The ‘haves’ and ‘have-nots’ of PPE in COVID-19

By Cliff Shelton, Kariem El-Boghdadly, John B Appleby.

Photo provided by authors
Photo provided by authors

Personal protective equipment (PPE) has been a frequent source of controversy during the COVID-19 pandemic. At times, supplies have run short, leading individuals to purchase (and sometimes improvise) their own PPE; debate has raged over what PPE should be worn in different circumstances; and pictures of healthcare workers bearing the scars of long hours in respirator masks have been an enduring feature of social media feeds. At first glance, these issues may seem to unify a healthcare workforce who have faced adversity together during this difficult time, but we suggest that several inequalities have emerged between the ‘haves’ and the ‘have-nots’ of PPE.

As is sadly so often the case, inequalities arise in connection with finance, ethnicity, gender and professional power. Individual purchasing of PPE favours those with the resources to acquire scarce equipment. Professional guidelines are inevitably written from the perspectives of the profession in question, thereby neglecting those groups of workers who lack organised (and expert) professional representation. Personal protective equipment is often made for industrial rather than healthcare use, and is designed with a particular shape and size of a worker in mind. Moreover, this prototypical worker is seldom representative of our diverse healthcare workforce.

Though the vaccination programme provides a glimmer of light at the end of what seems like a very long, dark, tunnel, new variants of the SARS-CoV-2 virus pose a perennial threat. We must reflect on how decisions relating to PPE have impacted inequalities amongst healthcare workers. To avoid repeating the errors of the COVID-19 pandemic, governments, industry and healthcare organisations should strive to develop PPE, policies and practices that work equally well for everyone facing COVID-19 as well as future pandemics.

Paper title: The ‘haves’ and ‘have-nots’ of personal protective equipment during the COVID-19 pandemic: the ethics of emerging inequalities amongst healthcare workers

Authors: Cliff Shelton, Kariem El-Boghdadly, John B Appleby

Competing interests: The authors have no competing interests to declare

Social media: Twitter: @DrCliffShelton @elboghdadly @JohnBAppleby

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