Government failed on PPE
Jane gasped for air, gripping her chest. I watched helplessly. She is a young, healthy woman admitted to the hospital with COVID-19.
She had been working as a nurse in a facility that did not have consistent access to personal protective equipment — masks, gowns, gloves, and face shields — due to the nationwide shortage. Without adequate PPE, she knew that when she fed, cleaned and cared for her patients, her health was at risk. This time, she had not beaten the odds. She had COVID-19.
Jane was still struggling to breathe despite additional oxygen. I needed to place her into a medically induced coma and put her on a ventilator. I looked at the two brown paper bags in front of me — my face shield in one, and my N95 mask (now in its fifth day of use) in the other. Under standard conditions, these are for single use only, but during this pandemic, I must reuse the same masks between patients, increasing the risk of infecting them and myself.
I put them on, took a deep breath and entered her room, hoping that I’d beat the odds.
More than 60,000 people have died in the U.S. from COVID-19 since this pandemic began. Some of these deaths likely resulted from infections related to an inadequate supply of PPE.
At the start of the pandemic, according to the Department of Health and Human Services, the Strategic National Stockpile contained 42 million medical masks. The Johns Hopkins Center for Health Security estimates that healthcare workers need at least
236 million medical masks for a 100-day COVID-19 wave, assuming strict adherence to social distancing measures.
Earlier this month, the Centers for Disease Control and Prevention recommended that everyone wear cloth face masks in public. Acting upon this recommendation, the governors of seven states, including New York and Connecticut, have required everyone in their states to wear masks or face coverings in public. If the general public adopts the widespread use of medical masks, an additional 45 million masks per day will be needed.
All community members need equitable access to medical masks. However, given the dire shortage, this is currently not possible.
Today we face a battle. As the demand for masks rises, state governments, federal agencies and hospital systems are frantically bidding against each other to purchase the remaining limited supplies. PPE hoarding and price-gouging abound.
The United States must ensure an adequate supply of masks for both front-line health care workers and for community members in order to slow the spread of COVID-19 and reduce the number of deaths.
To be sure, the federal government has taken some steps. On April 2, the Department of Homeland Security used the Defense Production Act to require one company, 3M, to manufacture N95 masks for America. On April 11, the Department of Defense issued a contract under the DPA to produce an additional 39 million masks in 90 days. While these are steps in the right direction, far more needs to be done to meet our national demand for PPE.
As a coalition of resident physicians at Yale, we have all cared for patients like Jane. We started NeedMasksToday, a movement calling for adequate masks and other PPE for both front line healthcare workers and all community members. Today, we are asking the federal government to step up.
Groups such as NeedMasksToday, GetUsPPE and Masks for America are coordinating efforts. We are calling on President Donald Trump to expand the use of the DPA to include a broader sector of the U.S. manufacturing industry. Invoking the DPA would provide incentives to businesses, such as low-cost loans, protection from litigation, and guarantees from buyers.
If the president fails to act, then Congress must pass the Medical Supply Chain Emergency Act, which would take advantage of the DPA’s full potential.
Health care workers are showing that they are willing to risk their lives to help others. They shouldn’t have to.
Asadullah Awan, MD, MPH, Nazeela Sabir Awan, MD, Janani Raveendran, MD, MEd, and Sumit R. Kumar, MD, MPA, are resident physicians at Yale New Haven Hospital.