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Health care protective equipment shortage reaching crisis point

March 20, 2020
In The News

NORTHAMPTON — Nowadays, when Kurt Bahneman enters a patient’s room to start his day as a respiratory therapist at Cooley Dickinson Hospital, he said he writes his name on a mask and prays it will be enough. It is the only mask he can use all day long.

“We typically change masks with every patient encounter,” he said. But these are not typical times, and amid the COVID-19 pandemic there is a national shortage of protective equipment for front-line health care workers like Bahneman. “I understand these decisions are being made out of desperation; however, reusing potentially infected masks is terrifying— as is the possibility of running out of them.”

Health care workers nationwide are facing dangerous shortages of personal protective equipment, known as PPE. Given the national scarcity, the Centers for Disease Control and Prevention is now recommending that PPE be reused in order to conserve limited supplies. The CDC has even gone so far as to recommend that health care providers, as a last resort, use homemade masks made out of bandanas or scarves if they have nothing else.

When asked how she felt about the protective equipment shortage, Cooley Dickinson’s manager of infection prevention was blunt.

“We would not send soldiers to war without all the equipment and supplies they need,” Linda Riley said. And yet that’s exactly what’s happening with vulnerable health care workers: “We are on the front lines and we don’t have what we need.”

The situation is not unique to Cooley Dickinson. In a telephone town hall Wednesday, Baystate Health President and CEO Mark Keroack also said protective equipment is his “major worry,” with only a 10-day supply remaining. As COVID-19 spreads at a rapid pace, health care workers across the country are facing the possibility of running out of the equipment needed to prevent them from getting sick.

Riley said that Cooley Dickinson has an adequate supply of protective equipment for now, and that staff is using and conserving it appropriately, given the guidelines of the CDC and Partners HealthCare, which runs the hospital.

“The problem is, this isn’t going to be over in a couple of weeks or a couple of months,” she said.

Riley said normal protocol would have health care workers throw away disposable masks and eyewear in a patient’s room. Now, she said, hospital workers have to reuse masks all day. They place those masks in a plastic basin if they need to eat, for example, and then put them back on to go from room to room, using their regular strict protocols for putting on and removing equipment.

“Do I like it? No, I don’t,” she said. But her primary fear is not reusing masks, she added. “What I’m more concerned about is that if we have no masks, health care workers will be using no masks.”

The shortage is forcing health systems and their employees into difficult choices across the country. Many have called on President Donald Trump to use the broad powers afforded to him under the Defense Protection Act to compel industry to manufacture medical supplies. Trump invoked the act Wednesday, but as of Friday afternoon he had not ramped up production of masks, ventilators and other essential equipment, despite mounting calls from governors and lawmakers.

“In order to truly combat the coronavirus, our health care professionals urgently need an influx of medical and personal protective equipment,” U.S. Rep. Richard Neal, D-Springfield said in a statement Friday, urging Trump to enact the Defense Production Act powers. “Time is of the essence and President Trump must act before this shortage worsens.”

State Sen. Jo Comerford, D-Northampton, said that the state is “laser-focused” on PPE. Comerford, who is heading the state Senate’s working group on COVID-19, said the shortage is “at the very top of urgent issues facing the Commonwealth.”

In the short term, Comerford said, state lawmakers are engaged in creative work to boost the amount of PPE in hospitals, such as asking industry and vocational schools to donate their supplies.

South Hadley-based roofing and siding contractor Adam Quenneville is one of those heeding that call and a similar one from Vice President Mike Pence, he said in a press release. He put out a call Friday for area contractors to donate protective eyewear and N95 surgical masks — with labeling indicating they are “NIOSH-approved” — to Baystate Health. The hospital said for potential donors to call ahead of doing so to 413-695-0944, or email Mary.Persaud@baystatehealth.org.

At Cooley Dickinson, hospital spokeswoman Christina Trinchero said people in the community have offered to quilt masks for hospital workers, should that be necessary.

The state’s nurses union has also called on hospitals to create separate triage and treatment facilities in order to separate COVID-19 patients and conserve limited PPE supplies. The nurses association also expressed concern about the CDC’s “weakened” PPE guidance.

The federal government passed new legislation this week allowing manufacturers of N95 face masks to sell them to hospitals without facing the possibility of lawsuits, according to the Washington Post. That will free up those producers to boost supplies, though increased production figures given by Pence on Friday will fall very short of the 3.5 billion respirator masks the country could need, according to figures given by Robert Kadlec, assistant secretary at the Department of Health and Human Services.

Comerford said it is incumbent on the federal government to boost production to meet the significant need in the country.

“The issue is really about the care of the people who are on the front lines, and that’s what we owe them,” she said. “And if we aren’t able to give them that, we’ve put them at risk, and putting them at risk isn’t going to help the Commonwealth through the crisis.”

That’s exactly what worries Bahneman, who has a wife and two children he worries about infecting. He said he has already purchased bandanas, even though his training tells him they are a last resort and ineffective.

“I’ve thought about wearing a mask at home or sleeping in a tent in the backyard,” he said. “I worry this will scare my 2- and 5-year-olds and just make us all really sad. But, I see this as a better solution than sleeping in hotels for weeks, which is what I have heard some medical workers in Italy have had to do.”

It would be Bahneman and other respiratory therapists who hook a patient up to a ventilator or intubate them if needed — a job that comes with a high risk of exposure to the virus. And with a dire dearth of PPE, he and some colleagues have considered renting hotel rooms or designating one of their homes as a “contaminated house” to live in while their uninfected family members move in together in another home.

“I hope that somehow Massachusetts will ramp up production of masks so that we can do our jobs and keep people alive,” Bahneman said. “We cannot afford to get sick during this crisis, our community needs us more than ever.”