Bengal COVID warriors worry over tiny, oversize PPE By Sudipto Chowdhury

Kolkata, May 15 () One size doesn't fit all, andmany doctors and other medical staff on the frontline of thefight against COVID-19 in West Bengal are learning this thehard way.

Donning and doffing the armour-the PPE- their defenceagainst the disease, has become a daily struggle for them,with some complaining that their colleagues got infected withthe coronavirus because of the wrong size of the battle gear.

Some from the medical fraternity, including thoseserving in government hospitals, said putting on the personalproctective equipment (PPE) and removing it, particularly thelatter, in an incorrect way, exposes them to the risk ofcontracting the disease.

"There is a process of correctly donning and doffingthe PPE. Non-adherence to that process can put a medical staffat risk," a doctor at R G Kar Medical College and Hospitaltold .

Expressly insisting that he should not be named, thedoctor said the coveralls supplied to them often did not matchtheir size.

"We need PPE that match out height and body mass whichwe don't always get. At times we have to squeeze ourselvesinto the coveralls and there are times when they hang looselyover us. A little carelessness can leave us sick with thevirus," he said.

The doctor said the virus sticks to the outer surfaceof the coverall and incautious removal of the gear couldtransfer it to the human body.

Around 150 frontline COVID fighters, including doctorsand nurses, have fallen sick with the virus in West Bengal sofar.

The doctor said some training was required before amedical professional can wear and remove the air-tight andstifling synthetic clothing correctly.

A PPE consists of a mask or respirator, goggles orface shield, gloves, coverall/gowns (with or without apron), ahead cover and a shoe cover. All frontline health workerstreating COVID-19 patients should necessarily wear it.

"The causative agent for COVID-19 is transmittedhuman-to-human mainly through respiratory droplets generatedwhen people cough or sneeze, and also by touching contaminatedobjects... So PPE is very important for us, and proper donningand doffing is even more important to avoid contamination,"another senior doctor at the Nil Ratan Sircar Medical Collegeand Hospital said.

Two doctors in the acute respiratory infectionssection of the Institute of Child Health could not get PPEbecause they were too tall, while three lady doctors at NRSMedical College and Hospital treating COVID-19 patients had tomake do with oversized personal protective equipment.

Another doctor at R G Kar Medical College Hospitalsaid wearing a tight coverall was risky as even a small tearcould let the virus in.

"First, for almost a month we did not get any PPE andthen what we are getting is not fitting us. How can you expectus to take the risk. I have purchased at least 7 PPE from thelocal market at a very high cost. My safety is my prioritynow," a senior gynaecologist at Basirhat Hospital in North 24Parganas district told .

Most of these doctors are using PPE for the firsttime, said a doctor at Beleghata Infectious Diseases Hospital.

In the absence of training on how to don and doff thecoveralls, some medical professions have turned to YouTube forhelp, he said.

"Correctly doffing the gear is very important as it'sthen that the chances of getting infected are high. As soon asthe patient care tasks are over, careful removal of the PPEand discarding it in the receptacle is very crucial.

"While removing them we must pay attention to avoidself-contamination or contaminating the environment withinfected equipment. The PPEs must be opened inside out," hesaid.

West Bengal faced acute shortage of PPE during theearly days of the outbreak and decided to get themmanufactured 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 statehad manufactured 8 lakh PPE till May 14, while orders for 8.50lakh are pending delivery. SCH RG SKSK SK