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Hospitals already short N95 respirators, ventilators, surgical masks, survey shows

Dive Brief:

  • Hospitals are burning through N95 respirators, surgical masks, isolation gowns and face shields faster than they can replace them, according to group purchasing organization Premier, and are critically short of swabs necessary for COVID-19 testing.
  • Premier’s report about March supply levels at the nation’s hospitals found that, in response to the COVID-19 outbreak, the vast majority are conserving at least one type of personal protective equipment in light of shortages. One in five hospitals said they were immediately experiencing a shortage of ventilators.
  • “It’s clear that supply shortages have only grown worse as COVID-19 cases spread, and there are now multiple domestic and international organizations competing with healthcare providers for limited supplies,” Premier warned.

Dive Insight:

Along with trying to flatten the curve of the COVID-19 outbreak, another major concern is whether the nation’s hospitals are able to treat the anticipated wave of patients. Hundreds of thousands of Americans are expected to show up at hospital emergency rooms. Many will require testing and some will need to be admitted, possibly even requiring intensive care on a respirator.

The Premier survey, conducted between March 16 and March 20 and involving 260 healthcare systems including 990 acute care hospitals, lends credence to the concerns of the medical community that hospitals are at risk of being overwhelmed.

The biggest concern centers around a shortage of N95 respirator masks. Although 39% of respondents say they have more than 1,000 of those masks on hand, 23% of respondents say they are using more than 100 per day, and many healthcare systems report having fewer than 10 days worth of inventory on hand. Of those surveyed, 60% say they are extending the use of their ventilators, while 40% say they are reusing them. One-third say they are also deploying expired N95s.

Surgical masks are also apparently in short supply, as 56% said they had more than 1,000 masks on hand but were using that amount every day, and that the on-hand supply was at a day or less.

Hospitals were also concerned about shortages of hand sanitizers, with 64% saying they were experiencing a shortage, while 25% say they had less than a two-week supply.

Premier recommended that hospitals follow Centers for Disease Control and Prevention guidelines for preserving supplies. The guidelines, which included the suggested use of surgical masks and even bandanas if no other alternatives were available, were condemned by the National Nurses United labor union.

“Without proper action from Congress and the Trump administration, it is certain that nurses and healthcare workers will continue to be exposed to the virus causing COVID-19. When that happens, they will need to be quarantined, or they will be putting their patients, families and communities at further risk of infection,” said NNU Executive DIrector Bonnie Castillo. “When nurses get sidelined in quarantine or die because they are not protected, who will care for this country’s patients?”

Front-line healthcare workers have been publicly sounding the alarm about the dangers that come with a lack of PPE. One Atlanta doctor on a press call with Mizuho analysts Thursday said a friend of his had been forced to use a single N95 mask for the past two weeks, cleaning it as best she could. Charles Fox, a gastroenterologist and also assistant professor of medicine at Emory University, said it was “totally unacceptable.”

The American Medical Association agrees. The group’s president, Patricia Harris, wrote during a Twitter Q&A on Thursday there are no CDC-approved decontamination methods for PPE. “Forcing physicians and nurses to reuse masks is unacceptable,” she wrote. “Expecting loved ones to sew masks is unacceptable. This is no way to protect from illness and it is not sustainable. We need all hands-on-deck to get our medical workforce what they need.”

Despite urging from AMA and others in the healthcare community, President Donald Trump has so far declined to use the Korean War-era Defense Production Act to mandate the private sector produce needed medical supplies already running dry in the pandemic.

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