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NEW STUDY: CURRENT PPE NOT FIT FOR PURPOSE

04 May 2020

• NEW Pioneering UK Tests Show Standard Surgical Masks DO NOT Offer Protection Against Covid-19^[1]
• Spike in Incidence and Severity of Covid-19 Among Healthcare Workers^[2]
• The UK’s Only Surgical Trade Union Across All Specialties Calls for Urgent Action and Transparency
• NEW Volunteer Group Launched by Medics Reaches Out to Industry to Supply Reusable Protective Masks Such as Used in Construction, Asbestos Clearance, Pest Control, Factories, Shipyards, Oil & Gas, and Routinely by Members of the Armed Forces
• Four Volunteers Ballooned to Over 400 including Engineers, Med Students, Seamstresses, and Taxi Drivers in Just a few Weeks, Providing/Delivering Over 100,000 Pieces of PPE to the frontline
• ‘Every Man, Woman and Child Was Issued a Gas Mask in Wartime – We Have the Capabilities’
• One UK Community Successfully Furnished All Frontline Workers – in Hospital, Community and Nursing Home settings with Top-Level PPE from the Local Saw Mill, Fish Processing Factories
• Guidance on Masks for NHS Staff Based on ‘Weak Evidence and No Industrial Expertise’ 

London – 4 May, 2020 -  The UK’s only trade union representing surgeons across all specialties as well as anaesthetists, the Confederation of British Surgery (www.cbsgb.co.uk) today highlights NEW evidence  which shows the standard level of protection being advocated by Public Health England (PHE) and adopted throughout the NHS after their latest guidelines^[3] is woefully inadequate. The organisation; which was founded by the Presidents of surgical specialist associations across the UK and Ireland; is demanding transparency from the Government on PPE in safeguarding staff who may interact with Covid-19 positive patients and environments.

The Confederation highlights a new study by experts which shows the standard surgical facemask (known as Type IIR wet mask) currently recommended,  is unsuitable in the prevention of contamination from the Novel Coronavirus. Testing included wearing several surgical masks in layers and sealing the sides to the face with tape. The ONLY mask which proved effective was the FFP3 (‘Filtering Facepiece Particles’) model.

The traditional IIR-type mask is designed to protect the patient during a surgical procedure from the surgeons’ breath germs; not to protect the surgeon from the patient. Wearers of the classical version breathe unfiltered air in from the sides, in contrast to the FFP3 industrial mask - commonly used in construction, manufacturing and even in the art world - which is sealed and filters all the air breathed in by the healthcare worker. A technical review^[4] by HSE in 2008 showed a 6-fold reduction in inhaled aerosol with the surgical mask versus a 100-fold reduction in the industrial FFP3 mask.

A new volunteer group launched by medics is calling for personal protective equipment which may currently be stored unused in warehouses or factories to be donated – with PPE just from local saw mills and fish processing plants, one UK constituency was able to furnish all front line workers; from bus drivers to shop assistants; with kit.

Consultant Plastic Surgeon and Founding Member of the Confederation of British Surgery Mark Henley said: 

“The surgical world has been vocal in our grave reservations about the level of protection offered by current recommended personal protective equipment (PPE)^[5] and we are extremely concerned about the safety of our workforce - in particular those undertaking procedures within close proximity to the mouth and nose.

Med Supply Drive UK is a volunteer group of NHS doctors, medical students and allies who are urgently appealing for donations of high quality personal protective equipment for the NHS from industry; facilitating efficient transfer of resources locally. It was launched in late March by Dr. Jasmine Ho, a Surgical Research Training Fellow, and grew from a handful of volunteers to over 400 in just a few weeks, providing and distributing over 100,000 pieces of personal protective equipment (PPE). They are working on new designs and templates, such as gowns that don’t require sewing and 3D-printed visors.

According to Ms. Gillian Higgins, a surgical trainee who leads Med Supply Drive Scotland; which through simply cold calling local industry was able to supply nearly 10,000 pieces of kit in just a few days (even distributed via volunteering local taxi companies);

“During wartime, every man, woman and child was supplied with a gas mask – and we were effectively turning pots and pans into aeroplanes. Today, the global supply chain of PPE has turned into something like eBay, with global shortages, countries vying for equipment and shipments from abroad being delayed or diverted.

“We have the capabilities and the expertise, right here in the UK, to be able to address these issues. At MedSupplyDrive, we’re collaborating with other volunteer groups, industry, expert occupational health and scientific partners in order to develop innovative and sustainable solutions for PPE shortages, such as utilising manufacturing laser cutters, 3D printing and injection moulding manufacturing techniques.”

“Frontline workers exposed to the highest viral load and repeated exposure of COVID-19 remain the highest risk of contracting the virus.  There are issues with fit testing and worldwide shortages of disposable FFP3 masks; so we strongly endorse the use of reusable FFP3 respirators and the local expertise of the industries who routinely use them. This high-quality PPE can be cleaned and maintained, providing protection for many years.^[6] In the short term, for every additional individual wearing a reusable FFP3 respirator, it means disposable FFP3 masks can be made available for the other members of the workforce^[7][8] - we are not intending to replace the chain, but certainly to help supplement and replenish it with the highest levels of protection possible.”

