As Mexico prepares for the peak of the pandemic in May, health workers say PPE shortage is fuelling hospital outbreaks.

Oaxaca, Mexico – For three years, Patricia* has trained to be a surgeon at a Mexico City hospital where there is a chronic lack of surgical equipment. Each winter when supplies dwindle, she and fellow medical residents organise a stockpile of masks and gloves to tide them over until the new fiscal year. But in 2020 the new supplies never arrived.

“It was a streak of ‘there’s nothing, there’s nothing, there’s nothing’,” Patricia said. Then, the coronavirus pandemic hit.

As authorities announced Mexico was entering the most critical stage of the pandemic last week, Patricia’s hospital ran out of surgical masks. She says working without one is risky since she reviews patients with COVID-19 symptoms who have not yet been tested for the disease. “No one is looking out for us,” she told Al Jazeera.

Hospital workers across the country have echoed this sentiment in recent weeks. In pandemic hotspots such as Mexico City and Monterrey, doctors and nurses have protested the lack of personal protective equipment (PPE), which they say is accelerating the spread of the novel coronavirus in hospitals and beyond. Additionally, President Andres Manuel Lopez Obrador has been criticised for a delay in taking the pandemic seriously, as well as the scarcity of testing in the country.

Public hospital health workers protest outside a hospital to demand protective gear and training in Mexico City [Fernando Llano/AP Photo]

As of Wednesday night, Mexico’s health department had reported 1,732 deaths from COVID-19 and nearly 18,000 cases, though authorities say the actual numbers are far higher. At least 15 percent of confirmed cases were employees of the Mexican Social Security Institute (IMSS), which provides health services to nearly half of the country’s population. Thousands of other health workers are quarantined with COVID-19 symptoms as the country faces a severe personnel shortage.

The battle for PPE

As authorities expect the pandemic to peak in Mexico in the second week of May, health workers are taking stronger actions to call for equipment to keep themselves safe. This month a union representing some 5,000 IMSS employees threatened to strike work if authorities failed to provide its members with PPE. The leader of the union, Armando Rosales Torres, also promised to sue the state for negligence.

The government, however, insists there is no equipment shortage. Mexico’s coronavirus czar, Hugo Lopez-Gatell, said shipments arriving in April from Shanghai to Mexico City would meet “practically 100 percent” of Mexico’s PPE needs. The epidemiologist speculated that any scarcity in hospitals was due to corrupt supply chains or staff’s inadequate use of equipment.

But health workers in four hospitals who spoke to Al Jazeera on the condition of anonymity described a different reality.

Protesting healthcare workers stop the traffic to demand personal protective equipment at Tacuba General Hospital, as the spread of the coronavirus continues, in Mexico City, Mexico [Edgard Garrido/Reuters]

On April 8, Diana*, an IMSS anesthesiologist in the southern city of Oaxaca, obtained a court order forcing the health department to provide her with PPE. But even then she says her hospital was unable to comply with the judge’s ruling. “When we won the injunction we were given a laughable amount of equipment,” said Diana, whose real name is withheld; “a pair of glasses that don’t fit, a pair of disposable gloves that can only be used for one patient, and a sterile disposable gown that isn’t waterproof”.

Diana decided to buy her own PPE since she intubates patients – a procedure with a high risk of contagion. So far she has spent nearly $300 on reusable gear, plus $500 this month alone on disposable items like gloves, gowns and N95 respirators – practically her entire paycheque.

“I took out my savings,” she told Al Jazeera. “I was left with nothing.” This financial stress comes on top of the fear of being attacked in the street, following a spike in assaults against healthcare workers by people terrified of catching the virus.

Doctors and nurses stand outside the intensive care unit where COVID-19 patients are being treated in Mexico City, Mexico [Carlos Jasso/Reuters]

Dr Amparo Vera Cerda, the spokeswoman for the National Assembly of Medical Residents (ANMR), confirmed that such experiences were widespread. Of nearly 1,500 health workers surveyed by the organisation in mid-April, 93 percent lacked supplies to confront the coronavirus pandemic. In a survey conducted in March, the assembly found that more than 40 percent of hospitals had no protocols for attending to COVID-19 patients. “In every hospital in the country there should be a protocol for treating suspected cases and there should be adequate supplies to carry out this protocol,” insisted Vera Cerda, who said this is far from the reality.

The consequence, according to medical personnel interviewed, has been the accelerated spread of the virus in hospitals and the communities they serve, resulting in deaths that could have been avoided.

A spate of hospital outbreaks

Health workers’ fears have already started playing out at a growing number of IMSS facilities with coronavirus outbreaks. In Social Security Hospital No 7 in the northern city of Monclova, more than 40 employees tested positive for COVID-19. Dozens of other health workers were infected in the Tlalnepantla Hospital in State of Mexico.

In both cases, hospital staff sounded an early alarm about the lack of equipment, testing and safety measures. In both cases, their warnings went unheeded. IMSS authorities initially announced that medical personnel had been infected outside of the hospital and not through contact with patients. In both cases, officials later admitted that staff had contracted the coronavirus at the workplace.

“We did have some outbreaks in some medical units,” Víctor Borja, a senior IMSS official, told Mexican media. Still, he said, the institution is prepared “to handle the outbreaks with our maximum capacity and with the maximum number of patients we expect in the coming weeks”.

A woman carries a sign that reads in Spanish: ‘I’m a nurse. I fight for you and for my life. Stay home.’ during a protest by public hospital workers demanding protective gear and training related to the new coronavirus in Mexico City [Fernando Llano/AP Photo/Daylife]

Although Alberto Vasquez San German, a leader of Local 35 of the National Health Workers’ Union, hopes Borja is right, he believes ill-equipped hospitals will be overwhelmed in the case of an uncontrolled outbreak. He says the blame for this lies not with President Lopez Obrador but with previous administrations that he says practically dismantled Mexico’s social security system.

“The [health] system in Mexico has been undermined through many years of neoliberal governments,” he said. “Today we are paying the consequences.”

*Name has been changed to protect the individual’s identity.