One size doesn't fit all, and
many doctors and other medical staff on the frontline of the fight against COVID-19 in West Bengal are learning this the hard way.
Donning and doffing the armour-the PPE- their defence against the disease, has become a daily struggle for them, with some complaining that their colleagues got infected with the coronavirus because of the wrong size of the battle gear.
Some from the medical fraternity, including those serving in government hospitals, said putting on the personal proctective equipment (PPE) and removing it, particularly the latter, in an incorrect way, exposes them to the risk of contracting the disease.
"There is a process of correctly donning and doffing the PPE. Non-adherence to that process can put a medical staff at risk," a doctor at R G Kar Medical College and Hospital told PTI.
Expressly insisting that he should not be named, the doctor said the coveralls supplied to them often did not match their size.
"We need PPE that match out height and body mass which we don't always get. At times we have to squeeze ourselves into the coveralls and there are times when they hang loosely over us. A little carelessness can leave us sick with the virus," he said.
The doctor said the virus sticks to the outer surface of the coverall and incautious removal of the gear could transfer it to the human body.
Around 150 frontline COVID fighters, including doctors and nurses, have fallen sick with the virus in West Bengal so far.
The doctor said some training was required before a medical professional can wear and remove the air-tight and stifling synthetic clothing correctly.
A PPE consists of a mask or respirator, goggles or face shield, gloves, coverall/gowns (with or without apron), a head cover and a shoe cover. All frontline health workers treating COVID-19 patients should necessarily wear it.
"The causative agent for COVID-19 is transmitted human-to-human mainly through respiratory droplets generated when people cough or sneeze, and also by touching contaminated objects... So PPE is very important for us, and proper donning and doffing is even more important to avoid contamination," another senior doctor at the Nil Ratan Sircar Medical College and Hospital said.
Two doctors in the acute respiratory infections section of the Institute of Child Health could not get PPE because they were too tall, while three lady doctors at NRS Medical College and Hospital treating COVID-19 patients had to make do with oversized personal protective equipment.
Another doctor at R G Kar Medical College Hospital said wearing a tight coverall was risky as even a small tear could let the virus in.
"First, for almost a month we did not get any PPE and then what we are getting is not fitting us. How can you expect us to take the risk. I have purchased at least 7 PPE from the local market at a very high cost. My safety is my priority now," a senior gynaecologist at Basirhat Hospital in North 24 Parganas district told PTI.
Most of these doctors are using PPE for the first time, said a doctor at Beleghata Infectious Diseases Hospital.
In the absence of training on how to don and doff the coveralls, some medical professions have turned to YouTube for help, he said.
"Correctly doffing the gear is very important as it's then that the chances of getting infected are high. As soon as the patient care tasks are over, careful removal of the PPE and discarding it in the receptacle is very crucial.
"While removing them we must pay attention to avoid self-contamination or contaminating the environment with infected equipment. The PPEs must be opened inside out," he said.
West Bengal faced acute shortage of PPE during the early days of the outbreak and decided to get them manufactured in micro, small and medium enterprises (MSMEs) in the state. It still has to depend on other states for PPE.
According to a government health bulletin, the state had manufactured 8 lakh PPE till May 14, while orders for 8.50 lakh are pending delivery.
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