From the start of the Coronavirus crisis, critics of Boris Johnson have done everything they can to exaggerate and amplify any potential shortfalls in the UK’s strategy – to make the Government look as bad as possible.
The latest battle is around personal protective equipment (PPE), which Ministers are under enormous pressure to obtain.
Bill Esterson, the Labour MP, called the Government’s approach to obtaining it “shambolic“, and the media has not been particularly polite either. On Monday Hugh Pym, the BBC’s Health Editor, asked whether MPs were “ashamed” about the lack of supply for NHS workers.
The consistently hyperbolic tone of PPE questions at daily briefings arguably tipped Dr Jenny Harries, the Deputy Chief Medical Officer, over the edge on Sunday. She told reporters that we need to have a “more adult and detailed conversation” on PPE.
Harries is right. Throughout the Coronavirus crisis, what’s been disappointing is the infantile way in which this pandemic has been treated. From medical equipment, to herd immunity, to data collection, everything has been reduced and given no nuance – in order to frame Governmental decisions as simply “good” or “bad”.
Yes, it’s true that many doctors, nurses and care staff are crying out for more PPE – and the Government and NHS must work as fast as possible to sort it out. But there are also huge complexities to the situation, which are left out of the media narrative.
Far from being “shambolic”, the UK has moved mountains around PPE, with over a billion items delivered to the NHS between February 25 and April 18 (53 days). The problem the country has, along with many others, (which strangely never make it into debates on shortfalls) is that global demand outpaces this. It has been astronomical.
Furthermore, this demand is fragmented – and cannot be neatly dealt with. PPE is an umbrella term that describes all sorts of separate products, such as masks, aprons, gowns, gloves, body bags, pulse oximeters, swabs, clinical waste containers, detergent and cleaning equipment. The production of each of these involves different processes, supply chains, some of them have shorter expiry dates than others, and so forth, and the demand for these varies too.
One need only examine data from Lincolnshire Hospital Trust (covering three hospitals) to see big variations in how PPE is needed. Figures released by Matt Warman, the MP for Boston and Skegness, showed that 39,500 surgical masks per day were used, along with 11,495 gloves, 1,501 gowns and 4,201 highly-protective FFP3 respirator masks.
Trusts have now started to calculate daily usage rates for PPE, versus stock levels, and it appears that gowns are the most in demand. Conversely, in some cases, supply might actually outstrip demand – for instance, 470 million pairs of gloves have been shipped (compared to 1.2 million gowns), forming the bulk of supplies – but there is no evidence that half of demand is for gloves. Demand will also vary according to what part of the UK needs it, with some areas more affected by Coronavirus than others. The interplay of these factors needs to be appreciated.
There will be other considerations in due course, as to the UK’s relationship with PPE. One fact about our shortages is that they show the downsides of globalisation, which has advanced our economy in enormous ways – but ultimately means we are at the mercy of other countries’ manufacturing chains and decisions, in regards to how quickly we get equipment.
Right now, our reliance on global supply networks not only means equipment is slower to arrive with big transport costs, but that there is the potential for other governments to be uncooperative, depending on their own needs.
Take what’s happening with Turkey. The British Government has been called an “embarrassment” for not getting 400,000 protective gowns from the country (which would only last three days, incidentally, for all the newspaper hysteria around it).
But it actually seems Turkey is to blame for what’s happened. Not least because Italy, Spain and Belgium have all had similar hold-ups from the country. Belgium’s health ministry has even filed a criminal complaint after delays in receiving masks from Turkish companies. Don’t hold your breath for any condemnation from our media, though…
Similarly, our reliance on China – where the UK has bought PPE, such as fluid-repellent non-woven gowns – looks less and less desirable, for lots of reasons. One area causing concern is that the country has introduced tighter customs inspections on exports – ostensibly for quality control, but some suspect these are actually designed to slow down how quickly it can ship stock (in case it has a second wave of the crisis).
Some, of course, have criticised the UK for not building enough of its own PPE. Yesterday, The Daily Telegraph reports that millions of PPE, such as masks and respirators, had been shipped from Britain to Europe – in news that has angered many.
One explanation for this is that the World Health Organisation declared the virus a global pandemic on March 11 – and that was when (largely) unaffected countries, like ours, had the signal to massively step up emergency efforts, such as obtaining PPE. All the while Italy and other countries had experienced COVID-19, and filed their orders for more equipment – and had bought from the UK.
Even so, the UK ultimately has to accept its own part in the globalisation bargain. It is reasonable for other countries to be able to purchase equipment from us, and may be damaging to limit exports.
If there’s anything the Government could improve on, two main steps come to mind.
The first is being as clear as possible of its expectations of NHS workers, who are put in the worst situations – should they not have sufficient PPE, and have to choose whether to help a patient, putting their life at risk – or step back for their own protection.
Public Health England has made guidelines available around these scenarios, and they should be conveyed as widely as possible.
There are also clearly UK organisations that would like to be involved in producing PPE for the pandemic. Esterson, the aforementioned Labour MP’s, Twitter post brought up a constituent who had offered to make “10 million masks”. The Government has said its investigating 159 potential manufacturers. Additionally, it has recruited the former Olympics chief to deal for help with PPE, who will hopefully be keen to enrol many new providers.
The nation clearly has untapped potential to produce more PPE. The short-term question is how the Government can quickly mobilise these resources. The longer-term question is what our desperate calls for PPE from abroad will mean, in the future, for British industry.