India’s journey from manufacturing zero PPE kits to two lakh PPE kits per day

India was manufacturing nearly zero PPE kits until January 2020. It was manufacturing only medical gowns, which was just one of the components of the kit, whereas, no PPE coveralls with seam tapes were manufactured. Around 2.75 lakh kits were available in the country in January 2020, and were mostly imported.  In May 2020, the country ramped up its production capacity to produce around two lakh kits per day and had about 15.96 lakh PPE kits in the centre-state buffer stock. This has been a great support to all the healthcare workers who have been in the front line of this war against COVID-19.

India ramped up its manufacturing of PPE kits because of the poor quality of kits coming from China along with the growing anti-Chinese sentiment among people. The protective equipment is a garment placed to protect a healthcare worker or any other person having the possibility of an infection. If the infection is air borne, the PPE kit includes goggles and mask or face shield, gloves, gown or coverall, head cover and rubber boots or shoe cover.

The main aim is to protect the mucous membrane in eyes, nose and mouth from the infective droplets. The ideal component list should seal properly with the skin, have higher resistance property, is impermeable to blood and other body fluids, maintain its shape and is wearable.  

There are currently more than 110 Government identified domestic PPE manufacturers in the country. With time, the system is being put in place to sort out issues like transportation, availability of raw materials, labour, etc. to increase manufacturing from two lakh PPE kits and 10 lakh masks per day in the country.   

In India, the guidelines for rational use of PPE kits are provided by the Ministry of Health and Family Welfare. It’s been providing detailed information about the raw materials as well as the use of PPE. It has also rolled out information about what is required for different settings. These guidelines have been developed based on the availability of materials and the technical requirement for a high level of protection for healthcare professionals in consultation with medical experts in the field.

As of May 26, 2020, there were nine laboratories in the country equipped with Synthetic Blood Penetration Resistance Test facilities as well as the necessary approvals required for conducting tests and certification for Body Coveralls (PPE) required for COVID-19.  These laboratories include: South India Textiles Research Association (SITRA), Coimbatore; Defence Research and Development Establishment (DRDO), Gwalior; Textiles Committee (TC), Mumbai;  and six laboratories under Ordnance Factory Board (OFB) – Heavy Vehicles Factory, Avadi; Small Arms Factory, Kanpur; Ordnance Factory, Kanpur; Ordnance Factory, Ambarnath; Metal & Steel Factory, Ishapore; and Institute of Nuclear Medicine & Allied Sciences (INMAS), Delhi.

A Unique Certification Code (UCC-COVID19) is generated for each PPE kit, having a record of the type of fabric, type of garment, its date of testing, testing standard and other relevant information. UCC-COVID-19 is given to prototype samples sent by respective manufacturers to labs. These are published on the official website of DRDO, OFB and SITRA for verification by any user of the product.  

Ministry of Health & Family Welfare, Department of Pharmaceuticals and Ministry of Textiles are continuously working with various industry bodies, stakeholders and manufacturers 24x7 to streamline the supply chain, remove bottlenecks and maintain a steady supply of all materials required for healthcare professionals.

There have been various innovations to reduce the cost of the kit, make it more comfortable for healthcare workers as well as follow the criteria specified by the Ministry of Health and Family Welfare.

Department of Textile and Fibre Engineering has developed a breathable and light-weighted PPE at Indian Institute of Technology-Delhi to strengthen the fight against COVID-19. It’s comfortable to wear for a longer period and is more breathable without compromising safety. It exceeds the property requirement at 15 kPa (kilopascals), which is almost 4.2 times more than the basic requirement of 3.5 kPa. This PPE is also less in weight compared to others and can be re-used thrice, bringing down the cost of purchase by three times. 

Indian Navy made PPE kit, 'NavRakshak', is focused on enhancing the comfort of healthcare professionals working under diverse Indian conditions and strengthen the fight against COVID-19. Navrakshak, which translates to a "novel protector", has two unique features – optimal protectiveness and optimal breathability (property that allows water vapour to pass through and prevent the entry of water). This adds comfort to the fabric as thermal energy generated by the body is transmitted and vapour moisture is diffused. The kit was approved by DRDO and a patent has been filed for this innovative and cost-effective PPE developed by the Indian Navy.

Indian Institute of Technology (IIT)-Kanpur manufactured PPE kits at a cost of mere Rs 100 (US$ 1.41), which is 20 times cheaper than standard PPE kits. These kits are called PIPES (Polyethylene-based Improvised Protective Equipment under Scarcity). They use thin cylindrical rolls or pipes of polyethylene (polythene). The material is non-porous and is commonly used in the industry for packaging and making plastic-bags, which is very cheap, whereas, the standard PPE kits are made from non-woven polypropylene, which have been short in supply. Additionally, stitching and ultrasonic welding is required for standard PPE kits, which is time-consuming and very expensive. Thus, the large demand is met through PIPES, which are cost-effective. But these kits are yet to be tested by the Government, and therefore, can’t be used by doctors working in ICU. These kits are suitable for sanitary workers, policemen, grocery vendors, etc. 

In May 2020, Reliance Industries converted its newly acquired textiles and apparel fabrics maker, Alok Industries, into a PPE manufacturer. The daily production capacity has been scaled up to more than one lakh PPE kits and cost has been decreased to nearly Rs 650 (US$ 9.22) per unit from about Rs 2,000 (US$ 28.37) a piece for the imported price. These kits manufactured by Alok Industries account for nearly a fifth of India’s total PPE production capacity. Other PPE kit manufacturers include JCT Phagwara, Gokaldas Exports, and Aditya Birla.

Recently, DRDO introduced a disinfection unit named Ultra Swachh to disinfect a wide range of materials including PPEs, electronic items, fabrics, etc. Ozonated Space Technology is being used for multiple barrier disruption.

Different healthcare providers require different kits – those going to isolation or operation wards need sterilised kits. Thus, manufacturers will have to equip themselves  to provide kits for different uses. It is estimated that PPE kits will have a market of Rs 10,000 crore (US$ 1.42 billion) in India by 2021.

India has created an opportunity in the time of crisis and will soon be able to export these kits along with meeting its domestic demand. This will contribute to India’s economy.