Coronavirus: Three ways to prevent PPE shortages in future outbreaks

05 June 2020

Provision of equipment should fall under critical national infrastructure, argue policy and manufacturing experts

By Kevin Wong, Reader in Community Justice and Barbara Shepherd, Head of Business Engagement at Manchester Fashion Institute, Manchester Metropolitan University

As Coronavirus (COVID-19) lockdown restrictions ease across the country, it is tempting to be lulled into a false sense of security that society has returned to normal and the urgent concerns magnified during lockdown have been resolved.

Of course, those concerns haven’t gone away and they have yet to be resolved. One of the most contentious life and death issues since the start of the pandemic has been the availability of personal protective equipment (PPE).

Since March we have witnessed regular accounts from NHS staff and their representatives about the lack of PPE; a situation which has received added poignancy by claims from the families of health and social care staff that they have contracted the virus and died because of this failure.

In March, the Government and senior NHS officials initially maintained that there was sufficient supply, but distribution was the problem. A month later, Matt Hancock the Health Secretary admitted that PPE provision was a "a huge challenge" and that: "we are tight on gowns and that is the pressure point."

Nationwide, initiatives sprung up to help production of protective equipment. A project led by Manchester Fashion Institute at Manchester Metropolitan University sped up bulk manufacturing of medical scrubs to ease shortages experienced by one regional NHS Trust.  

As reported by the BBC, the Department of Health stated that by 26 May, NHS Trusts and social care systems in England had received approximately 1.48 billion items of PPE.

One of the most contentious life and death issues since the start of the pandemic has been the availability of personal protective equipment

However, it is unclear if this has kept up with demand. As recently as the end of May, professional bodies and health unions warned that frontline staff may refuse to work if there is not enough PPE to ensure their safety. It is difficult to see what difference the Government’s appointment of a PPE Tsar in late April has so far made.

In the short term, we will have to see if Government, equipment importers and UK manufacturers can address demand, although they may be hindered by cumbersome procurement processes as experienced by one UK textile manufacturer .

In the medium and long term what can be done to avoid a recurrence of the same problem?

Here are our recommendations for the Government.

Recommendation one

The sourcing, manufacturing and distribution of PPE should be designated as being a sub-sector of one of the UK Government’s Critical National Infrastructure (CNI) sectors.

The UK government’s official definition of CNI is:

‘Those critical elements of infrastructure (namely assets, facilities, systems, networks or processes and the essential workers that operate and facilitate them), the loss or compromise of which could result in:

a)    Major detrimental impact on the availability, integrity or delivery of essential services – including those services whose integrity, if compromised, could result in significant loss of life or casualties – taking into account significant economic or social impacts; and/or

b)    Significant impact on national security, national defence, or the functioning of the state.

In the UK, currently there are 13 national infrastructure sectors: Chemicals, Civil Nuclear Communications, Defence, Emergency Services, Energy, Finance, Food, Government, Health, Space, Transport and Water.

Several of these sectors have defined ‘sub-sectors’. For example, Emergency Services can be split into Police, Ambulance, Fire Services and Coast Guard.

The sourcing, manufacturing and distribution of PPE should be designated as being a sub-sector of one of the UK Government’s Critical National Infrastructure (CNI) sectors

We would argue PPE provision should be designated as a sub-sector under Health.  This should ensure that PPE provision would then receive the priority and attention that it deserves.

Specifically, it would then fall under the purview of the Centre for Protection of National Infrastructure (CPNI). This is the government authority for protective security advice to the UK national infrastructure. Their role is to protect national security by helping to reduce the vulnerability of the national infrastructure to terrorism and other threats. The CPNI is accountable to the Director General of MI5.  

Recommendation Two

The Government should legislate to ring-fence the production of PPE equipment to the UK.  It will not be economically feasible for all equipment to be produced this way, but a partial application of the Berry Amendment in the UK would guard against the supply gaps currently experienced.

Manchester Fashion Institute technicians designed medical scrubs for manufacture when the virus first struck

The Amendment is a statutory requirement in the United States (US) that restricts the:

“Department of Defense (DoD) from using funds appropriated or otherwise available to DoD for procurement of food, clothing, fabrics, fibers, yarns, other made-up textiles, and hand or measuring tools that are not grown, reprocessed, reused, or produced in the United States.”

Applied to US armed forces, the Amendment encompasses end products and components such as the production of clothing and yarns and applies to prime contractors and subcontractors.  

Recommendation Three

The Government should convene a taskforce to progress recommendations one and two. Importantly this should review the capacity and capability to scale up and respond to demand underpinned by the application of Industry 4.0 digital manufacturing principles. This needs to involve representatives from the manufacturing industry with the capability to produce PPE and selected academic textile and manufacturing technicians.

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