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Survey highlights inadequate supply of PPE to front-line workers by hospitals

By Jeremy Booth, DTI
June 10, 2020

DAVOS, Switzerland: An international cross-sectional survey has found that most surgeons believed that the supply of personal protective equipment (PPE) to front-line healthcare workers by hospitals in the first month of the SARS-CoV-2 outbreak was inadequate.

Conducted between 8 April and 12 April, the survey was sent to members of the Davos-based AO CMF global network of clinicians, and aimed to assess the impact of the SARS-CoV-2 pandemic on AO CMF surgeons and on patient care across different regions. It also aimed to measure the adequacy of the PPE supplied to front-line healthcare workers by hospitals.

It found that only 42.6% of respondents had access to adequate PPE and that the availability of PPE among healthcare workers and surgeons differed significantly across the regions where respondents were practising.

According to the results, most respondents felt that hospitals had not provided front-line healthcare workers with adequate PPE. The majority of respondents from Africa (79.2%), Asia (54.0%), Europe (54.0%) and South America (66.7%) said that the PPE supplied by hospitals to front-line healthcare workers had been inadequate. The majority of respondents practising in Australia (60.0%) and the Middle East (57.7%) indicated that the PPE supplied to front-line healthcare workers by hospitals was adequate. Of the respondents from North America, 51.1% reported that the PPE supplied was not adequate and 48.9% reported that it was. When the findings were applied to individual countries, PPE was reported to be less adequate in countries with a lower number of cases of COVID-19.

The survey found that the best protection was offered to surgeons in Australia, where 60.0% of surgeons worked with N95/FFP2 masks and 40.0% with powered air-purifying respirator (PAPR) systems. In North America, 47.7% of surgeons worked with N95/FFP2 masks and 42.2% worked with PAPR systems.

It was found that, in Africa, only surgical masks were available to the vast majority of surgeons when treating patients with COVID-19, and a high percentage of surgeons also reported that they had to rely on surgical masks for protection in Asia (30.0%), Europe (24.2%), the Middle East (36.0%), North America (11.1%) and South America (30.2%).

Respondents practising in Africa and South America were more likely to report inadequate PPE when compared with those practising in Europe. Respondents were also asked whether their regions had previously experienced an outbreak of severe acute respiratory syndrome or swine flu, however, and no statistically significant difference in the availability of PPE between regions was found once the survey results were adjusted for the factors of a previous outbreak, the adherence to guidelines and the availability of maximal face mask protection.

The survey found that more than 80% of surgeons across all regions had stopped performing elective surgery.

Commenting on the risk of infection for front-line healthcare workers and the responsibility of hospitals to minimise occupational health risks, the authors stated in the survey results that “it is remarkable to notice that from this survey the majority of CMF surgeons feel the hospitals do not provide adequate PPE”.

They continued: “Furthermore, we found that as the number of confirmed COVID-19 cases per country decreases, adequate amount and quality of PPE for the [healthcare workers] and surgeons decreases. This is a troubling finding, since countries with low numbers of confirmed COVID-19 cases (Pakistan, Mexico, the Philippines, Colombia and Argentina) are probably more at risk for further spread of [SARS-CoV-2] making access to adequate PPE even more important.”

Six respondents to the survey indicated that they had tested positive for SARS-CoV-2.

There were 511 respondents to the survey from the regions of Africa (24), Asia (135), Australia (five), Europe (124), the Middle East (28), North America (59) and South America (124). Surgeons from a number of specialties participated in the survey, but those specialised in oral and maxillofacial surgery were the vast majority (412), followed by those specialised in plastic and reconstructive surgery (54), and ear, nose and throat surgery (25).

The study, titled “The global impact of COVID-19 on craniomaxillofacial surgeons”, was published online on 31 May 2020 in Craniomaxillofacial Trauma and Reconstruction, ahead of inclusion in an issue.

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