Doctors in parts of the UK do not have the PPE they need to keep themselves safe, the BMA has said, accusing the government of 'forcing doctors to place themselves and their patients in grave danger'.
Amid growing anger over acute supply shortages in parts of the country - with doctors forced to crowdfund to pay for PPE, buy supplies from DIY stores and work with schools and businesses to 3D print or laser cut equipment - doctors' leaders say frontline staff may have to deny some patients face-to-face care to keep themselves safe.
The warning comes amid reports that three GPs are among 19 frontline NHS staff to have died after contracting coronavirus during the outbreak.
The government has launched a three-pronged plan to improve PPE supplies, but sparked fury by suggesting that some staff are overusing equipment and claiming 'there is enough PPE to go around'.
BMA chair Dr Chaand Nagpaul said: 'No doctor should ever have to be in harm’s way when they go to work, and in these unprecedented times, this has never been more important.
'This is not the flu. We are dealing with an unknown, highly infectious, and potentially deadly virus that has already claimed the lives of several healthcare workers, including 11 doctors in the UK. It is absurd that the people trained to treat this disease are the ones who are not being appropriately protected – and without them, we face real disaster.'
Speaking to GPonline, BMA representative body chair Dr Helena McKeown said it was not natural for doctors to say 'no', but that in cases where they did not have access to proper PPE GPs could be justified in refusing to see patients face-to-face.
'If you heroically see patients who may have COVID-19 with or without symptoms without proper PPE, you may get infected - and ultimately you may die. If you end up on a ventilator you could be unable to work for six months.
'It's nuanced and it's not natural to say "no", but as a GP I want to know I am seeing patients knowing I am protected and am not going to be infected and bring that home to my family. If you get infected you are a doctor who cannot see many hundreds of other patients.
'Looking at the greater good, as an individual you can justify saying I will not see someone who has possible COVID-19 without proper PPE because I may get ill.'
Dr Nagpaul said it was not known whether a lack of PPE was directly linked to recorded deaths among doctors so far - but pointed out that high quality PPE in Italy had ensured no healthcare staff had been infected in hospitals there throughout the pandemic.
Frontline NHS staff
He added: 'This must be replicated here, in every healthcare setting, as a matter of urgency. Without it, doctors are being forced into a corner, facing heart-breaking decisions over whether to carry on caring for patients without proper protection and put themselves and patients at risk.
'This is an immensely difficult position to be in, but is ultimately down to the government’s chronic failure to supply us with the proper equipment. We cannot continue like this, and need to see enough, adequate PPE delivered to staff across the country as soon as possible, not just for our health, but also, and most importantly, our patients.'
The BMA has reported 'dangerously low' supplies of PPE in both London and Yorkshire. GPonline reported last week that just 2% of GPs felt adequately protected against COVID-19 - and that large numbers of doctors are being forced to self-isolate.
The government's three-point plan on PPE focuses on guidance, distribution and future supply. Guidance should provide clarity on who needs PPE and focus on 'making sure PPE is only used when clinically necessary and isn't wasted or stockpiled', distribution will be improved through a 'new national supply system' and future supply secured through working with industry, ministers say.
The Doctors Association UK called suggestions that overuse of PPE by healthcare staff has contributed to shortages 'an insult' and has teamed up with non-profit organisations set up to crowdfund to boost PPE supplies.