Coronavirus: Ambulance crews ‘treating Covid-19 patients without warning’

Jeff Pitman, a senior paramedic and health and safety officer for trade union Unison, has penned a lengthy letter in which he covers an extensive list of concerns on behalf of ambulance crews.

It came just days after an East of England Ambulance paramedic from Hertfordshire tested positive for Covid-19.

Mr Pitman’s letter, written on behalf of Unison to East of England Ambulance Service Trust bosses, lists worries over a lack of preparation, training, and equipment they are given before being sent to treat potential Covid-19 patients.

Mr Pitman says there has been a “total lack of adequate and suitable training” about contagious diseases.

He states the trust has been “very slow” to provide adequate personal protective equipment (PPE) to ambulance crews.

And there has been “no active training” on how to correctly put on or take off this PPE, including full body suit, gloves and masks.

He also worried that ambulance crew members are unable to follow the Government’s advice to self-isolate, or work from home, as the nature of their jobs requires them to be on the front line.

Mr Pitman added: “The current system of call-taking is letting our members down.

“I am receiving calls from reps and members who inform me that crews have been sent to patients who had telephoned 111 because they were suffering the signs and symptoms of C-19.

“But this crucial information is not apparently being passed to the crews.

“This fails to comply with the NHS England advice that where possible cases are identified, this information must be passed to the responding resources (ambulance or response car) prior to arrival on scene.

“This failure results in ambulance crews entering the hazardous area inside the patient’s accommodation, handling doors, furniture and the patient, without PPE, because they were not pre-warned in the messages that assigned them to the patient.”

Mr Pitman cited a case in which a crew completed a clinical assessment on a patient who had recently returned from Italy and believed the patient to be a suspected Covid-19 case.

He wrote: “They were concerned that they had been within the hazardous zone in excess of 50 minutes, potentially handling and breathing in the aerosol droplets.

“The crew then informed 111 who instructed the crew that the patient must be swabbed to establish if they actually were infected.

“With this in mind, the crew asked their manager if they too should self-isolate because of the given circumstances.

“But their manager said they need not self-isolate unless the patient’s swab was positive - how and when would the crew know of the result? - or the crew developed symptoms.

“A case of horse, gate, bolted.”

Mr Pitman said that this raises “a whole bucket load of issues”.

He wrote: “The crew who are potentially infected are expected to attend to other patients, before then going home and potentially infecting their own family members.

“By the time their patient’s swab is positive, they have potentially spread it further, at which point they would be expected to self-isolate.

“Unfortunately this may be too late.

“The UK Government has advised that residents in the UK should self-isolate if they have been in contact with anyone that has returned from certain foreign countries, or been in contact with persons that are suspected or confirmed to have C-19.

“It is even recommended that where possible they should consider working from home.

“This does not appear to apply to ambulance crews who are in the thick of it.

“Our clinical members cannot work from home; the very nature of their work requires them to go into the personal spaces of patients.

“This means they are exposed to potential bacteria, viruses and diseases even before making contact with the patient.

“The World Health Organization recommends staying at least three feet away from a person who is sick, but we have to go much closer.”

His letter then laid out all the most frequently asked questions of worried ambulance crew staff.

These include at what point to self-isolate, and whether it is safe to attend to suspected Covid-19 patients if pregnant, suspected pregnant, or breastfeeding.

Other ambulance crew staff have asked if it is safe to attend to suspected Covid-19 patients if they themselves have a history of chest infections or respiratory infections.

And some have asked what the trust has agreed with Unison in respect of protecting their financial income if staff are self-isolating.

Mr Pitman wrote: “All these issues should have been discussed at great length in the earliest stages.

“Jointly agreed statements should have been issued to all staff in order to reassure them, with proper training conducted in the correct donning and doffing of full PPE carried out post haste.

“As the branch health and safety officer I am extremely disappointed that I have not been fully consulted with in all matters relating to the current C-19 pandemic.

“I am disappointed that the trust has not invited me to any meetings to discuss these issues in order to achieve a satisfactory outcome.

“The current state of play is far from acceptable and this will be discussed with the branch incoming branch secretary and branch chair this week.”

Marcus Bailey, chief operating officer at the trust, said all staff were fully trained in how to use personal protective equipment and they had been in “close direct links” with representatives at Unison.

“Call centres and 111 are following the agreed procedure for the assessment of patients,” he said.

“We are well prepared for incidents like this and the NHS and Public Health England are taking all necessary steps to manage the situation.”