Lack of protective gear endangers health workers

America is failing its health care workers. Only two months since the first reported case of COVID-19 in the United States, doctors and nurses are encountering widespread shortages of their only defense against the virus: personal protective equipment, or PPE.

PPE — including masks, gloves, and gowns — protects wearers from being exposed to or transmitting infectious diseases such as COVID-19. As a medical professional, I have relied on PPE countless times to protect myself and my patients.

Last week, the Center for Disease Control and Prevention reversed its longstanding guidelines on the use of PPE, advising health care workers to reuse masks in the face of rapidly diminishing supplies, or use homemade masks (like bandannas or scarves) as a last resort.

This is an unprecedented move by the CDC and represents a turning point in the U.S.’s response to this pandemic. These new guidelines reflect practical necessities but also put health care workers in a precarious and dangerous situation on the front lines of care.

A few months ago, one doctor or nurse may have used more than a dozen masks in one day. Now, health care workers are being asked to reuse one mask for a full day or longer.

No scientific studies have examined the effects of reusing PPE like masks, which are designed to be discarded after a single patient encounter to prevent the spread of disease. However, a report from the National Academies of Sciences’ Institute of Medicine outlined potential issues: “(T)here is currently no simple, reliable way to decontaminate these devices that would enable people to safely use them more than once.”

Studies have also shown that using substitutes for medical PPE like cloth masks puts health care providers at risk. A paper published in The Boston Medical Journal found that health care workers wearing cloth masks had significantly higher rates of infection than those wearing PPE. Cloth masks also allowed higher penetration by particles such as those that carry COVID-19; cloth masks allowed 97 percent penetration, medical masks allowed 44 percent and N95 respirators allowed less than 0.01 percent.

To understand the potential impacts on health care workers, we need look no further than Italy, where health care workers make up almost 10 percent of the nation’s COVID-19 cases. At least 40 doctors in Italy have died since March 11, including 57-year-old Dr. Marcello Natali, who died from COVID-19 after working for days without protective gloves because his hospital ran out.

In the United States today, health care workers are increasingly concerned about what the PPE shortage may mean for themselves and their families. Using the hashtag #GetMePPE, health care workers have taken to Twitter to share their stories. Dr. Cornelia Griggs, a New York City surgeon, tweeted: “Mother of two, double frontline MD couple. Don’t make us orphan our two toddlers. Running out of masks, eye protection and gloves at work.”

The PPE shortage has effects on patients, too. Poorly protected doctors and nurses are more likely to spread infections like COVID-19 to patients as unwitting carriers. Rationing of PPE has also meant patients are seen by fewer medical professionals. Dr. Fredrick Altice, an infectious disease physician in New Haven, described these challenges in a Facebook post: “To reduce the unnecessary use of PPE we have limited the numbers of people who enter rooms. Instead, we interview patients using new video equipment and rely on a limited few to do physical exams.”

There are no simple solutions when it comes to addressing the PPE shortage. However, the evidence is clear that current strategies — reusing masks or resorting to homemade options — are far from ideal and endanger our country’s health care workers.

We have made strides as a community to address this PPE shortage through local donation drives, deployment of PPE from the Strategic National Stockpile and by increasing domestic production, but there is still work to be done.

To face this pandemic, the U.S. must tap every available opportunity to provide essential PPE to medical personnel. We must incentivize industries that use PPE — like construction, manufacturing, veterinary, dentistry and research — to donate supplies to hospitals. We must generously deploy the Strategic National Stockpile to medical centers across the country. We must fully utilize the Defense Production Act to sequester additional manufacturing power for PPE. And we must establish international collaborations, especially with countries that have contained their own domestic epidemics, to secure donations of leftover PPE and support PPE manufacturing abroad.

Now is not the time for partisanship, for ego or for separatism.

We are facing a crisis, and the safety of American health care workers is on the line.

Getty Images People make face shields at the Brooklyn Navy Yard in New York City.