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Saturday, 11 April 2020

Some things are not easy to say

I've always hated waste. Not just cost, or carelessness, but the idea of waste. I never accepted that 10% of bricks or roof tiles would be broken by handling, or 15% of plasterboard deliveries would be wasted. I always challenged such assumptions - and when I became a CEEQUAL assessor, would try to gently nudge jobs I was assessing not to drop points by careless waste. It didn't even have to be related to value; I once watched a worker assisting in the application of a skin-irritating substance needlessly change pair after pair of latex gloves. It was just deliberately throwing away someone else's money - out of irritation at being employed, being instructed, being constrained. Even an office worker who throws a new biro slow to start writing in the bin before giving it a chance is in part just kicking his boss, his firm and his office. If he was at home, if they were his own gloves or his own biros he wouldn't do it.

So I can understand Matt Hancock's difficulty yesterday in urging health and care workers not to cream through the nation's stocks of PPE quite so vigorously. It's OK to wear the same mask to see two patients in a row; you don't need to change plastic aprons every 15 minutes - well, I guess that's what he wanted to say but couldn't really say it. Can you imagine the press fury at asking NHS workers who are losing their lives to cut back on 10p latex gloves?

We need to remember that just as not all soldiers are gallant, not all health workers are selfless. Many will be feeling pissed off at their well-paid indoors job with no heavy lifting suddenly turning lethal, with no hiding place at home because the bloody neighbours are all standing in their drives clapping every morning at going-to-work time. What makes the workforce as a whole exceptional is that 85% do turn up each day, and care diligently and conscientiously for our sick and dying.

So some PPE will be wasted out of genuine fear and ignorance - this is a training matter. Some will be wasted (a very small proportion, I'd guess) by those wanting to run out of PPE to make a political point - this is a disciplinary matter. But some I'd think will be wasted because wasting a mask, gloves, gown or apron is about the only gesture open to workers working under the most stressful of conditions, with the nation's gaze upon them. I think we must just accept this as a small price to pay.

27 comments:

Smoking Scot said...

For sure these face masks - medical grade - can be worn for hours; medics must wear them to protect patients. They're uncomfortable and get contaminated with your natural skin oils, furthermore they get clogged with your own saliva. Frankly after a shift of 12 hours they stink, though they can be used for days if pushed.

It's a different case with the 3 or 5 ply paper jobs; they have no form and fit very close to the face, so saliva knackers them in no time and the elastic stretches with each removal, or when the user pulls it down to their chin to have a drink, food or a ciggie; the cost is pennies and they're the preserve of ancillary staff as well as the porters. They need binning after a couple of hours, especially if you perspire a lot.

Gloves should be disposed after each patient to guarantee no cross contamination. I know some nurses, when supplies are low, will use hand sanitizer directly on the glove, sort of like a second skin and that's a reasonable compromise.

The trick with these is to have one person issuing the stuff and a record kept. Not gloves, or paper masks, but for sure all the high value items, because another reason for the "high usage" is straight theft. That's the big unknown.

Mostly it's for their family, then friends, then friends of friends because quality masks are difficult to find and expensive. Big theft is when they're in transit, which is why the Irish treat each incoming consignment like the crown jewels with full police escort.

DiscoveredJoys said...

@Smoking Scot

The trick with these is to have one person issuing the stuff and a record kept.

I expect that gloves and masks are issued in boxes 'valuable' enough to track.

Decades ago (I'm an old git) the big office I worked in had to mind its 'stationery' budget. The first thing done was to gather back in all the 'squirrel stocks' of paper, pens, forms etc. that people had built up in their local cupboards 'just in case' Stationery ran out of supplies. Enough was recovered to reduce re-supply orders for a month or so. Supplies 'found' out of nowhere, substantial amounts in some cases. Which is why even the 'small stuff' needs to be tracked and also poor behaviour addressed.

Anonymous said...

As a student I worked as a storeman for a small firm. I was taught to go round the shop floor the day after we had taken delivery of paint brushes. It was remarkable how many had two or three new ones 'just in case' or 'to save time going to the stores'.

It probably isn't the case with facemasks but these low-value items are often 'anonymous', put your own Parker pen down on the desk and you make damn sure that you pick it up, mislay an office one and get a fresh one from the cupboard. Pens and pencils easily and innocently find themselves taken home but never returned, (the pencil in the back pocket, removed when getting into the car etc.).

Dave_G said...


Interesting to read of Raed's almost-cynicism over the untouchable NHS staff! I've been saying all along that the situation is being manipulated and it's only small things (like shortage of PPE) that starts to expose the real issues.

But even a few 'missing gloves' gets more attention than the magic and sudden availability of hundreds of billions of funds for the banks - which is not even talked about any more. Very much like "a hundred deaths is a tragedy but a million deaths is just statistics".

OT (sorry but its important) ZH has an article from a Coroner who exposes the manipulation of death certificates to inflate Covid 10-related deaths. The exposure of this as being a scam is getting closer.

jim said...

Poor judgement by Hancock, got well chewed up on R4 interview.

