Masks, gloves and other gear are essential as healthcare workers deal with the COVID-19 outbreak. The East a strategic national stockpile that the US government controls – but no one knows what, beyond this stockpile, is available in the private sector.
Some hospitals have a surplus of protective equipment and others not enough. The Centers for Disease Control and Prevention is working on a system that would track inventory across the United States
The big obstacle is not the technology. The problem is making hospitals feel comfortable sharing information about their preparedness — information they have until now considered confidential.
Protective masks have become a rare commodity, even within hospitals. At Nashville General Hospital, for example, several weeks ago, employees casually approached the director of supply chain management, Tom Cooper, and asked if they could have a box. personal use.
Cooper told them the masks were only available to “clinicians as needed, for their professional duties.”
And Cooper said he felt more protective of his hospital’s supply, particularly of N95 respirators. General hospital distributor Medline has already limited ventilator orders. Cooper said he couldn’t get more than his usual monthly allowance, even if he could afford it.
“Right now we’re fine,” he said. “But next month, what could happen?”
The CDC has tried to avoid such a shortage and the costs associated with shortages. Often there is plenty of disposable protective gear for everyone, but it’s not always in the right places before pandemics.
“It can lead to ‘panic buying,'” said CDC nurse epidemiologist Megan Casey. “That’s where the installs buy as much as possible, just to be on the safe side.”
At present, public health agencies only know what is in government stockpiles of protective gear. Health and Human Services Secretary Alex Azar has told Congress in recent weeks that the government has 30 million masks, though 300 million may be needed. (The few U.S. companies making masks say demand in recent weeks has far exceeded their production capacity, though they are growing.)
The country’s 6,000 hospitals have been more of a black box – now and in previous outbreaks. In past outbreaks — of the H1N1 flu, for example — some hospitals have resorted to informal supply swaps around the corner, according to project leaders from the nonprofit Center for Medical Interoperability. based in Nashville.
Last year, before the emergence of COVID-19, the center won a $3 million contract with the CDC to build a system that asks hospitals to submit information about their inventory in real time. Information can usually be retrieved directly from a facility’s electronic medical record system. Using this accumulated data, the CDC should be able to use a digital dashboard to easily identify which facilities need it the most.
“It could also, potentially, provide a tool for hospitals to request personal protective equipment from state or local health departments, stock or even other hospitals that may have an excess,” Casey said. “We see this as a potential opportunity to share resources and have these kinds of discussions.”
But the prospect of sharing supplies is where the healthcare industry makes cooperation difficult even in a crisis, Melanie Thomas said. She is director of information at Nashville General, one of the pilot sites for the CDC-sponsored project.
“It’s sometimes difficult and scary to share data and equipment, especially with your competitors,” Thomas said, “because you want to have the advantage.”
Nashville General is the smallest of the pilot sites, which includes Northwestern Memorial in Chicago and Nashville-based Community Health Systems, a for-profit chain of nearly 100 hospitals in the United States.
Thomas acknowledged that it’s easier for his taxpayer-funded hospital to grant access to his inventory system because he doesn’t have the buying power to stock equipment.
“It will never be our problem,” she said. “We want the information to be shared because we’re going to have just enough.”
And when they run out, she wants to know where to turn for more.
A theoretical threat becomes real
The Center for Medical Interoperability began its work quietly, a few months before the emergence of COVID-19. But project officials have noticed a greater willingness to participate among major health systems now that a theoretical threat has become very real.
“We know … their supply chains are under pressure right now because these products are coming out of China,” said Tommy Ragsdale, the center’s chief strategy officer.
China needs the disposable material produced there for its own use. And only a handful of companies in the United States still manufacture the protective gear in the country. We have orders for over a billion masks.
“It certainly created different discussions at the hospital and health system level than we had in October or November,” Ragsdale said.
The CDC has injected an additional $600,000 into the data-sharing project, with an accelerated go-live date in May, Ragsdale said. The center plans to host a webinar on April 1 for other hospitals interested in participating in later phases.
At this point, the CDC said, hospitals have no mandate to participate. But Ragsdale said he hoped they would see the benefits: “It’s clearly for the greater good.”
This story is part of a partnership that includes Nashville Public Radio, NPR and Kaiser Health News.