2. The inadequate supply of personal protective equipment (PPE)

The inadequate supply of PPE is a feature of almost every evidence session (more so than the focus on adequate numbers of ventilators and ICU capacity – 17.3.20: q67, q124, q139-44; 26.3.20: q194; 14.4.20: q306; 17.4.20: q296).

Initial sessions focused on who should have access to PPE (for example, perhaps not GPs since people are advised not to attend surgeries – Harries, 5.3.20: q51) and the limited training on how to wear or dispose of it safely (Whitty, Chief Medical Officer, 5.3.20: q53).

The remaining sessions exposed a gulf in feedback between: (a) people giving oral evidence to the committee on behalf of government bodies, and (b) most other people responding to requests for information by MPs.

This disconnect prompts several MPs to describe PPE as a policy ‘fiasco’, note its impact on already decreasing trust in government, and connect this problem of trust to issues such as

• PPE standards that seemed out of step with WHO guidance (for example, 26.3.20: q237-48), and
• the reclassification of COVID-19 as no longer a ‘high-consequences infectious disease’ (note: it relates to the individual, not the population) (17.3.20: q170; 26.3.20: q258-9).

In other words, UK bodies denied – with only moderate success – that changes to PPE advice related to shortages of the right equipment.

Examples of specific PPE discussions include:

Pritchard (Chief Operating Officer, NHS England) and Stevens describe sufficient stockpiles but temporary distributional issues and a need to ramp up supply in the future, perhaps solved in a week (17.3.20: q129-31; 137). The Chair, Jeremy Hunt MP suggests that this answer is at odds with feedback from NHS staff describing access only to paper masks and aprons (17.3.20: q132).

Feedback from representatives of staff seeking PPE describe something more akin to a shortage crisis (for example, Nagpaul, 26.3.20: q239; Bullion, 26.3.20: q264; Green, 26.3.20: q266 and 289; Pittard, 17.4.20: q296; Kinnair, 17.4.20: q297 and 305). Again, Sarah Owen MP (26.3.20: q249) sums up the major gulf between oral evidence on PPE (from PHE and others) and the wider feedback from NHS and other care workers on the inadequacy of supply of the right protective equipment.

Hancock (17.4.20: q306) describes the supply of PPE (and ventilators) as the third element of his ‘battle plan’ (compare with Taiwo Owatemi MP, 17.4.20: q316 and Yvette Cooper MP, 17.4.20: q319 and a series of questions q348-58). However, Hopson (Chief Executive, NHS Providers, 14.5.20: q92-95) describes continued uncertainty (particularly with gowns), making it difficult to plan surgery or find the right PPE for women and ethnic minority staff, while Green (19.5.20: q470) describes the situation as far worse outside of NHS settings (on the assumption that the NHS was prioritised).

By June, Deighton, as ‘Adviser to the Secretary of State on PPE’, describes overcoming supply problems and taking the ‘kinks’ out of logistics (3.6.20: q553-4) and improvement by the day, while most questions suggest that this image of hope is still at odds with other feedback to MPs.

COVID-19 policy in the UK: oral evidence to the Health and Social Care Committee (5th March- 3rd June 2020)

1. The need to ramp up testing (for many purposes)
2. The inadequate supply of personal protective equipment (PPE)
3. Defining the policy problem: ‘herd immunity’, long term management, and the containability of COVID-19
4. Uncertainty and hesitancy during initial UK coronavirus responses
5. Confusion about the language of intervention and stages of intervention
6. The relationship between science, science advice, and policy
7. Lower profile changes to policy and practice
8. Race, ethnicity, and the social determinants of health