UK is well on track to be the most affected European country. Worse than Italy and Spain on a daily basis but less so far on a cumulative basis. Italy, Spain and France look to have peaked. We look as if there is 5 days to the peak (with luck). But the roll off is fairly slow, in 10 day's time we are likely to have accumulated about a further 38,000 cases. In a further 10 days a reasonable guess is a further 10,600 cases and the death rate down to say 300/day.

What we don't know is the rate of cured patients going back home nor any idea of the re infection rate.

Without any cure the position is a bit tricky. Once HMG says 'those under 35 can go back to work' I don't see HMG keeping control any longer, everyone is going to say 'sod it' and go back to 'normal' life. Heaven knows what happens then. Perhaps Spain, Italy and France will provide a steer. The other early exits, Iran and China don't seem fully comforting.

Then we come to the airlines and international travel. Most destinations are still at an early stage, especially the USA. There may be a pent up demand for holidays but there is nowhere to go. As they say, 'too late to sell, too early to buy'.

JPM said...

What do New Zealand, Germany, and Denmark all have in common, apart from not being in the same mess as the UK and the US?

Peter MacFarlane said...

The reluctance to waste anything at all is a generational thing imho.

Those of us (including me, and I guess our host) who grew up in the 50's when nobody had any money and nothing could just be replaced if you broke it or lost it, have a completely different attitude to the monay-no-object just-go-out-and-get-another-one approach of the generations since, the more so more recently as we've all got richer.

When my children were teenagers I used to get unreasonably (to them) angry about silly wastages like scratching a CD or damaging some worthless trinket of a cheap toy, simply because in my youth everything was valued, even small things.

Once this is all over, I wonder if younger people are going to learn a few of those lessons, once they're all poorer - as they will be - and "stuff" is not as easily obtained as they expect.

Dave_G said...


@JPM - those countries have HONEST reporting of Covid deaths behind their 'success', nothing more, nothing less.

If the UK, Spain, Italy did the same there'd be no threat to economies and no lock down, there'd just be a bad flu season happening.

Dave_G said...


@PM - I have a similar 'just get another one' policy if I damaged/lost something however that worked to my advantage with my 'never throw anything away' policy as the duplicates now find their use!

The local blogs are full of people wanting stuff to complete a DIY project as I would equally be restricted but my 'ocd' hoarding is proving remarkably useful right now.

Anonymous said...

One reason for the shortage, if there is one in the NHS, is as many people as possible having stored some ppe in their car just in case, and the ppe generally comes in bulk packs. If I go on a community visit I will take what I need for that visit and a spare. A lot of my colleagues have a box of gloves, a box of aprons, a box of masks, a litre bottle of alcohol gel etc in their car. I suspect every administrator and receptionist had also stocked up. It's like the toilet paper shortage, the supply chain can't cope with such a massive short term increase.

Oldrightie said...

PPE has also become a stick for the leftard dominated GMC to unfairly help their media mates to shout their spite at our very popular, large majority Government. Must be dreadful for that lot to see Boris getting better.

terence patrick hewett said...

No doubt I am very unworthy but as a professional engineer dealing with medical, defence and automotive I find all the armchair authorities on medical who have appeared as tedious and ignorant as all the amateur defence and automotive experts.

Anonymous said...

All this confuses me. If you have a ward full of Covid-19 sufferers, you can't cross contaminate them, and the PPE is to protect the medical worker. I can't see why it should need to be changed every patient for routine jobs like reading a monitor. On the other hand, if the medic needs to wipe a dozen arses, then it makes sense for the gloves etc to be changed between patients, or you can get the transfer of other diseases that might act in concert with Covid and make some patients worse. It seems to me that just a measure of common sense is needed.

Incidentally, what has happened to deaths from other causes. They must be down. After all, if the Covid likes to finish someone off who already had another serious condition, then they can't die of that (heart, cancer, ordinary flu).

Anonymous said...

JPM said @ 10:45

'What do New Zealand, Germany, and Denmark all have in common, apart from not being in the same mess as the UK and the US?'

You've got nothing mate, flailing around with whataboutery; condemning your own country because the you don't like the political flavour in office, or in the States.. because orange man bad. I'll tell you how bad it is over the pond.

Thus far Only 150 Americans with no pre-existing conditions have died from the Coronavirus COVID-19 (0.9%).

Washington State's massive Coronavirus Field Hospital is being dismantled having not treated a single patient.

Massachusetts is going back and adding Coronavirus deaths to totals in order to get more cash from the federal government.

Massive nothingburger with a rate of death predicted to be below that of seasonal flu.

Steve

Scrobs. said...

Raedwald, I hope you don't mind me re-posting this from ten or so, years ago. You were kind enough to respond that you weren't the Site Agent in question, but the sentiments of saving costs still linger to this day...

http://scroblene-webley-bullock.blogspot.com/2010/12/nut-screws-washers-and-bolts.html

Nick Drew said...

A surgeon of my acquaintance has a fine collection of stainless steel surgical scissors being repurposed at home (and so do his family and friends). They are routinely binned after single use, which is sometimes no more than snipping a patient's stiches.

