Dr Sameer Gupta
Director
Umkal Hospital, Gurgaon

The PPE crisis with COVID-19

COVID-19 pandemic has taken a significant health and economic toll on the population. As we learned more about the disease and how it spreads, reports started emerging of healthcare workers getting infected. We were also taught the importance of PPE (personal protective equipment) in safe-guarding our frontline healthcare workers. A PPE consists of a body-protection suit, gloves, facemask, eye goggles, hair cover, and foot cover. PPEs in the past were called Hazmat suits and used in surgical cases with HIV-positive patients and such cases. With the advent of HIV treatment, the cases became fewer, and hence the use of PPE was not frequent. With the COVID-19 pandemic, PPE has come in the forefront, and it has gained importance like never before.

Hospitals now have to ensure that all healthcare personnel coming in direct contact with patients, even in non-COVID-treating centers use PPE; albeit they come in contact with the asymptomatic patients and require quarantine for 14 days or worse if they contract the disease. If proper PPE precautions are not taken then multiple staff members may be required to be quarantined and in some cases the hospital maybe sealed – a trend we have seen across the country.

As we realized what PPE is, and its importance in prevention of the disease, there was a sudden global increase in demand for its use across the board, especially for healthcare workers. The national lockdown created logistical issues and some manufacturers faced challenges in transporting the PPEs. Around the same time, the government banned export of PPEs as Indian healthcare workers were grappling with the shortage.

The exponential worldwide demand and inability of healthcare equipment manufacturing industry to meet this surge was seen as a business opportunity, and many unscrupulous manufacturers and distributors started reaching out to health institutions offering these kits at exorbitant prices. Masks that were previously available for as low as one rupee are being marketed at many times that cost. Given the urgent need and very short supply, hospitals are left with no choice but to pay over-inflated prices for acquiring them. Though hospitals in a state of urgency are acquiring these kits, the quality of these kits is questionable as they might not be following the BIS standards.

However, as the pandemic continues to progress, a lot of renowned companies from multiple industries have stepped in to help deal with the shortage. These are non-traditional health equipment manufacturers but, given their infrastructure and historical commitment to quality, they can be better trusted with producing quality sanitizers, gloves, masks, PPE, etc., to help with the shortage.

Though it is encouraging to see everyone stepping in and doing their bit in this time of national crisis, the cost of gloves, masks, and other components of the PPE is still very high. A single healthcare worker requires multiple PPE kits a day; this adds up to the cost of treatment. Hospitals are forced to charge the cost of the PPE to the patient, but this has received a lot of criticism. Hospitals that are already running at low occupancy rates, along with the increased cost of operations with PPE costs, are facing major financial challenges.

COVID-19 pandemic has already taken significant health and economic toll on the population and healthcare systems across the world. Further, they have been overburdened owing to lack of facilities. We need to ensure that the situation does not worsen further.

The government must put a price cap on the cost of essential items that are required in the treatment and prevention of the COVID-19 pandemic. As it seems this situation might endure for some time to come, the government must step in and ensure that the hospitals are not forced to overpay to protect the healthcare workers who are at the forefront of this pandemic.

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