Providers face supply shortage as COVID-19 spreads

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When a chain of Columbus-area optometry clinics closed to stem the spread of COVID-19, it donated its protective gloves to OhioHealth to bolster their fight against the deadly virus.

Similarly, a construction company donated some of its masks to the 12-hospital system based in Columbus.

"There is an altruistic sense behind it because all of us are in this," said Andrea Darby, vice president of IT integration at OhioHealth. "The community wants to know how they can help."

OhioHealth is giving around 500 iPads to its intensive-care and surgical units with patients who have COVID-19 or are awaiting test results, which is expected to cut in-person visits in half. The health system is replacing face-to-face consultations with audio or video connections where possible, hoping to reduce infection rates and preserve personal protective equipment, or PPE.

While OhioHealth isn't short on masks, scrubs, gowns, gloves, hand sanitizer or other PPE yet, the U.S. healthcare system is relying on an increasingly tenuous supply. Some health systems have seen PPE orders surge more than 200% as they await a wave of patients infected with COVID-19.

Some front-line healthcare workers have had to justify their requests for masks, use protective gear longer than manufacturers' recommendations and re-use equipment.

"Before, it was our call to follow our training and intuition when to use masks and to protect ourselves," Gabe Montoya, an emergency department assistant at Kaiser Downey (Calif.) Medical Center, said on a call with reporters Monday. "Now that decision has been taken away—masks and gowns are locked up and we have to justify usage for each mask."

The call was coordinated by the Service Employees International Union, which called on the Trump administration to implement a coordinated, comprehensive plan to boost the supply of personal protective equipment as well as transparently and equitably distribute PPE from the Strategic National Stockpile.

Testing and treatment for COVID-19 should be free for protective workers, federal funds should be used to train and hire more staff and the National Guard should be deployed to support healthcare operations, said Mary Kay Henry, SEIU president.

"It is unconscionable and immoral that healthcare workers are forced to figure this out on their own," she said. "The least our nation can do is ensure our healthcare front lines have the supplies and protective equipment they need to stay safe."

A group of Chicago medical students launched a crowd-sourcing campaign to secure protective equipment for area hospitals, and similar efforts are springing up throughout the country.

More than two-thirds of 179 senior-living facilities polled said they don't have enough PPE, N95 masks being the most pressing need, according to a survey conducted in early March by Premier, a group purchasing and consulting organization.

Yazmin Soto, a certified nursing assistant who works at a nursing home in Perth Amboy, N.J., said her facility is low on masks and instructed workers to re-use them, which the Center for Disease Control and Prevention supported in certain circumstances. The nursing home only has large gloves, which makes it harder for her to work, she said.

"I feed patients, dress them and bathe them—I get dirty and coughed on a lot. I need new equipment so I don't get others or my family sick," said Soto, adding that she is a single parent who also supports her parents. "I can't afford to get sick."

On Monday, President Donald Trump signed an executive order to ban hoarding personal protective equipment. The administration looks to boost domestic production of medical supplies and equipment through the Defense Production Act, which gives the executive branch authority to influence the nation's industrial base for national defense, including the production of essential goods and materials. The Trump administration also temporarily expanded reimbursement for telehealth services and relaxed patient privacy regulations.

A COVID-19 economic stimulus bill has stalled in Congress. It would provide $1 billion for purchases under the Defense Production Act and $1.7 billion for the strategic national stockpile, among other provisions.

Meanwhile, imports of medical supplies have dropped significantly, with N95 mask imports sinking 55% over the past month and hand sanitizers and swab imports both falling 40%. Most of the U.S. supply of masks and other equipment come from China.

Some healthcare workers have moved out of their homes to protect their families, Montoya said.

"Imagine coming home from work and not being able to hug and kiss the people you love," he said.