Thread by @faisalislam

On PPE, I’ve been tracking entire supply chain, for a month.

can be both true to say:
A. huge amounts of PPE have been distributed from large stockpiles
B. But some that need havent yet got enough

What matters is
- 1. size of stockpile
- 2. usage rates
- 3. Resupply capacity

On A.

Hundreds of millions of items have been shipped, and that’s solved many of the immediate problems that were there.

There were large stockpiles of the stuff for pandemic flu, and for No Deal...

Though that does mean some eg masks officially out of date, or not right fit

On B.

So ICUs shd be well stocked but have been other distribution probs..qn about whether supply chain being moved more closely to “just in time” efficiencies, & centralised purchasing, is what you need during pandemic, but Army brought in with new specialist contractor

Bigger point is - how were PPE stocks being managed? The most protective stuff (eg FFP3 masks) was/is being saved for ICUs. Was this because they were trying to eke out supply? Many medics watched closely what was happening in Italy and openly questioned the initial standards...

ie they saw high medic infection/death rates in Italy/Spain, looked at the virus, and concluded correctly that Covid19 is NOT flu. Much more infectious. So others outside of ICU & “aerosol generating procedures” -eg A&E triaging or ENT or maternity felt need for higher protection

Authorities only recently raised the standards on PPE, well after lockdown, but that does mean for the previous period of rising infection, many in NHS were correct to complain that they weren’t getting PPE appropriate to the risks they were taking...

So that is the tension between authorities who say there is enough PPE, as long as it is not wasted, & medical staff who say they also need highest levels of protection available..eg FFP2 instead of surgical masks. FFP3 instead of FFP2. Visors instead of goggles. Gowns not aprons

And thats just the NHS. The Pandemic Flu strategy I saw, said the stockpile should also cover all of social care. But then there’s also other emergency services, volunteer workers etc... and again if CV is more infectious than flu - the large stockpile, becomes not so large.

So on point 1 - how big is the stockpile?

They (Flu plus Brexit) are massive, no doubt. But we have had no numbers apart from “28m of the most intense masks” from NHS chief exec..

On the Government’s measures of having distributed 761 million items, it would have to be billions

On point 2 - how fast is it being used...

There are some incredible numbers from US authorities on US alone needing up to 3.5 billion N95 masks for pandemic flu... Drs were reporting dozens of respirators used per Covid patient day in ICU...
...

But there is the fact that CV is more infectious than assumed for a pandemic flu, so more PPE required everywhere... and the fact that its not flu means no quick vaccine - so more PPE required for plausibly longer than planned pandemic too...

On 3, resupply:
massive global PPE fight on, which involves export controls, Trump using Defense Production Act.
Much supply actually made in Hubei. Some China manufacturers quadrupled prices upon factory reopening

Hence last week story on UK production
bbc.co.uk/news/business-…

Anyway - as you can tell I’m doing something much longer about this PPE supply issue and on “pandemic protectionism” that sits at cross roads of economics, business, health, politics, trade and diplomacy... hope this helpful now. Look forward to clearer Govt numbers on all this.