Frontline staff in some dialysis units and aged care facilities are reporting significant difficulties accessing personal protective equipment, while a cancer treatment centre was forced to produce its own hand sanitiser from donated ingredients after 200 litres “strangely went missing”.
Unprecedented demand for personal protective equipment (PPE) and hand sanitiser during the pandemic has caused shortages across the healthcare system, prompting warnings from Catholic Healthcare Australia, the Australian Nursing and Midwifery Federation, the Australian Medical Association and the Royal Australian College of General Practitioners.
On Sunday, the government enacted new regulations banning the export of disposable face masks, gloves, gowns, goggles, alcohol wipes and hand sanitiser.
It has also sought to boost supply by opening up the nation’s emergency medical stockpile and increasing domestic production, including through calls for Australian companies to pivot into the production of PPE, and sending in the army to help double the production of local manufacturer Med-Con.
Globally, the World Health Organisation has urged nations to boost their domestic PPE production by 40% and lift export restrictions that are interrupting usual supply.
But PPE shortages are continuing to be felt to varying degrees in hospitals and clinics, including in some services caring for extremely vulnerable patients.
Patrick Beissel, a registered nurse, said medical staff at his dialysis unit in Sydney’s north-west had faced critical shortages of masks. At some points, staff had been forced to either re-use the equipment or go without.
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Dialysis units treat some of the healthcare system’s most vulnerable patients, who are at “higher risk of severe symptoms and complications from coronavirus”, according to Kidney Health Australia. The leading not-for-profit organisation has advised dialysis patients to continue receiving their treatment amid the Covid-19 pandemic and to contact their dialysis unit to do so as safely as possible. If patients are unwell, particularly with a fever, they are advised to phone their unit and act on the advice of nursing staff.
Beissel said his unit generally saw a maximum of about 32 patients a day across two shifts. They had, until recently, had only half a box of surgical masks to share between staff and patients.
Beissel said promises of more stock had not materialised and staff had resorted to scrounging for their own masks.
“Our situation is not unique, which makes it even more appalling,” he told the Guardian. “No one as far as I know is wearing a mask full-time. We are also running out of hand sanitiser, aprons and antiseptic wipes, with uncertainty about when or how we will get more.”
Beissel said staff at the unit received new surgical masks last week, but not the N95 or the P2 masks recommended by the federal government and NSW Health in certain higher-risk circumstances.
The unit is run by Fresenius Medical Care, a multinational giant, and one of the biggest dialysis treatment providers in the country.
Fresenius denied any suggestion of PPE shortages in its dialysis units and said it was meeting the government’s guidelines on PPE use.
The Health Services Union, which represents aged care workers, said its members were also continuing to report problematic access to PPE.
In response to the recent PPE shortages in aged care, the government has opened up a direct line to the federal health department for providers, through which they can request supplies from the national medical stockpile.
Requests are being triaged to prioritise PPE for providers who have had a confirmed case of Covid-19.
The Health Services Union’s national secretary, Gerard Hayes, said it was crucial that PPE was distributed in a preventative way, rather than simply waiting for a problem to emerge.
“Everybody is on the same page here,” Hayes said. “Don’t wait for the issue, you’ve got to prevent it. That’s the only way to resolve the matter in aged care. If they can open up those stockpiles now, and hopefully they have, that will at least stop issues developing.”
The Australian Healthcare and Hospitals Association’s chief executive, Alison Verhoeven, said there was currently a “high degree of prioritisation” of PPE to critical areas of the healthcare system.
The national pandemic plan set out a hierarchy of organisations that could distribute PPE, she said.
Hospital access to PPE from the national medical stockpile was requested by the state health departments. General practice and community pharmacy requests were being governed by primary health networks, with GPs given priority, particularly in areas with high rates of chronic disease.
Verhoeven told the Guardian that other health businesses, such as dentistry and physiotherapy, were much further down the priority list. “What the government has been doing has been prioritising that to areas which absolutely have to function and can’t function without PPE.
“Clearly that’s intensive care, and it is the management of vulnerable patients … dialysis patients, Aboriginal communities, some very vulnerable older people. Managing their care is actually quite tricky without PPE.”
The cancer treatment centre Chris O’Brien Lifehouse currently had adequate stocks of PPE but knew it had “greater challenges to face before this is over”, said its chief executive, Eileen Hannagan. The centre was left in a difficult position when 200 litres of its hand sanitiser “strangely went missing” earlier this month.
Hannagan said the losses were made up by donations of sanitiser ingredients from across Sydney and interstate, including from universities, gin distilleries, hairdressers and chemists. The centre was now using the donations to produce its own sanitiser.
“The challenge is looking after our staff and ensuring they feel safe and supported,” Hannagan said. “We’re balancing their understandable anxiety and fears against the responsible use of PPE for the protection of staff and patients and ensuring supply into the future. We know we have greater challenges to face before this is over.”