Hospitals must fulfil their obligations to staff by providing the right equipment, says academic
New Zealand’s healthcare workers dealing with Covid-19 patients must have access to high-quality personal protective equipment or they cannot “reasonably be expected” to continue working, a University of Otago academic has said.
Elizabeth Fenton, a lecturer with the university’s bioethics centre, warns that hospitals and clinics must provide staff with the “best chance of protecting themselves from the most severe forms of Covid-19”.
“Anything less is a failure of our obligations to them, and of our obligations to provide a functioning health system to all those who will need it,” she writes in a blogpost for the Journal of Medical Ethics.
“Covid-19 poses risks to healthcare workers that exceed those posed to members of the public. Repeated exposure to infected patients increases their risk of infection and might also make their symptoms more severe if they become infected.”
Fenton said that in Italy, approximately 9 per cent of Covid-19 cases were health workers and at least 37 doctors had died from the disease.
“Covid-19 is highly infectious in hospital settings, and some settings are much more dangerous than others. Operating theatres, for example, are particularly problematic because the virus can be widely distributed through the intubation process and also through the spread of the patient’s bodily fluids around the room,” she writes.
“Aerosol spread means the virus will remain on surfaces in the room, including the walls and ceiling. It is not surprising that surgeons are concerned about the implications for risk exposure in theatre.”
The NZ government published updated guidelines on 7 April for the use of PPE by health workers. The Ministry of Health has also increased the supply and distribution of equipment such as gloves, medical masks, face shields and gowns.
“Frontline healthcare workers are questioning whether sufficient PPE will be available to them in the coming weeks and months, and whether the forms of PPE they are given will provide sufficient protection against Covid-19,” Fenton writes.
“Many staff are being advised to wear PPE only when caring for patients with confirmed or suspected cases of Covid-19. But if infected patients who are not symptomatic—and who therefore may not have been tested, so are neither suspected nor confirmed—can spread the virus, this advice suggests a potentially dangerous underuse of PPE.”