother, who is over 70, during this epidemic.
"Morale is low as it is, so a lack of PPE provision will only reduce morale further."
Kevin Edwards, the managing director at Meddyg Care Group Holdings which runs two specialist dementia care homes in Porthmadog and Criccieth, Gwynedd, said there been been no information provided from the local authority about when they can expect PPE supplies to be delivered.
"We have standard PPE but if we had a confirmed case of coronavirus right here, right now, we wouldn't have the appropriate masks or eye protection," he said.
"It's extremely concerning and could have significant consequences for the residents and the safety of our 125 staff across our two homes."
Mr Edwards added that around 10% of his workforce have had to self-isolate since the outbreak began but he admitted if that were to increase to 20% unaffected staff many have to take on extra shifts.
He said the loss of frequent public transport means they have to buy their own transport, a minibus, and hire a driver with no additional financial support.
"It has been hellish for us. We have had to stop visitors coming into the homes – it is a necessary measure," he said.
"The staff have been exceptional at explaining the situation to our residents, encouraging them to watch the news and talking to them in a way they can understand."
Dr David Bailey, chairman of the British Medical Association's Welsh Council said it was "vital" that all frontline NHS staff treating patients with, or suspected to have, Covid-19 were supplied with proper protective equipment.
He said: “We’ve heard from members on the frontline who are anxious over the adequacy of PPE currently being provided to healthcare professionals in Wales as well as those experiencing shortages.
“We welcome the commitment from Welsh Government to follow WHO guidance regarding eye protection, however we’ve heard from GPs who feel they are putting themselves at risk because the eye masks which have been delivered to surgeries are completely inadequate and do not cover their eyes appropriately – some are opting to wear goggles bought from DIY stores they already had at home. This is unacceptable.
“At a time when we need our NHS more than ever staff must be properly protected and should not be exposing themselves to high-risk situations where they could become infected.
“Welsh Government must find a reliable way to substantially increase the production and distribution of PPE as well as ensuring what is being provided is appropriate. No healthcare worker should be putting themselves at risk.”
Plaid Cymru are calling on the Welsh Government to provide clarity on how much PPE is on order, how many units there are currently, and who will get them and when.
The party's health spokesman Rhun ap Iorwerth AM said: “There are serious concerns about gaps in the provision and distribution of personal protective equipment across Wales.
“It is unacceptable that key NHS staff and care workers working on the frontline in the fight against the coronavirus feel exposed, fearing they, their patients and their families are being put at grave risk of contracting or transmitting the virus. Many are now afraid of going into work.
“Of particular concern are nurses and carers working in the community, often with very elderly or vulnerable patients.
“There appears to be inconsistency in the approach across Wales – and inadequate guidance about what equipment will be required under particular circumstances and who will be given the equipment and when.
“As one health chief told me, Welsh Government has to be honest with both frontline workers and the public about the challenge ahead, and the plans in place to provide enough PPE, and the correct PPE over coming weeks. This is a real priority.”
On Wednesday Mr Gething authorised a range of new measures to improve supply of PPE.
These included:
- PPE from the Welsh Government's pandemic stockpile being released to the NHS and to social care to reinforce the regular NHS supply routes that have come under substantial pressure;
- A significant push of PPE to the seven health boards, Welsh Ambulance Service, and Velindre;
- Distribution of face masks, gloves and aprons to all 640 GP clinics and the 40 GP out of hours services in Wales, as well as eye protection;
- Distribution of PPE for all 715 pharmacies in Wales;
- A contingency plan for social care access to PPE through local authorities’ directors of social services and also put in place arrangements to monitor the use of PPE and top up these supplies when needed.
However Mr Gething did warn that the "re-supply timeframe" of some of the PPE was "uncertain".
NHS chief executive Dr Andew Goodall said on Thursday efforts were being made to "step up" the very high volume of PPE being distributed across Wales.
"We have been increasing that over the last week or so in particular," he said.
"It's important to remember that while there has been a focus on the hospital environment we also need to recognise that it need to be available in other settings and we've changed those arrangements.
"On top of the local supplies that have been available, just over these recent weeks we have issued around three and a half million items from our pandemic stock from our warehouse. That includes things from face masks to clothing to gloves as you would expect.
"They have been distributed to GP practices over the last couple of weeks. We have also extended it to other areas such as social care and these should have been received [by local authorities] on Monday or Tuesday."
Dr Atherton concluded: "I know that staff in Wales are worried and anxious. I hear that through our health boards and medical directors.
"Our job is to give them reassurance on three things. First of all, that the guidance is right. It's difficult because the guidance is changing and being updated all the time as we learn more about the virus.
"Secondly we know there is PPE available here in Wales but it's a scarce resource and we need to use it wisely. We cannot afford to misuse it. And the third is that we really need to communicate to staff effectively."
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