Healthcare workers across the U.S. are taking to Twitter to talk about how they are perilously close to running out of vital protective equipment during the coronavirus pandemic. Using the hashtag #GetMePPE, many of them are already reporting shortages of masks, gloves, eye shields and other items they need to protect themselves when dealing with patients with confirmed, or suspected COVID-19.
“Right now at Oregon Health and Science University (OHSU), we have adequate supply in place, but we are trying to plan for the future,” said Renee Edwards, MD, MBA, Chief Medical Officer of OHSU, which has two hospitals in Portland. “We have projections for anticipated surges in COVID-19 patients we are expecting to see soon, but our current supply is based on what we normally see. We are seeing an increase in the PPE our providers are using and our concern is that the supply chain will not be able to ramp up with our increased demands for more PPE,” she added, noting that manufacturers are currently unable to guarantee or predict delivery dates for orders.
Some healthcare workers report that they are already rationing supplies or re-using equipment such as masks. Most masks are intended to be for be single-use for safety and hygiene, but many healthcare workers are saying that they are already re-using them as they have no other options. Some are even trying to disinfect their protective equipment using household cleaning products.
“In order to preserve our PPE stocks, we have put in place measures for conserving some PPE, guiding our staff as to what can be re-used and re-cleaned,” said Edwards. “Typically masks and eye shields are used only once and then thrown away, but we like many other places are given our staff instructions as to what may and what may not be reused and how to go about cleaning it,” she added, noting that face shields are in severe short supply at OHSU currently.
Other tactics being used to preserve supplies are mass cancellations of routine procedures, including many surgeries.
“Across the entire Portland metropolitan area, all major health systems have stopped all elective surgeries. Surgeries use a tremendous amount of PPE and we are aware that we must preserve these materials. We’ve seen what’s happening around the world and in this country, so if we don’t conserve these things now, we wont be prepared for the future,” said Edwards.
On March 17th, the CDC updated its guidelines about optimizing the supply of face masks to include a section about what healthcare workers can do when none are available.
“In settings where facemasks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort. However, homemade masks are not considered PPE, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face,” – CDC Strategies for Optimizing the Supply of Facemasks.
There is no evidence that these makeshift “masks” can protect healthcare workers from COVID-19 or any other infections they may be exposed to. The suggestion was met with shock from healthcare workers and in many cases, resignation as some of them attempted to prepare by ordering items off of Amazon.
This news is especially worrying considering growing evidence that healthcare workers seem to be at more risk of severe COVID-19 than the general population, although the reason for this is not yet known.
On Thursday, House Speaker Nancy Pelosi urged President Trump to immediately force manufacturers to produce the supplies that front line healthcare workers need.
“The president must immediately use the powers of the Defense Production Act to mass-produce and coordinate distribution of these critical supplies before the need worsens and the shortages become even more dire,” Pelosi said in a statement.
The statement follows a letter to the President, signed by 57 house democrats on 13th March asking him to invoke the defense act to produce vital supplies. President Trump signed the defense act late on Wednesday night, potentially giving him authority over private manufacturing, but has not yet used it.
“I’m appreciative of the representatives of the people who wrote the letter to President Trump, asking him to activate the defense act. I hope that with this, production will be able to increase and we will be able to figure out a good way to distribute these items,” said Edwards.
Across the world, many businesses already are attempting to switch production to vital healthcare provisions to help with the response to the pandemic. Distilleries across the U.S. and wider world are producing hand sanitizers, and car manufacturers such as Tesla and General Motors offered to use their manufacturing plants to produce ventilators. Hospitals are also starting their own initiatives to try and get more PPE from other local organizations which may not have such an acute need for it at the current time.
“In Oregon we have started on an initiative where we are reaching into every place where these supplies may exist, and then redistribute them based on need. e.g. vet offices, dental offices, smaller practices – places that are closed or operating on reduced schedules. We are reaching out to those places to ask for their PPE,” said Edwards.
However, these individual efforts will likely not go far enough to guarantee adequate supplies for those fighting the COVID-19 pandemic and seems increasingly likely that the President taking control of manufacturing of these supplies is a question of when, rather than if.
This article was edited at 7.55pm ET on 19th March 2020 to add comments from Renee Edwards, MD, MBA, Chief Medical Officer of OHSU.
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