# QotW: How much PPE do hospitals go through?

Why is the number needed so high?
14 July 2020

## Question

The government has provided  more than a billion items of PPE to hospitals. There have been 130,000 covid cases in hospitals, about 10,000 items of PPE per patient. Can you find out why so much?

Eva Higginbotham's been scrubbing up to get answer to Carol's question...

Eva - I’ll just pop on my gloves. Now, let’s have a look at those numbers shall we. Between the 25th February and the 5th of July 2020, the government provided 2.2 billion items of PPE, or Personal Protective Equipment, to the NHS. That’s a big number, for the 280 thousand-ish cases of coronavirus we have had so far. So where is it all going? I put the question to medic Isabelle Cochrane.

Isabelle - Let’s start by considering the figure itself: this 2.2 billion comprises not only the more obvious items, such masks, aprons, gowns, individual gloves, all things that we automatically think of when considering PPE - but also includes ‘behind the scenes’ provisions, such as cleaning equipment, detergent, swabs, and body bags.

Eva - So the definition that the government is using for PPE is broader than you might think. But how do the numbers scale up to nearly 10000 items per patient?

Isabelle - Let’s do the maths: When seeing a patient, a member of staff would be expected to wear a minimum of gloves, an apron, and a mask - so at least four items of PPE. Usually, a visor and hat would also be needed, increasing this to six items per patient encounter. Although PPE can sometimes be reused, generally between seeing patients, you would be expected to change at the very least your gloves and gown, to minimise the possibility of transmission of infection. Add to this that medical teams are pack animals - a patient in A&E might expect to be seen by a couple of junior doctors, a consultant, one or two nurses, then accompanied by two porters to the radiographer who takes their chest X-ray… you get the idea.

Eva - Latest government guidelines also state that staff should wear PPE when seeing any patient, not just confirmed or suspected covid cases. There’s also the tremendous work being done by the NHS outside of hospitals in community settings.

Isabelle - Finally, it might be worth asking how much PPE the NHS uses on a good day - the figure for PPE provision across the NHS in the year 2019 was around 2.4 billion - so despite the pandemic, we are only using about three times as much PPE as ‘normal’ - a comparison which can help put numbers with lots of zeroes on the end into perspective.

Eva - So there you have it - PPE isn’t just masks and gloves, but aprons, visors, and all sorts, patients are seen by lots of different people over the course of their stay in hospital, and to really prevent transmission an individual has to change all their PPE between each patient. Thanks Isabelle! Next week, we’ll be getting in a lather over this question from Julie:

Julie - I’m wondering if there’s any science around the wash rinse repeat method that manufacturers tell us is the best way to use our shampoo, or is it just a really clever way of getting us to use more?