COVID-19: Personal Protective Equipment Central Supply

Personal Protective Equipment (PPE) for New Zealand's COVID-19 response is sourced and distributed as part of a nationally coordinated approach, managed by Te Whatu Ora - Health New Zealand. 

A nationally coordinated approach enables supply directly to the groups that need PPE and overall stocktaking and management of supplies at a national level.

Te Whatu Ora’s Central Supply services New Zealand’s health care workers that contribute to New Zealand’s response to COVID-19.

PPE distributed from the Central Supply has gone through a robust quality assurance process with verified documentation and product certification.

Products are approved by the Ministry of Heath’s (the Ministry) Infection, Prevention and Control (IPC) Sub-Technical Advisory Group and the Clinical Oversight Group.

These clinical groups consider all of the evidence to make informed decisions about whether products are fit for purpose in localised settings.

Where health care providers and health care workers choose to wear PPE that is not in accordance with the national COVID-19 IPC guidance, the responsibility to source and fund this PPE resides with the provider.

PPE from the Central Supply is provided in accordance with the direction set by the Ministry’s IPC guidance and any current COVID-19 response settings.

Te Whatu Ora reviews and approves orders for PPE by considering evidence of PPE requirements as informed by IPC guidance.

Te Whatu Ora has distributed contingency stock of PPE to critical health care services, so they hold 1–2 weeks of PPE in case of local COVID-19 transmission.

The benefit of these service providers holding and maintaining a contingency supply of PPE is that they have what they need to hand when they need it, while further supplies are provided.

Te Whatu Ora will review holdings regularly and replenish contingency as required.

The COVID-19 PPE Central Supply is comprised of 7 categories of PPE:

1. Masks
   • P2/N95 particulate respirators
   • Medical masks – Type IIR / Level 2 and Level 3 masks
2. Isolation Gowns
3. Disposable Aprons
4. Nitrile gloves
5. Eye protection – Face-shields/visors and safety glasses/goggles
6. Hand Sanitiser
7. Disinfectant Wipes

The national COVID-19 IPC guidance for the use of PPE in specific settings should be followed.

Te Whatu Ora and the Ministry, in partnership with health and disability system stakeholders, have developed Principles of Supply to guide the distribution of PPE from the Central Supply.

Under this system:

• regional hospitals, general practices and urgent care, pharmacies, aged residential care, disability support services and home and community support services, managed isolation and quarantine facilities and border services (when required) may receive stock directly from the central supply in line with the principles for supply
• private providers use their own networks to source and purchase PPE.

If you are a health and disability sector provider, the PPE you access and receive from the Te Whatu Ora Central Supply will be in line with the IPC risk assessment matrix.

Principles for supply

• The Central Supply enables PPE to be sourced to meet demand from essential publicly funded services that are in scope.
• PPE for non-publicly funded services should be sourced from commercial or retail suppliers. Te Whatu Ora may provide PPE if commercial or retail suppliers are unable to source it, and it does not jeopardise the Central Supply.
• The ability to pay is not a consideration in providing or prioritising distribution from the central supply.
• PPE must be used according to the relevant national COVID-19 IPC guidance and processes published by the Ministry.
• Any orders from providers must be reasonable, evidence based and proportionate to demand.
• In times of increased demand, decision-making criteria are used to understand where PPE is to be distributed first, based on the following:
  • the type of service that requires the PPE (criticality of the service, eg, hospitals, managed and community isolation quarantine providers)
  • services providing support for vulnerable communities (high risk populations)
  • the level of inventory: stock on order, on hand and consumption rates (manage risk with early identification of supply shortage)
  • urgency of need across the country (balancing competing demand).

NOTE: Te Whatu Ora is reviewing the Principles of Supply in light of recent changes to response settings.  Providers can continue to access the Central Supply in accordance with the current principles and at a level reasonably expected with the current outbreak.

It’s important to use the most appropriate PPE correctly and safely for the work you are doing.

The national COVID-19 IPC guidance defines the PPE that should be used in various settings and is the basis of supply to providers.

You should always follow routine IPC precautions (Standard Precautions as well as any necessary Transmission Based Precautions) for all care.

Te Whatu Ora recommends PPE should be stored as per the manufacturer’s recommendations on the packaging – generally this includes being stored in a dry environment within appropriate temperature ranges.

Storing outside of the recommended conditions may result in damage to the packaging or to the PPE itself.

PPE should be stored at least 40mm off the ground.

Expired PPE should not be used unless it is under exceptional circumstances and consultation and agreement with Occupational Health and IPC at a regional level has been sought as it is unknown whether the PPE will function as intended and may result in inadequate protection for the user.

Physically damaged PPE must not be used, however, PPE with damaged packaging can be visually inspected by a health professional to determine if it can be released.

Manufacturer’s storage recommendations can usually be found near the Lot number on the product’s box label.

When specific conditions are not listed and descriptive terms are used, the WHO recommends the following interpretations: 

In the absence of any storage recommendations, we can refer to the environmental limits of 25°C and 60% relative humidity, or 30°C and 65% relative humidity which New Zealand uses to test the long-term stability of medicine as a guide for appropriate conditions.

Therefore, whenever possible use 25°C and 60% relative humidity as a default storage condition if there are no storage instructions on the PPE.

Disposing of PPE

PPE that is not fit for purpose (eg. damaged or expired) should be disposed of in a way that reduces the risk of PPE inadvertently being utilised in a health care setting.

For further guidance on the disposing of PPE safely, please refer to IPC recommendations for health and disability workers.