Making homemade washable isolation gowns for the NHS — a guide for desperate times

Procurement of PPE across the UK is falling apart. There isn’t enough equipment to meet demand and the British government is failing to deliver what is needed. Cabinet minister Robert Jenrick promised that 84 tonnes of PPE, including 400,000 much needed surgical gowns, would get here yesterday (Sunday 19 April) but the shipment from Turkey has failed to arrive and there are huge shortages. The reality is that doctors, nurses, carers and others on the front line are losing their lives. At least 77 NHS workers have already died.

It’s an intolerable situation. For weeks, frontline workers in need of scrubs have been forced to work with insufficient supplies and there aren’t enough face shields or masks for those who need them. The Guardian recently revealed that NHS staff have been told to ‘wear aprons’ as protective gowns run out contravening original guidelines to wear full-length waterproof gear for high-risk procedures.

And it’s not just NHS workers who are struggling with PPE shortages. Care home workers, carers working in the community and others also need protective equipment and aren’t getting what they need.

In the absence of a government solution to this shortage, volunteers across the UK who can make things have mobilised, deploying their sewing machines and their 3D printers and setting up workshops in their garages and front rooms to create thousands of desperately needed items of PPE in order to help meet demand on the front line.

This response is hyper-local, fast and responsive and means that some of those risking their lives to treat people with Covid-19 are at least getting the protective gear they need in some form. But it’s far from ideal. Local coordination relies on people making up distribution systems as they go along, which can be unreliable and inefficient. What’s more, none of this is regulated, which means the quality of the kit made varies enormously. Though these initiatives are fuelled by the goodwill of tens of thousands of people who care enough to provide a temporary solution to this crisis (a crisis to which the government’s response has been dangerously lacklustre), the people who are working to save our lives should not have to wear protective clothing made from old duvet covers.

In the absence of professional equipment, how can homemade PPE be as good as possible? What are the specifications? What are the best patterns/instructions? What are the best materials and who are the best suppliers? And how do we collectively work together to get supply and demand right and ensure delivery of the kit to where it is needed?

This is why I, along with friends, colleagues and family, have set up a A Stitch in Time. It’s an online resource we are developing as the crisis unfolds to provide easily accessible information for making PPE as well as links to the huge numbers of volunteer initiatives across the UK that have sprung up in recent weeks to meet this urgent demand.

Scrub caps from Sew Support arrive at one of the surgeries in West Cumbria

There are huge numbers of initiatives doing incredible work, among them Facebook groups with volunteers in their thousands creating scrubs for hospitals; teachers making protective face shields in school workshops, and small teams in villages around the UK using WhatsApp to co-ordinate the production of homemade protective equipment for their local GP surgeries.

Alongside setting up A Stitch in Time, I’m part of one of these local initiatives in West Cumbria — Sew Support. My mum, Susie Davies, is a force of nature when it comes to creating patterns and dressmaking. She’s the kind of person who can make pretty much anything and is currently leading one of the Sew Support teams — 12 talented women who have volunteered to sew gowns, scrub hats and bags for the dedicated staff of a group of local GP surgeries, some of whom are working in a “red centre” (caring for those with confirmed Covid-19 cases).

Over the last week we have modified patterns, sourced and tested fabrics and created processes for hand-making washable isolation gowns. This has resulted in a prototype water-resistant gown which the local GPs are happy with. Our first delivery of fabric for the volunteers to start making around 50 gowns is arriving today (Monday).

I am sharing here what we have learned so far to provide information for anyone else trying to do the same. Any questions or comments, feel free to get in touch via jen@astitchintime.cc

The pattern

We are using a free pattern available from Peekaboo Pattern Shop.

This can be printed at home on an A4 printer and taped together. Size L can serve as a ‘one-size-fits-most’ gown, and this is the size we are making for the first batch.

Some modifications to the pattern

• We are making the length 15cm longer.
• Based on tips from a medic friend we are using ties rather than velcro for the neck closure, and shorter ties at the back to prevent contamination (rather than longer ties which can wrap around waist).

Tips and tricks

• Use clips or pegs or weights rather than pins. Avoid any unnecessary holes.
• Double stitch where seams cross to reinforce them (e.g. armpits).
• Double stitch the seams where the ties are attached to ensure that they are very securely attached.
• If you make any mistakes which require unpicking, give a larger seam allowance when fixing to ensure no unnecessary holes in the fabric.
• No topstitching around the sleeves — again this is to reduce unnecessary holes.
• The fabric is slightly slippery to sew, keep a bit of tension both ahead and behind the foot as you sew.

The fabric

Our local GPs requested that it be machine washable at 60°C and water-resistant.

We are using a 2oz PU coated polyester from Talon Textiles (fabric reference T508). They are an industrial supplier but given the situation are happy to sell multiples of 100m rolls to smaller initiatives.

Other successful trials of fabric were a coated duchess satin (from Litmans, reference 1282) and a water-resistant polyester from UK Fabrics Online (fabric no longer listed on their site). Both performed as well as the fabric from Talon Textiles in our kitchen water-resistance tests. They didn’t shrink and they retained water-resistance after a 60°C wash and low tumble dry. However both of these fabrics were heavier in weight and more expensive.

Other information

Some common sense guidelines:

• Wash your hands thoroughly and often with soap and water for at least 20 seconds before making or packaging any kit. Follow NHS handwashing guidelines.
• Work in a clean space and disinfect all surfaces and equipment likely to be in contact with the kit. Ensure all kit is laundered at at least 60°C, hot ironed if possible (not appropriate for these gowns) and packaged into clean bags and sealed/taped shut.
• Only make kit for others if you have no Covid-19 symptoms and have not had contact with a known case. Here is the UK Government’s official guidelines on symptoms and quarantining.
• When passing packages on to co-ordinators or organisations, please follow all current social distancing recommendations. If you are at risk, please connect with others for support to ensure you are in line with all current social distancing guidelines for vulnerable people.
• Anyone using PPE should be familiar with best practice for use, donning and doffing, and laundering.

Some information we will be passing on to those using the gowns:

• Please be aware that a homemade gown will not offer the same level of protection as a commercially made gown. Use at your own risk. This is a better-than-nothing option for you to decide for yourself whether or not to use.
• Note that seams are not sealed.
• Laundry instructions: wash at 60°C, drip dry or tumble dry on a cool or low setting.
• Test after laundering to ensure that you are still happy with the level of water resistance offered. The waterproof coating will become less effective after repeated laundering.