US still lacks enough masks
Treating coronavirus patients in one of the busiest emergency rooms in Manhattan, Dr. Jason Hill wore the same disposable respirator mask for up to four shifts in a row.
He would take the mask home from Columbia University Medical Center, his coffee-flavored breath clinging to its fibers. Then he would bake it in an oven to kill any viral hitchhikers. A half-hour at 140 degrees.
For months as the virus filled hospitals in New York and across the nation, doctors, nurses and other medical workers risked their lives in similar ways – sharing protective gear, reusing masks or going without – simply because there weren’t enough to go around.
Thousands of health care workers got sick, and hundreds died.
Nurses at Mount Sinai West hospital in New York City wore Hefty trash bags to protect themselves. Doctors at a California veterans hospital were handed one single-use disposable respirator in a brown paper bag at the beginning of the day to use for an entire shift.
The stories spawned a massive volunteer network to make cotton masks and donate supplies. The Federal Emergency Management Agency created an airlift to bring in emergency supplies from around the world. U.S. companies that had never made personal protective gear filled in as pinchhitters, all in an effort to ease shortages. Six months into the nation’s fight with the novel coronavirus, doctors and nurses still face a dearth of supplies as cases rise nationwide. Nearly 45% of those surveyed by the American Nurses Association said they experienced protective gear shortages as late as May 31. Almost 80% said their employers encouraged or required them to reuse disposable equipment.
Things have improved since the severe shortages in March. Major mask manufacturers increased production. Federal officials eased some rules for masks and other personal protective equipment, commonly known as PPE, allowing reuse and cleaning. But those efforts haven’t matched, much less gotten ahead of, the demand.
The USA TODAY Network analyzed dozens of government reports and interviewed more than 50 experts – including health care administrators, traders and lawmakers – about the PPE shortages, especially the disposable masks that cost a few pennies to a dollar.
The blame, experts agreed, goes beyond any single person or agency but is the culmination of decades of change in the nation’s manufacturing capabilities, a worldwide shift in how goods are delivered and the country’s long battle with medical costs. Warnings about how these factors set the stage for shortages during a worst-case scenario went unheeded, leaving the country unprepared for a pandemic.
Michael Akire, president of Premier, one of the nation’s largest hospital purchasing organizations, is optimistic the supply chain problems can be corrected.
“Nothing is insurmountable,” Alkire said. He and others recommended moving manufacturing of critical supplies out of China and closer to home, better coordinating supplies during emergencies and ramping up emergency manufacturing when needed.
Will the country be ready if a second surge of the virus hits this fall? It’s too soon to say, Alkire said. Much depends on how many hospitalizations occur and where.
Some of the PPE shortages are being addressed by U.S. manufacturers who continue to add manufacturing lines and capacity, Alkire said, but fully resolving the situation could take years.
The problems span multiple federal administrations.
Federal pandemic planners, scholars and some manufacturers warned for at least 15 years that shortages of respirator masks and other supplies, including prescription drugs, were likely during a pandemic. They warned billions of masks would be needed.
“All of us knew how desperate the need was,” said Sonja Rasmussen, a University of Florida professor who cowrote a federal study at the Centers for Disease Control and Prevention in 2017 on the lessons learned about personal protective equipment from public health responses.
Less than 10% of the masks used in the U.S. are made here. China makes almost half the world’s masks, gowns, gloves and other PPE.