Filipino nurses need protection in the UK

Why are healthcare workers still dying from COVID-19? And why are so many of them of Filipino heritage?

Francis Fernando, a veteran nurse with more than 20 years experience at the UK’s National Health Service (NHS) under his belt, was in an online meeting with other Filipino nurses from around the world two weeks ago. “Some of them told me that there had not been a single death of a healthcare worker in their countries, like Singapore and Australia.”

What has gone wrong in one of the richest countries in the world that at least 200 have died (according to the independent group Nursing Notes)?

The UK government just this week declared the “apparent success” of the government’s approach, despite the death toll having reached more than 29,000. One of the main criticisms against Boris Johnson’s administration has been the slowness of providing personal protective equipment (PPE) to healthcare workers. This was apparently addressed promptly by the government which mobilised the military to despatch the supplies around the country from its national pandemic stockpile in a well-publicised display of preparedness.

An investigation by independent television Channel 4 News, however has found that in total, 45 percent of the 19,909 boxes holding PPE supplies had exceeded their use-by dates. It found that “a substantial number of the expired respirators in the pandemic stockpile were originally amassed between 2009 and 2010 and had already had their shelf life extended – sometimes twice before.” Disturbingly, the manufacturer’s guidance is that respirators past their shelf life should not be used. Studies have raised questions about whether out-of-date respirators offer the same levels of protection as in-date masks.

“I’m not surprised,” Fernando replied, when I asked what he thought about this, as a representative of the Philippine Nurses Association UK. “Staff had sent us photos of expired surgical masks covered with the date recently, but if you peel off the sticker, they had expired years ago.”

The risk to ALL healthcare workers in the UK is under immense scrutiny from the media and the public. After all, these are the people who are having to risk their lives to look after the sick and are being praised universally for their courage in doing so. The point that they themselves want to make is that it shouldn’t be a risk at all, if proper health and safety procedures were actually being followed.

Take the case of Singapore for example. It so far appears not to have had a single recorded health-care-related transmission of the coronavirus, despite the hundreds of cases that its medical system has had to deal with. Even though there was a critically ill pneumonia patient who exposed 41 health-care workers in the course of four days before being diagnosed with COVID-19. These were high-risk exposures, including exposures during intubation and hands-on intensive care. Eighty-five percent of the workers used only surgical masks. Yet, owing to proper hand hygiene, none became infected.

Fernando points out that there have been NO Intensive Therapy Unit/High Dependency Unit staff deaths in the NHS as they are all using World Health Organisation (WHO) standard PPEs.

The UK government has launched a public inquiry into why so many people from the black, Asian and minority ethnic (BAME) community are falling ill from COVID-19 in the UK. A recent study of 2,249 patients acknowledged that despite making up just 13 percent of the UK population, a third of people who become critically ill with COVID-19 are from BAME groups. The data is even more worrying when it’s narrowed down to healthcare workers because around 80 percent have BAME backgrounds and a full 20 percent have Filipino heritage.

As a result, the NHS faces a new set of wide-ranging requirements as part of a comprehensive plan to mitigate the impact of COVID-19 on black, Asian and minority ethnic staff. “This is a system-wide challenge that requires a system-wide response,” according to a draft NHS England/NHS Improvement document.

Filipino migrant healthcare workers are finding their voice in the face of the intense risks they face. Fernando’s group is in discussions with the head of the NHS Equality and Diversity Council to raise its concerns and recommendations. They request financial assistance and bereavement counselling to families of those who died whilst in service, for example, and a Filipino nurse representative to the team which will investigate the high proportion of BAME staff deaths in the NHS.

They make an urgent call to action for all the NHS Trusts in the UK to implement the legally required assessments to prevent more deaths of Filipinos and other frontline staff. Eighty percent of Filipino healthcare workers who have died were in the high risk category and should have been shielded, but for various reasons, including demands from their bosses, went to work and made the ultimate sacrifice.

Most importantly, according to Fernando, is the call for healthcare workers unions to advise their members not to work without WHO standard PPEs. Evidence shows that mortalities amongst staff are significantly in wards (ie not in Intensive Treatment Units), making a strong case that full PPEs must be observed in all areas of suspected or confirmed COVID-19. Inadequate protection is still to blame, 10 weeks since Feb. 29, when the first transmission of COVID-19 within the UK was confirmed.

There are specific issues for frontline Filipino nurses and healthcare workers. They have urgent concerns that they are “always being assigned to COVID wards and without adequate PPEs.” They are asking for reassurance that if they are unwell, they must go home and follow the government advice to self-isolate without any fear of being reprimanded, especially for new nurses from the Philippines. Filipino colleagues, they say, “are being asked to do extra shifts to cover for others who have gone off sick and some are being asked to come back to work even before they have recovered, therefore they are over-worked and stressed and prone to catching COVID-19.”

The group has already independently managed to set up a 24-hour helpline specifically for the Filipino healthcare workers and their families, that will be manned by Filipino volunteers to help, support, and advise as needed.

The Filipino healthcare community here in the UK is in the spotlight of society as it faces this desperate situation. Its requests would not be hard to fulfil. We must  protect their lives, as they save ours.