An NHS doctor who died of Covid-19 had pleaded in vain for his hospital to provide protective equipment in the days before he caught the virus, emails shared with the Guardian by his family show.
Dr Peter Tun, from Reading, died on 13 April. Three weeks before his death, he warned Royal Berkshire hospital that unless they supplied the vital kit he and his colleagues needed to avoid becoming infected, “it will be too little and too late”.
But he was unable to persuade managers to even give his team surgical masks because there were no suspected or confirmed cases on his ward – even though two members of his team were self-isolating. Instead, a manager replied: “These supplies are not widely available and need to be used sensibly … This is the trust position at the moment and I do not have any powers to influence this.”
Tun’s son, Michael, said: “When a doctor of 40 years’ experience has had to literally beg for surgical masks, and it is denied, something has gone seriously wrong.”
Emphasising that he did not blame the Royal Berkshire for the nationwide PPE shortages but accusing managers of “hiding behind policies”, he added: “I think that my dad’s death was avoidable and that that probability would have been reduced if he had had proper personal protective equipment.”
The Guardian is aware of at least 108 UK healthcare workers who have died of coronavirus so far.
Tun, who was born and trained in Burma, was an associate specialist in neurorehabilitation at the Reading hospital. He was diagnosed with Covid-19 on 6 April and died aged 62 in his own hospital.
The emails, all sent on 23 March, show that increasingly anxious requests from Tun and his colleagues for PPE were rebuffed by hospital managers. .
In one, Tun said: “We do not have any basic surgical masks for Caversham ward neuro-rehab medical team. The ward stock has been taken by ICU [intensive care], according to a staff nurse … We do not have eye protection kits, gowns nor scrubs.”
However, one manager emailed the ward team to refuse his requests. They said: “Matron … will confirm that you don’t have any ‘hot’ [confirmed Covid-19] patients on your ward. You do not require PPE currently. It’s ‘business continuity’ at this time.”
A second manager also refused. Their response acknowledged that PPE was in short supply and made clear that personnel in other areas of the hospital were deemed to need it more. “I am unable to order masks for Caversham without any suspected or confirmed cases on the ward,” the manager said.
“These supplies are not widely available and need to be used sensibly for those staff most at risk (ie those looking after suspected or confirmed cases). I will be able to get supplies immediately if and when you need them.”
In his reply, Tun pointed out that the hospital could not know which patients had caught the virus because at the time it was not testing most people with symptoms – fever, cough and breathlessness – and therefore his Caversham ward could have undetected cases.
Tun said in a further email: “If we are not prepared in advance before the ward becomes ‘hot’, it will be too little and too late.”
Two colleagues backed up Tun’s request. One asked managers: “Please can you get some PPE urgently for us? Can you help us?” Another said: “I do not think it is business [as usual] continuity at the time … It is only a matter of time before our ward patients and ourselves get infected (if not already) and suffer significant morbidity or mortality.”
That proved tragically prophetic. A week after the emails were sent, on 30 March, Tun was tested after displaying symptoms. On 1 April the test showed he had the disease. He was taken into the Royal Berkshire’s intensive care unit on 6 April and was put on a ventilator two days later, but died on 13 April. His wife, Win Mar, also caught Covid-19 and is also in the hospital but “is doing well and getting stronger and will hopefully be out soon”, said Michael, a 34-year-old product manager at a tech startup in Melbourne, Australia.
Michael praised the staff at the Royal Berkshire who treated his sick father. “The doctors and nurses there are fantastic. They gave my dad great care in their efforts to keep him alive. After working there for 21 years, many of them were like family to him,” he said.
But he feels hospital managers applied an overly strict interpretation of Public Health England’s guidelines on what PPE health service staff should wear in what situations. And he insisted that a statement the trust made to the BBC denying that it lacked PPE could not be true. “If there were no shortages, why did my father not get even the basic masks when he was asking for them? It’s irresponsible to hide behind policies. They aren’t making common sense decisions.”
He said he had passed the emails to the Guardian in the hope that his father’s story would prompt those in positions of power to take whatever action is needed to end the shortages. “This is so painful for our family. My grandfather, who is 91, has lost his oldest son. My mother has lost her best friend. And me and my brother William have lost our dad.
“When doctors sign up to the medical profession, they don’t sign up to lose their lives.”
In a statement, the Royal Berkshire said it had correctly applied the NHS-wide guidance on PPE. “Everyone in the trust is deeply saddened by the death of Dr Peter Tun,” a spokesperson said, describing him as “popular and respected by all who knew and worked with him”.
Emphasising that the trust followed strict national guidelines, the spokesperson added that managers and matrons regularly checked wards to ensure staff were “always safely, properly and appropriately kitted out”.
‘Too little and too late’: Peter Tun’s email pleas for PPE
From: Tun Peter
Sent: 23 March 2020 15:16
Subject: RE: PPE for Caversham Ward Neurorehab Medical Team
Dear _________
According to the President of the Royal College of Physicians guideline advice, we are not supposed to touch or do CPR in a suspected or confirmed COVID-19 patients unless appropriate minimal PPE (like basic surgical masks, none available on Caversham ward).
Two doctors in our department are already self-isolating for 14 days currently. One [member of our] team has regular duty … with suspected COVID-19 patients, and she is coming to our office daily.
We do not know for sure whether a patient needing CPR (could be anywhere in the hospital), could have been exposed to COVID-19 patients in RBH [Royal Berkshire Hospital] since admission, because RBH policy does not test PCR for COVID-19 for all patients with “Fever, Cough and Breathlessness”, unless they fit a certain criteria to be agreed by the microbiologist and chest physician.
If we are not prepared in advance before the ward becomes “HOT” [has confirmed cases], it will be too little and too late.
Yours sincerely,
Peter
To: Tun Peter
Sent: 23 March 2020 15:26
Subject: RE: PPE for Caversham Ward Neurorehab Medical Team
Dear Peter
The advice that you have quoted is the same that we are following for suspected or confirmed patients. Many people are currently off self-isolating for 14 days however as we have no directive from the government at this point about testing of staff we will not know if these are COVID or not, they may just have a cough or a temp for other reasons.
I am unable to order masks for Caversham without any suspected or confirmed cases on the ward. These supplies are not widely available and need to be used sensibly for those staff most at risk (ie those looking after suspected or confirmed cases). I will be able to get supplies immediately if and when you need them.
This is the Trust position at the moment and I do not have any powers to influence this
Apologies