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, known as PPE, may need 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 develop a national strategy to acquire and distribute equipment in anticipation of the crisis worsening in the months to come.
“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 cited the results of a survey of union members. âThey 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 claim to be in better shape. But medical professionals and some lawmakers have questioned these improvements as shortages begin to recur.
Dr Aisha Terry, associate professor of emergency medicine at George Washington University in Washington, said she has good access to PPE, but some non-university and rural health facilities 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 DuPage County, Illinois, near Chicago health department 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.
New York Rep. Carolyn Maloney released a memo last week ahead of a Congressional committee hearing that raised concerns about looming supply chain issues. His report was based on interviews with anonymous employees of medical supply companies, one of whom warned that the 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.
âIt looks like in less than 30 days we’re going to have a real crisis,â said Illinois Rep. Bill Foster.
FEMA, which manages the country’s stocks, would not determine which states have enough equipment to last longer than 30 days and which do not. 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 distribution method 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 PA 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.
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 in 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.
– #GetUsPPE (@getusppe) July 7, 2020
The group saw 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.
âWe anticipated that we would need to be there for a few weeks until someone else stepped in and fixed this problem,â said Dr. Megan Ranney, an emergency physician at Rhode Island Hospital who was one of the founders of the group. âHere we are, we still receive hundreds of thousands of requests per week. “