Shortage of protective gear is now being felt in many hospitals around the country as the number of patients testing positive for the potentially deadly coronavirus continues to increase.

So far, four doctors are being tested for the virus after developing symptoms, including the one who took a swab from a patient who passed away in Khyber Pakhtunkhwa on Wednesday.

Medical staff at various public and private sector hospitals — doctors, nurses and even lab technicians — now say they fear for their safety and don’t want to serve in wards where coronavirus patients are lodged.

A Personal Protective Equipment (PPE) kit consists of specialised clothing and devices — disposable masks, gowns, hoods, gloves, shoe covers, face shields and protective goggles — and must be worn by healthcare providers dealing with infectious diseases.

Talking to Dawn, infectious diseases experts said young doctors and medical staff demanding PPE kits must be educated about infection control and prevention. The PPE kits they are demanding are often not needed for their regular duties. If all of them are provided the specialised protective equipment, the kits’ supply to doctors who are actually seeing coronavirus patients as well as those with tuberculosis, swine flu and Congo fever will be adversely affected.

Dawn also reached out to infectious diseases experts in Khyber Pakhtunkhwa, Punjab and Balochistan to assess the situation and received a similar feedback.

“We are running short of PPE kits and sanitiser,” one senior doctor at a public sector hospital in Karachi, which has been designated for treatment of coronavirus patients, said. “Face shields and goggles are being reused by medical staff directly taking care of COVID-19 patients.”

Doctors at the Indus Hospital and Dow Ojha — two facilities dealing with coronavirus cases — expressed the same fears, emphasising they did need masks and PPE kits.

Meanwhile, at the Civil Hospital, Karachi, a shortage has yet to be felt, but the staff members are worried about continuation of the kits’ supply.

“So far, surgical and N95 masks and PPE kits are available in Civil Hospital, but there is a shortage in the market and many private facilities are already struggling to get them,” said infectious diseases specialist Dr Azizullah Khan Dhiloo, an assistant professor at the Dow University of Health Sciences/Civil Hospital.

“At this point, only the government can ensure the availability of these items since the number of COVID-19 cases is increasing very fast,” he said.

Facing protests from doctors and hospital administrations, provincial governments are scrambling to arrange more kits. Protective kits worth Rs216 million have been ordered by the Punjab government. The Khyber Pakhtunkhwa government has allocated Rs500m for PPE kits, of which Rs40m has been spent on procurement thus far, according to the government’s spokesman.

The Services Institute of Medical Sciences, Lahore, saw protests by doctors in the past few days as stocks of protective gear ran low. The institute’s principal Dr Ayaz Mahmood said the hospital has made available sufficient stocks of the safety equipment for use by the frontline employees. “We have purchased new inventory, including 13,000 facemasks, 25,000 surgical gowns, 10,000 gloves, 13,000 caps and 250 litres of hand sanitiser as well as 1,950 hazmat suits for use in isolation wards housing suspected and confirmed patients of coronavirus,” he said.

The hospitals in Peshawar are also reeling from growing shortages. “There is a major shortage of PPE kits in public and private hospitals,” said Dr Mukhtiar Zaman, the head of pulmonology at the Rehman Medical College, Peshawar. “Even something as basic as a glove or sanitiser is not available, making it extremely difficult for healthcare providers.”

Dr Shireen Khan of the Fatimah Jinnah Hospital in Quetta, said past experience with infectious diseases had left her hospital better equipped and prepared for this outbreak, but warned that kits’ shortage could become a problem down the road.

Ashfaque Yusufzai in Peshawar and Asif Chau­dhry in Lahore also contributed to the report

Published in Dawn, March 20th, 2020