Smoking Scot said...

@ Anon 14.03

You've got these stages.

- Person tests positive for the virus, but is the picture of health. They're asked to stay at home, or if they came off a plane they go to an hotel or other facility... and wait.

This is where cross contamination can happen, because some will go through the 15 days without any hassle, then go home. Some won't.

- Those who's condition worsen go to hospital where they get treatment like Boris. Most will have a "mild" version; some won't. It's at this stage they are very careful because they'll all be coughing, hacking and sneezing. That's why they have separate rooms, or good spacing and curtains.

- For those like Boris, they have to go to ICU - and this is the point where they don't worry about cross contamination. They're all pretty bad and some have to be put into a comma to use ventilators. However the medical staff should all be in hazmat suits and should have their own supply of air going through their helmets.

- If all goes well, then they go through a reverse process, however they've found these patients can still infect others. So correct protocol is for them to either go home and self isolate, or go to an hotel for 15 days. That's why there's such a big lag before people are declared free if the virus.

It also explains why they're real careful with the bodies. They're still infectious, so get buried at least 2 metres down.

- Governments are paying for the hotel and food; patients are invariably fairly tolerant of this, having been through a real life changing experience.

In addition a fair number of recovered will have permanent damage to their lungs. Most will work round this and adapt but a small number will qualify as handicapped.

Dave_G said...


"Incidentally, what has happened to deaths from other causes."

If you look at the CDC data from March COVID-19 seems to have cured heart disease and pneumonia.

Equally, 67million+ people HAVEN'T got Corona-19.

Similarly 0.001% of the population have.

Let's trash the economy, just to be safe.....

Nessimmersion said...

Idle feckless types, at my work what irritates the crap out of me is people mixing a whole tin of twin pack paint,using about 10 ml, then letting the other 3.9 L set, at £150 a pack they wouldn't do that if they'd had to pay for it.
Other than that the establishment is trying to justify cratering the economy over the great panic, they've slow walked Hydroxychloroquine long enough its been forgotten about by the media.

What needs brought to the publics attention is how many deaths occur where there was no underlying medical issue, I gather in the US it's around 200 as they have been going gangbusters on Hydroxychloroquine.
Interesting to find out the figures for UK

Anonymous said...

Re the comment "well paid indoors job" I suggest you look at what we actually pay nurses and junior doctors i.e. the ones bearing the brunt of the fight. A junior doctor, after years of study, is probably taking home half as much as a new train driver.

Nessimmersion said...

Anonymous, tend to agree, however we also need to look at average GP incomes & pensions, then consider why GPs often make more than consultant surgeons.
We should also look at why doctors were unwilling to work overtime last year as it took their income & pension into the super tax category.
We may find there is massive inequality built into the system.

jim said...

Re disposable scissors etc, they are disposable because that is cheaper for the taxpayer.

Small surgical instruments cost around £1 to £3 in bulk, sterile packed etc. To sterilise against prions etc, repack and provide lawyer-proof docs/tracking is too expensive for the UK market.

Remember they are sold as 'single use' from which it follows that re-using them risks serious legal challenge and a great hoo-hah in the tabloids. So they end up in kitchen drawers or landfill or scrap metal or sent somewhere not so fussy/legalistic.

JPM said...

Yes, what they all have in common, like Iceland too, is female leaders.

Anonymous said...

Dear Smoking Scot, about your patients going into a comma - I suspect that for some of them life goes into a full stop!

Anonymous said...

I find the sanctimonious gushing about the NHS ( 'Save the NHS' ) to be rather nauseating, and I'm quite certain that the true picture of healthy young patients dying is rather small, and probably balanced by the drop off in road traffic accidents. However, the picture with a disease like Covid-19 in comparison with other causes of death for oldies with other problems is that the NHS can treat heart attacks, knifings, cancer and so on without fear of the medics catching what their patients have. Therefore, as the risk is vaguely one patient catching something from another patient, so they can be cavalier with PPE, now they can't really transfer Covid between patients who already have it, but they could catch it themselves and even pass it on outside.

In some ways it is like Bubonic Plague or Leprosy in the Middle Ages (although then they didn't understand what was happening, but I betcha they understood that you could catch it).

The problem with the medics catching it is that pretty darn quickly the hospitals would empty of medical staff, with some infected and others deserting their posts.

Billy Marlene said...

After my father shuffled off on 19 Feb I was left with an arsenal of community nurse kit fit to establish a field hospital.

I compared this wastefulness with the good old Army who seem to have a waste prevention policy consisting of not giving out the kit in the first place.

My Quartermaster Sergeant once said to me:

“Stores is for storing, Sir. If they was for issuing, they would be called ‘Issues’”.

Anonymous said...

Something that might resonate with you, Radders, is that in my experience of the construction industry, a tidy site is also one where there is little waste and profits are being made, whereas an untidy site is probably badly managed, and not only wasteful and losing money, but probably unsafe as well. I have always seen untidiness as a proxy for other bad things.