An intensive-care nurse in Illinois was told to make a single-use mask last for five days.
An emergency room doctor in California said her colleagues had started storing dirty masks in plastic containers to use again later with different patients.
A pediatrician in Washington state, trying to make her small stock last, has been spraying each mask with alcohol after use, until it breaks down.
“The situation is terrible, really terrible,” said Dr. Niran Al-Agba, 45, the pediatrician. “I don’t think we were prepared.”
Al-Agba was one of hundreds of health care workers this week who appealed to the public for help confronting the coronavirus pandemic, which has sickened thousands and killed more than 140 people in the United States.
As hospital supplies have dwindled, the vice president has called on construction companies to donate masks, the surgeon general has urged the public to stop buying them, and experts have warned that, the more doctors and nurses who get sick, the greater strain on a system already stretched thin.
Now, doctors, nurses and others are rallying on social media with the hashtag #GetMePPE, referring to personal protective equipment like masks, gowns and face shields, to put pressure on elected leaders to get them more gear to guard against infection.
Medical professionals need a large supply of the masks because they are in direct contact with infected patients and must change their masks repeatedly. The World Health Organization’s guidelines recommend that health workers use surgical masks to cover their mouths and noses, but some hospitals require masks known as N95s, which are thicker, fit more tightly around the mouth and nose, and block out much smaller particles than surgical masks do.
Charnai Prefontaine, an ICU nurse in Illinois, said she’s asking the public to implore lawmakers and government officials to speed up the process of bringing resources to hospitals.
“I would like to say there’s some major happy ending where a cowboy comes in with a ton of masks and we’re saved, but I don’t see that happening anytime soon,” said Prefontaine, 30, who regularly interacts with patients suffering from respiratory issues. “I think it’s going to get worse before it gets better.”
The emergency room doctor based in Northern California, who spoke on condition of anonymity to avoid a conflict with her employer, said her hospital had already treated several COVID-19 patients, forcing several exposed employees to quarantine at home.
Dr. Vidya Ramanathan, 43, a pediatrician in Michigan, said the need was dire.
There aren’t enough sanitizer wipes to clean the workers’ face shields and her hospital is almost out of masks, she said.
The hospital where Ramanathan works has set up tents outside the building and established a triage system so that those who don’t require further care can be sent home for quarantine. The process protects patients and workers inside the hospital and conserves the diminishing stock of protective equipment, she said.
“Health care workers are working diligently to keep the pandemic at bay,” Ramanathan said. “We hope that everybody takes this as seriously as we are. The keys for the public are social distancing and staying at home.”
Al-Agba, who runs a private practice about 10 miles west of downtown Seattle, said she had been monitoring the spread of the virus in the community since a person died at a nursing care center in Kirkland, Washington, in February.
Days later, Al-Agba asked her medical distributor to order gowns and N95s — but they were already all sold out. Then, she was told she could not get any protective equipment from local health officials because she wasn’t on the front line.
She had to rely on community donations.
“Someone left two boxes of masks on my doorstep,” Al-Agba said. “I will make them last; I’ll spray each one with alcohol and keep using it until it breaks down. We’re really improvising here.”
For weeks now, she said, she’s been conducting “car visits” with her patients who have a cough or a fever. The patient is instructed to pull up to the side of the office while Al-Agba puts on goggles, a mask, gloves and a zippered, hazmat-like suit. Then she approaches the vehicle.
“After practicing for 20 years and being a third-generation doctor, I can tell you this is new territory,” Al-Agba said. “I don’t know if we’ve ever had to go to work and fear for our lives in the same way.”
The hospital shortages stem mainly from the prolonged outbreak in China and a widespread buying of masks by anxious citizens in the United States and around the world.
China produced half of the world’s supply even before the coronavirus emerged there. As the country grappled with an outbreak, it expanded its mask production by nearly twelvefold, but stockpiled what it made. As a result, worries about mask supplies have risen as the epidemic in Asia rapidly transformed into a pandemic that reached more than 140 countries and all 50 U.S. states.
Last month, the U.S. surgeon general, Jerome Adams, urged the public to stop buying masks, warning that they would take away important resources from health care professionals. This week, Vice President Mike Pence asked construction companies to donate their N95 masks to local hospitals, and to stop making new orders.
A person is more likely to get infected by touching contaminated surfaces than from a droplet traveling through the air, according to infectious disease experts, who also warn about accidental contamination by touching the outside of the mask. But they also encourage health care workers to take serious precautions, given the risk their work exposes them to.
“We don’t have immunity; we don’t have prior exposure; a lot of people are susceptible and the virus is easily transmittable,” said Dr. Lucy Wilson, a professor of emergency health services at the University of Maryland Baltimore County. “I think it’s pretty unprecedented in modern times, and we are entering the crisis point.”
Wilson, an infectious disease physician and former public health official, said potential solutions to the shortage could include the federal stockpile, masks donated from other industries and increased domestic production.
The federal government’s Strategic National Stockpile of medical supplies includes 12 million medical-grade N95 masks and 30 million surgical masks — only about 1% of the 3.5 billion masks that the Department of Health and Human Services estimates would be needed over the course of a year.
During similar outbreaks in the past, like the SARS epidemic in 2003, a large number of hospital workers got infected, Wilson said. Protecting medical professionals is essential to managing the pandemic.
“Health care workers have become very vocal about their safety concerns because they are really on the battlefield 24 hours a day,” Wilson said. “They have organized and are raising awareness.”
Doctors and nurses who get sick can’t provide care for their patients, putting a tremendous strain on a health care system that is already in need of resources, she said.
“This is a think-outside-the-box situation, and we as a country need to be innovative,” Al-Agba said. “It feels like a war zone a little bit. We need to do as much as we can to save as many as we can.”
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