American health care workers still face dangerous shortages of personal protective equipment as the uncontrolled spread of COVID-19 fills hospitals across the nation and threatens patients and workers in long-term care facilities.
Dayna James, an emergency department nurse in Miami, said some days she's had to clean patient rooms with hand sanitizer because no disinfectant wipes were available. Other days she was rationed to three Clorox wipes per room. Like many colleagues around the U.S., she gets a single N95 mask per shift, which means she may bring a potentially contaminated mask into a new patient's room, ignoring longtime standard practice.
"Even that, we're grateful to have one," James said.
With the virus now surging in many large states, led by Florida and Texas, the nationwide pace of demand for the N95 respirator masks that give health care workers the best protection is 300 million a year, up from 25 million prior to the pandemic, according to Premier Inc., which helps hospitals and other health care providers buy supplies. And it's not just hospitals affected.
Almost one-fifth of nursing homes have less than a week's worth of PPE, and the N95 masks designed to be used in health care settings are scarce, according to a letter the industry groups for nursing homes and assisted living facilities sent to governors Tuesday. That shortages persist months into the pandemic response "is very concerning," the groups wrote. Meanwhile, physicians trying to re-open medical offices have similar concerns.
PPE and disinfectants "simply are not readily available from the usual sources our physicians use," the American Medical Association wrote in a recent letter to the Federal Emergency Management Agency.
It's a challenge compounded by competing demands: While facilities in some states including Florida and Texas are burning through their supplies quickly as their hospitalization rates surge, other states such as New York and New Jersey have seen a dramatic pullback in their immediate needs. Medical providers and government authorities fearful of a new wave of infections are now trying to build up stockpiles.
The situation makes it hard to gauge the true rate at which the country is using up scarce N95 masks. "What we don't know is how many of those are going into these efforts to create stockpiles," said Chaun Powell, group vice president of strategic supplier engagement at Premier.
New Jersey offers a case in point. Governor Phil Murphy said on Monday that his state aimed to build a stockpile that would last 30 or 90 days. "But we're not there yet," he said. "We still don't have the PPE we need as a state or as a country. And that's just a fact."
Domestic output of N95 masks has increased, with new projections of 110 million N95s manufactured this year compared with 30 million before the pandemic, according to Premier. Still, Powell said his company is calling for better coordination of national and local stockpiles to head off future shortages.