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One in four GPs has seen Covid-positive patients with no PPE



A Pulse survey of 675 GPs has revealed that one in four have seen Covid-19 patients face-to-face without PPE, while more than half feel unsafe as a result of the lack of PPE.

The survey, conducted between April 17 and 21, also found that more than three-quarters fear for their health or life.

GPs are continuing to struggle with PPE supplies, with only one-third receiving adequate facemasks, and only 13% and 12% say they have received adequate eye protectors and gowns (aprons) respectively.

Many of the GPs who have seen Covid-positive patients with no PPE said this was when travel history (ie, patients who had arrived from Italy or China) was – wrongly, in hindsight – being used as the main risk factor.

But a number of GPs said that they have seen patients who have been asymptomatic, but later found to have been positive at the time – which is indicative of the fact all patients should be considered potentially Covid-positive.

The survey found:

  • 74% of GPs fear for their health/life;
  • 26% of GPs have seen Covid-19 patients without PPE;
  • 52% of GPs feel unsafe as a result of lack of PPE;
  • Only 33% of GPs say they have received an adequate supply of facemasks; only 13% and 12% say they have received adequate eye protectors and gowns (aprons) respectively;
  • 61% of GPs say they are adopting a ‘no PPE, no see’ policy;
  • One in five GPs say they have had confirmed or suspected Covid-19;
  • 28% have had to self-isolate, increasing workforce pressures.

Public Health England changed its guidance to advise doctors to reuse PPE in certain situations. In the long term, health secretary Matt Hancock has announced that he is working with overseas factories, and that he has engaged 159 UK manufacturers to step up production. He said that around ‘one billion’ items a month were needed.

Pulse has reported on GPs relying on donations from dentists and patients for PPE.

Dr Tracey Turpin, a salaried GP in Durham, said: ‘We have no gowns, just plastic mini pinnies. My kids wear better protection for painting. We have eye goggles but only because donated by a school.’

There are also concerns that secondary care is struggling to obtain PPE, which will mean GPs will be less likely to receive equipment.

Dr Emily Armitage, a GP in NHS Vale of York CCG, said the CCG requested whether they could give some of the practice’s gowns to secondary care. She said: ‘We sourced some gowns (not many!) via a contact in our PCN and claimed the cost from the CCG. So knowing we had some, the CCG asked us this week if we would send them back to be used in secondary care – who are obviously in great need – which we have done.’

Dr Zishan Syed, a GP in Kent and a member of the LMC, said that the PPE guidance prioritise medics performing aerosol generating procedures (AGP)’. He adds: ‘[This] creates a divide between primary and secondary care with arguments of AGP being done predominantly in secondary care and not in primary care. This means that hospitals are prioritized for provision of FFP3 masks etc.’

Dr Nick Grundy, chair of GP Survival, said that Mr Hancock’s calculations are off: ‘A billion items a month would mean 166 million patient contacts all using two gloves, apron, mask, visor. This equates to 5.5m/day, which seems unlikely. Anyway, why are the government only discovering this now when it’s their job to know how many items/month they’d need in a pandemic?

‘Of course primary care is behind secondary care in the queue – but the fact that there is a queue is inexcusable, and the health secretary saying ever-larger numbers doesn’t get around that.’

Six GPs have tragically died with Covid-19.