The Irish government has pledged more than €220 million towards personal protective equipment or PPE.

As Ireland faces its biggest ever public health emergency, Maresa Fagan looks at the critical role PPE is playing in the battle to contain and eradicate Covid-19 and how it could mean the difference between life or death for those at the coalface at home and abroad.

This week saw healthcare workers at the coalface of the Covid-19 outbreak take to social media to make urgent appeals for personal protective equipment. They did so as a last resort.

Their desperate pleas sought goggles, visors, and face masks, basic protective kit, to help them deal with patients with the virus while protecting themselves.

The Irish Nurses and Midwives Union (IMNO) was inundated with calls about

limited supplies and concerns about the risks posed to staff.

General secretary Phil Ni Sheaghdha told RTÉ Radio 1 during the week there was no room for compromise on protective equipment for staff in all healthcare settings, whether in a hospital, nursing home, or in community services.

The shortage is not unique to Ireland. Headlines around the world echoed the same cry for more protective equipment for frontline staff.

On Thursday, acknowledging the limited supplies, the World Health Organisation (WHO) said equipment should only be reused as a last resort.

Mike Ryan, who heads the WHO’s health emergency programmes, said it was possible to extend the life of certain equipment but that reuse should be “very carefully considered in very limited circumstances and where we have no other options”.

The global demand for personal protective equipment, the HSE said, is “unprecedented” given the international public emergency posed by Covid-19.

It also signalled that it will have to prioritise who will receive protective kit.

In guidance issued to healthcare staff this week the HSE said it will need to direct supplies to “situations where the risk is greatest and where use of personal protective equipment is absolutely required”.

Supplies are critical in current global efforts to stem the spread of Covid-19 and bring the pandemic under control.

Respiratory masks, facial masks, long-sleeved gowns, goggles, and visors can prevent healthcare staff becoming infected and in turn help to reduce infection rates and potentially stop adding to the more than 24,000 deaths globally.

Creative solutions

The shortfall of personal protective equipment brought out the best in people this week.

The response from individuals, industry, and communities was extraordinary.

Necessity is the mother of invention and Covid-19 saw many examples of healthcare and industry professionals working together to respond.

Innovative tech companies are using 3D printers to run off visors and face shields. Co Wicklow-based company, Calt Dynamics, donated prototypes of its visor to a Dublin hospital this week and is now sharing its design with Stanley Black and Decker, a major US manufacturer.

“When we make the designs available, hopefully people with 3D printers in different regions can help out wherever they are needed,” Calt Dynamics CEO Ross Lawless said.

Cork-based company, Benchspace, made an appeal for volunteers with access to 3D printers to help with producing components for protective shields, while professor of Chemical Energy at UCC Colm O’Dwyer offered 3D-printing facilities in his applied nanoscience lab to print visors.

Another example of collaboration saw a group of Irish doctors join forces with two plastics companies in Northern Ireland, to produce a protective shield for use during high-risk procedures, such as putting a patient on a ventilator.

There was no end to inventive ideas and donations. Clothing manufacturer such as O’Neill’s sportswear has recommissioned production lines to make thousands of hospital scrubs. Boxer Conor McGregor also weighed in to pledge €1m to buy equipment.

Donations also came from universities and state companies such as Teagasc, which donated gloves and other kit normally used in its laboratories, as well as from the private sector from companies such as Intel.

Companies and individuals from all walks of life offered creative ideas to a critical problem. Welding masks, diving masks, and even masks that jockeys wear can be re-purposed for healthcare workers, some suggested.

Miriam Ahern, from Cobh, Co Cork, was among the many individuals to lend a hand.

Through social media she sourced 2,500 shower caps and goggles for staff at a Dublin hospital.

“I think it does people good to think that they are helping. It certainly gave me a lift to feel that I’m doing something that actually impacts people who are responding to the virus.

"It’s a great privilege to be able to do that,” she said.

The demand also prompted Professor Derek O’Keeffe from NUI Galway and Dr Kevin Johnson from the University of Limerick to launch a website — covidmedsupply.org — to co-ordinate the supply and demand of medical supplies and protective gear for hospitals and healthcare facilities.

Frontline infections

The need for basic protective equipment cannot be overstated.

The fact that one in four Covid-19 infections have been confirmed among healthcare staff bears this out.

As of midnight on Tuesday last, 321 healthcare staff had contracted Covid-19 in Ireland.

And this figure looks set to grow as Covid-19 testing is ramped up in the days ahead and more cases are confirmed.

Data analysed by the Health Protection Surveillance Centre further suggests that most of these healthcare workers contracted the virus on the frontline.

The majority, two thirds, had no recent history of foreign travel.

In response to calls for more protective equipment the Government said it has secured additional supply domestically and internationally and is expecting a large shipment from China this weekend.

The HSE has also established a national procurement office specifically to work on securing more of this essential kit.

HSE officials acknowledged stocks are running low but said €30m was invested in personal protective equipment stocks since the beginning of February and this weekend’s delivery will address shortages.

A spokesperson for the HSE said: “We are currently seeking to redistribute stocks to sites with particular shortages and are encouraging staff to use these resources appropriately at this stage of the crisis.”

As the Covid-19 crisis escalates in Europe, the European Commission is making bulk orders for ventilators and personal protective equipment.

Health Minister Simon Harris said the global shortage is massive but that the budget committed to personal protective equipment represented 15 years’ worth of supplies.

“We usually spend €15m each year and this year we are spending €225m. That is 15 years’ worth of personal protective equipment,” he told Newstalk radio.

“The world over, countries are competing to get personal protective equipment.

"The European Commission is now looking at how we can produce more,” he said.

Italy’s experience

To date, Italy has lost 45 doctors to Covid-19. The stark figure represents only a fraction of the toll Covid-19 has taken on the Italian healthcare system.

Estimates suggest more than 6,000 medical staff have been infected to date.

Without the necessary protective equipment to face down this biological threat, Italy’s hospitals became overwhelmed and doctors, nurses, and other healthcare staff died.

These deaths were preventable and prompted Italian doctors on the frontline to issue grave warnings to other countries grappling with Covid-19 to stock up on personal protective equipment supplies.

Nobody wants to see the loss of life witnessed in Italy replicated in Ireland. However, we are still in the grip of this pandemic. The

infection rate accelerated in Europe and the US in recent days.

That is why the supply of masks, visors, goggles, and basic protective kit, is so critical in the days and weeks ahead.

We must learn from Italy’s Covid-19 experience.

Every government and health service has a duty of care to those on the frontline. We must protect those striving to save lives to, ultimately, protect us all.

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