Personal protective equipment that was dangerously scarce in the first weeks of the coronavirus crisis in the United States is weak again as the virus resumes its rapid spread and the number of hospital patients increases.
A national nurses union is concerned that the equipment needs to be reused. Doctors ‘association warns doctors’ offices are closed because they cannot get masks and other supplies. And Democratic members of Congress are pushing the Trump administration to devise a national strategy to acquire and distribute equipment in anticipation of the worsening crisis in the fall.
“We are five months away from this and there are still shortages of gowns, hair covers, shoe covers, masks, N95 masks,” said Deborah Burger, president of National Nurses United, who has cited the results of a survey of union members. “They are distributed, and we are always told to reuse them.”
When the crisis first erupted in March and April in hot spots such as New York City, the situation was so dire that nurses turned plastic trash bags into protective gowns. Lack of equipment has forced states and hospitals to compete with each other, the federal government and other countries in desperate and costly bidding wars.
In general, supplies of protective equipment are now more robust, and many states and large hospital chains say they are in better shape. But medical professionals and some lawmakers have questioned these improvements as shortages begin to recur.
In other virus-related developments on Tuesday:
– Brazilian President Jair Bolsonaro said he tested positive for COVID-19 after months of downplaying the severity of the virus. The 65-year-old populist confirmed the test results while wearing a mask and speaking to reporters in the capital of Brasilia.
Bolsonaro has often appeared in public to shake hands with supporters and mingle with crowds, sometimes without a mask. He said his athletic history would protect him and the virus would be nothing more than a “little flu” if he got it.
– Australia’s second largest city, Melbourne, has been ordered to lockdown as infections continue to rise. Australia has been one of the most successful countries in the world to contain its coronavirus outbreak, with the exception of Melbourne.
Regarding PPE, Dr Aisha Terry said she had good access as an associate professor of emergency medicine at George Washington University in Washington, but some non-academic and rural health institutions in have much less.
âI think overall production, distribution and access have improved,â Terry said. âBut the fear is that we will become complacentâ and that supplies are scarce in some places.
In a letter to Congress last week, the Department of Health in DuPage County, Illinois, near Chicago, said all hospitals in the county were reusing protective equipment “in a way that was not not originally intended and which is probably less safe than the optimal use of PPE. “
The DuPage County Department is a supplier of last resort to respond when facilities have less than two weeks of equipment. As of Monday, there were only nine days of supply at the current level of demand. An increase in new infections could speed up the supply.
The American Medical Association has written to the Federal Emergency Management Agency, Vice President Mike Pence and members of Congress, calling for a coordinated national strategy to purchase and allocate equipment.
Representative Carolyn Maloney, a Democrat from New York, released a memo last week ahead of a Congressional committee hearing that raised concerns about looming issues in the supply chain. His report was based on interviews with anonymous employees of medical supply companies, one of whom warned that raw material for the gowns was not available at all prices in the quantities needed, leading to a situation ” unsustainable “.
Rear Admiral John Polowczyk, who is in charge of coronavirus-related supplies for the White House, told Congress last week that more than a quarter of states have less than 30 days of supply.
“It looks like in less than 30 days we’re going to have a real crisis,” said Representative Bill Foster, a Democrat from Illinois.
FEMA, one of the main federal agencies responsible for the coronavirus response, would not determine which states have enough equipment to last beyond 30 days and which do not. He referred these questions to individual states. In June, the government began to replenish its once-depleted stocks with the aim of building up a two-month supply.
As of June 10, FEMA had distributed or asked private companies to distribute more than 74 million N95 masks and 66 million pairs of gloves, as well as other equipment. The agency said it changed its method of distribution to send more equipment to hot spots.
Although all U.S. states and territories have received protective gear from FEMA, an Associated Press analysis of the agency’s own data found that the amounts varied widely when measured based on population and location. number of confirmed cases of COVID-19.
The AP analysis found that low-population, predominantly rural states received the highest FEMA allocations per confirmed case. By mid-June, for example, Montana had received 1,125 items of protective equipment per case, compared to 32 items per case in Massachusetts, an early hot spot. States like California, Iowa and Nebraska, all of which have seen an increase in confirmed infections, have received one of the lowest amounts of protective equipment from FEMA per case, according to the analysis. AP.
Many states claim that federal supplies are only a small portion of their inventory after spending millions of dollars acquiring equipment themselves. FEMA told the PA that its initial distributions were made on a per capita basis, but also said the agency had tried to meet individual requests from states.
The concerns extend beyond the amount of equipment. In New Hampshire, an association representing nursing homes said most items sent by FEMA in early June were unusable, including children’s gloves, surgical masks with earrings that broke when they were stretched out and isolation gowns with no openings for the arms.
A nonprofit group called #GetUsPPE was started in March by medics to help distribute donated protective gear.
The group has seen a 200% increase in claims in the last two weeks of June from medical providers in Texas, a state with a sharp increase in confirmed cases of the virus. State officials there said their supplies were sufficient.
“We anticipated that we would need to be there for a few weeks until someone else stepped in and fixed this problem,” said Dr. Megan Ranney, an emergency room doctor at Rhode Island Hospital who was part of the founders of the group. âHere we are, we still receive hundreds of thousands of requests per week. “
Fassett, a data reporter based in Santa Cruz, Calif., Is a member of the Associated Press / Report for America Statehouse News Initiative corps. Report for America is a national, non-profit service program that places reporters in local newsrooms to cover under-covered topics.
Mulvihill reported from Cherry Hill, New Jersey.