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Medical Staff Wary As Lack Of Quality Protection Gear Ails Hospitals

BENGALURU : The rush to manufacture more personal protective equipment (PPE) such as masks, gowns and gloves may lead to a compromise in quality, putting health professionals at risk in the middle of the coronavirus pandemic, said experts.

The comments come against the backdrop of the shortage of such equipment, which is causing a lot of concern.

The absence of specifications or guidelines has led to firms mushrooming overnight, stitching and selling masks and gowns. However, public health experts have stressed that accredited agencies must maintain quality control of PPE as healthcare workers face grave risks while treating covid-19 patients.

“We have told the health ministry that only PPE approved by accredited bodies should be supplied. These accredited agencies should start surprise checks of random batches to ensure we are using good quality PPE that is in line with specifications,” said Dr Giridhar P. Gyani, director general of the Association of Healthcare Providers of India (AHPI).

The shortage of high-quality PPE is because of the industry being largely unregulated, said manufacturers and industry experts.

India does not have specifications and standards of its own and follows those set by China or the US.

“In this time of crisis, we must explore locally available resources and test them to manufacture our own version of effective PPE at scale. Materials such as high density polyethylene film, polypropylene, and polyester are good enough for making coveralls and can be tested for mass production. They are locally available,” said Yadav Chandna, a researcher and industry expert based in Delhi.

“India must come up with its own specifications, just like China has. The absence of this has led to the shortage and quality issues,” said Chandna.

This is significant as coronavirus has spread to 30% of India’s districts and there are complaints of substandard PPE by healthcare workers. Mumbai’s Wockhardt and Jaslok hospitals have been declared containment zones after 30 nurses and doctors of the former and 10 healthcare workers of the latter tested positive for covid-19.

The Thrissur-based United Nurses Association (UNA), a body of registered nurses in Kerala, has approached the Supreme Court for a direction to the government to formulate a national covid-19 management protocol to address grave risks faced by healthcare workers and to ensure that PPE is available to them.

“Everyday our nurses treating covid-19 patients face the risk of getting infected and spreading it to other nurses when they return to their hostels. We filed a PIL (public interest litigation) in the apex court on 4 April seeking a coronavirus protocol for the country,” said Jasminsha M., Kerala state president of the UNA.

The shortage of supply has brought a lot of new players into the market and if healthcare workers and government agencies ensured the specifications were followed there would be no substandard kits in circulation, said Dr Ravindra Karanjekar, chairman of National Board for Quality Promotion.

“When doctors are treating covid-19 patients, PPEs must be changed for every positive patient. If this process is compromised because of the shortage, the PPE will have no effect,” Dr Karanjekar said. The board would discuss the issue of quality with the Indian Council for Medical Research, he said. “In emergency situations such as this, we can only take a good look at specifications and okay it.”

There are a number of reasons for the shortage, said Dr Prashanth R. Reddy, a Bengaluru-based ENT surgeon. The raw material for manufacture of PPE has to be sourced from China, which is difficult at this time. There is no Indian standard for manufacture of coveralls, gloves, masks, and face shield with most equipment being made to American or Chinese specifications, he said.

“Even for N95 masks, there is no regulatory mechanism that prescribes any alternative with its own specifications. The government should test and come up with its own standards,” said Dr Reddy. “The textile and fabric units with the ability to manufacture PPE and masks should have been identified and asked to operate in the lockdown to ramp up production.”

It is also important to create a digital communication platform to make healthcare workers across the country aware about the right use of PPE, Dr Reddy said.-Livemint

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