MetroHealth nurse Nancy Malinak, left, places a 3M Health Care Particulate Respirator and Surgical Mask 1870 on her face to make sure it fits properly during a mandatory Fit Test for the mask inside the MetroHealth Employee Clinic.
It has gotten so bad that hospital workers are now making their own masks.
On Tuesday, workers from Providence St. Joseph Health gathered on a makeshift assembly line at the hospital system's Renton headquarters and used materials from Home Depot and craft stores to assemble 500 face shields to be sent out for use that night. Later in the week, administrators demonstrated how to make face masks at home with a sewing machine and asked the public to help sew 100 million masks for front-line health care workers trying to do their jobs during the coronavirus pandemic.
Becca Bartles, executive director of infection prevention at Providence, said this week their hospital system was days away from running out of face masks and close to running out of face shields, the clear plastic visors that cover the face.
Personal protective equipment, or PPE, is on everyone's mind right now. But for health care workers, the masks, gloves and gowns they need to stay safe on the job are an urgent necessity. PPE shortages create risks not just for workers themselves, but for their families, patients and the already overburdened health care system.
Dawn Aldinger, a longtime registered nurse in the hematology oncology department at Swedish First Hill in Seattle, has been pleading with anyone who will listen to pay attention to the PPE crisis.
An Army veteran, Aldinger compared the needs of health care workers during this pandemic to being a soldier. In basic training, Aldinger said, you are given Kevlar body armor, a helmet and a rifle. For health care workers, the rifle is the equipment needed to care for patients; the body armor is the PPE workers need to protect themselves and keep themselves safe so they can continue to fight and care for their patients.
"As far as I'm concerned," Aldinger said, "[the Trump] administration has done the equivalent of sending a soldier into battle without their Kevlar helmet and body armor. They are expecting us to go in just with the rifle."
We knew this "tsunami" of need was coming since the virus took hold in China months ago, Aldinger said, but the U.S. was slow to acknowledge the severity of the coming crisis and failed to act to secure the necessary equipment. On Thursday, when discussing why the federal government had not done more, President Trump said it was up to governors to get the supplies they needed because, "you know, we're not a shipping clerk."
It's not just the shortage of PPE that workers like Aldinger are worried about, it's the shifting guidance on what kind of PPE to wear and for how long.
Aldinger and several other health care workers I spoke to, most of whom did not want to use their names for fear of reprisals from their employers, reported similar experiences in their Seattle-area hospitals.
First they were told, "Wear N95 masks. Don't reuse them." Then, "No, go ahead and use less protective surgical masks. And if you have an N95, store them in plastic bags for reuse." Finally: "Oh, what the heck: Use bandannas!"
In other words, CDC guidelines were being changed based on PPE availability, not safety. A Change.org petition signed by 750,000 people on Friday asked the federal government to do whatever it could to get PPE for workers and to not change CDC guidelines based on the supply chain.
The fears of health care workers are not hypothetical. In Italy this week, Doctors Without Borders reported 1,700 health care workers (or 8% of the total) were infected by COVID-19. An Italian doctor who complained of having to work without gloves, died on Wednesday. One emergency room doctor in Kirkland was infected and in critical condition with the disease.
With no PPE cavalry in sight, workers are reaching out directly to the public for help. With campaigns like #GetMePPE and #PPEIsNotOptional, workers are begging the public who might have masks and other PPE in their homes to donate it to hospitals.
While these efforts help, they are a drop in a huge bucket. A U.S. Health and Human Services official said earlier this month that the U.S. has only 1% of the masks needed in a full-blown pandemic.
Aldinger said workers have no illusions about what they are up against. "Every single health care worker working in a hospital right now is terrified of getting in the car and driving to work," she said. Yet, despite the dangers, health care workers will continue to show up and help patients, she said, because it's who they are.
"There are just people in this world that when there's a fire they will run toward it."
That's a noble virtue. But health care workers should not have to risk their lives to provide care. We must do all we can to ensure they have the armor they need to fight this battle, today and beyond.