The study was conducted by Dr James Douglas, who has been a GP for 40 years and has multiple peer reviewed publications in occupational health and aerosol generating procedures in industry. Councillor Niall McLean is a PPE expert based in Lochaber, Scotland, with a background in Nuclear Biological and Chemical Warfare Training from the British Military and 20 years’ experience of PPE training in the geotechnical industry.

Dr Douglas and Cllr McLean established a testing centre  using a smoke model to simulate an 8-hour shift exposed to COVID-19  in clinical practice. Their findings show that IIR masks are not effective against aerosol particles and therefore they collaborated to appeal to industry for high quality PPE to supply their community in Lochaber. Local donations from a saw mill, aluminium smelter and fish processing factories were able to provide high quality FFP3 respirators and Hazmat (Hazardous Materials) suits for frontline staff including hospital, NHS community staff and nursing home settings.

According to Dr. James Douglas; whose previous work includes ground-breaking research in occupational asthma;

“Whether it’s a fish processing plant or the paint shop in a car factory, the objective is always to reduce toxicity in the breathing zone of the worker by extraction ventilation and use PPE as a last resort. The NHS, in all its history, has never had to deal with any disease that is infecting and killing its workforce. But industry does have the experience. Asbestos is a tragic example, and the establishment underplayed the seriousness for decades – but we now know, that 1 in 10 people exposed to asbestos develop an incurable cancer 20 or 30 years after exposure to asbestos. And thus, asbestos clearance workers are sent into construction sites dressed as if they were going to land on the moon.

“The current guidelines on the standard surgical mask (IIR) are patently nonsense, and not even consistent with the guidance being given to the public on social distancing in a park. These masks were designed to protect the patient during surgery, they were never designed to protect the surgeon. This is why reaching out to industry makes sense – it’s ridiculous to be fretting about shipments from Turkey or China when there are store cupboards full of this equipment in locked down factories. Reusable masks could be cleaned and last the whole epidemic. Industry experts could advise hospitals on fitting and type of respirators. It feels almost like a pantomime: ‘(the solution) is right behind you!’”

Ms. Gillian Higgins added;

“The costs of disposable FFP3 masks can vary between £3-£5, and a re-usable one is priced around £30. It makes no financial or environmental sense, if you see a handful of cases that’s the bin full of disposable masks. There is machinery available in Europe for circa £100K which can produce 5,000 reusable respirators a week. In the short term, whilst industry is furloughed, buying their stockpiles of PPE allows efficient transfer of high quality protective equipment from stockrooms and warehouses to the NHS frontline where it is currently urgently needed, whilst giving the UK economy a cash injection. In the longer term manufacturing PPE in the UK will be important for the protection of key workers, the population and the UK economy.”

Mr. Henley, who is President of the British Association of Plastic, Aesthetic and Reconstructive Surgeons (BAPRAS) and who served in the Royal Navy including during the Falklands conflict, concludes;

“The British as a nation are brilliant at producing innovative solutions to unforeseen challenges and surgeons and anaesthetists constantly live with such challenges as part of their jobs. The Confederation of British Surgery applauds the Government and NHS for rising to this unprecedented challenge at so many levels but feel they might do well to learn from the lessons of history in warfare and the public response to national crises and seek solutions closer to home when establishing the new normal for living with COVID-19.”

-ENDS-

Launched in November 2018, The Confederation of British Surgery (www.cbsgb.co.uk) is the first and only trade union to be recognised under UK law to protect the welfare of surgeons, including the extended surgical team and their families. The CBS represents all surgeons, regardless of surgical

speciality or affiliation, and negotiates on their behalf the terms and conditions of service, contracts of employment, litigation and insurance. Follow @UKSurgeons on both Instagram and Twitter

For media enquiries contact Tingy Simoes tsimoes@wavelengthgroup.com on 020 7549 2863/07973 147388.

About MedSupply Drive UK

MedSupplyDrive UK (https://www.medsupplydrive.org.uk) is an organisation run by NHS doctors, medical students and individuals who are concerned about the interest of NHS frontline healthcare workers with inadequate PPE. We aim to coordinate supply of non-essential PPEs from other sources and re-direct them to the NHS frontline staff and other healthcare settings. We are also keen to support novel solutions for tackling PPE shortages. Additionally, we are exploring the scientific evidence for strategies that could be employed to prevent a critical lack of PPE.

DONATION: https://www.medsupplydrive.org.uk/donate

REQUEST: www.medsupplydrive.org.uk/make-a-request

VOLUNTEER: https://www.medsupplydrive.org.uk/volunteer

Email: info@medsupplydrive.org.uk

Facebook: @MedSupplyDriveUK https://www.facebook.com/medsupplydriveuk/

LinkedIn: https://www.linkedin.com/company/medsupplydrive-uk

Instagram: @MedSupplyDriveUK https://www.instagram.com/medsupplydriveuk/

Twitter: @MedSupDriveUK https://twitter.com/medsupdriveuk

MedSupplyDriveUK Scotland is the Scottish branch of MedSupplyDriveUK, a volunteer group of NHS doctors, medical students and allies urgently appealing for personal protective equipment (PPE) to be donated to local healthcare facilities in Scotland in order to protect frontline NHS staff and their patients.

Twitter - @MedSupDriveScot https://twitter.com/MedSupDriveScot

Facebook - https://www.facebook.com/MedSupplyDriveScotland

Instagram - @medsupplydrivescotland https://www.instagram.com/medsupplydrivescotland

 

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