“We want to protect public health and if we are sick there isn’t going to be anyone to treat these patients. America has no idea what it’s in for,” said one nurse practitioner.
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Nurses and doctors working on the front lines across the United States, preparing to treat an avalanche of patients suffering from the coronavirus epidemic, told BuzzFeed News they are facing a frightening shortage of the N95 masks that they’d normally wear to protect themselves while treating contagious patients.
With the pandemic sweeping the globe, demand has skyrocketed and global supply chain issues have resulted in plummeting availability.
The upshot, according to health care workers around the country, has been a frightening shortage, further exacerbated by hoarding - and even stealing. The lack of supplies has even forced the CDC to change its guidance for medical workers. Initially the agency advised those encountering patients suspected of having COVID-19, the disease caused by the coronavirus, to wear only N95 respirators, which filter out small particles in the air. Now the CDC says workers can wear other masks too. But some doctors and nurses worry that’s not enough protection.
In China, the epicenter of the outbreak, more than 3,300 health care workers have contracted the virus. There isn’t clear data yet on how many providers have fallen ill in the US, but the Washington Post reported this week that the federal government has received reports of at least 60 such infections.
Many doctors and nurses have complained on social media, posting pictures of themselves wearing their gear with the hashtag #GetMePPE. (PPE stands for personal protective equipment.) On Tuesday, a group of health care workers launched a Change.org petition to raise awareness of the shortage issue, garnering more than 16,000 signatures within 19 hours.
Here are stories from health care workers facing shortages of masks and other critical supplies, edited for clarity and length.
Dawn Aldinger, a nurse at Swedish Medical Center in Seattle, Washington:
“We're trying to reach out to our community, saying if you are one of the people with a box of masks next to the box of toilet paper, please consider donating it back to the hospital. We are desperate.
“[The stealing] started when the first case in the US showed up in Everett, at our sister hospital. And it was subtle at first. As this has ramped up: it's masks; we've had cases of hand sanitizer stolen; we've had gloves stolen. People are panicking and of course they are not getting correct information, so they are acting on their fears, which is understandable. But they are taking away from us, who that equipment is vital for in order for us to safely do our job and keep the community safe.
“We've had to pull all the masks off the halls of the hospital -this isn't just my hospital, it's region-wide -we’ve had people pull all the hand sanitizer and masks off the hospital floors and entryways, where usually the public has access to them, and lock them up, because we are at such a critical shortage. And the health care provider suppliers now are rationing them out and very tightly so. The N95 respirators -we're not even allowed to use for all COVID patients now. We're basically providing those only if a patient is positive and if there’s aerosol-like procedures that need to be done, like breathing treatments or CPR, things like that where we’re going to be at higher risk of contamination.”
A nurse at MultiCare Good Samaritan Hospital in Puyallup, Washington:
“Washington was the first state that had a patient test positive, and then we’ve had the most deaths because it ran rampant in a nursing home here. When that first started, our supplies started being depleted. Outside each room that has to be in isolation, we have these carts so nurses can gown up and mask up before they go into the room. Well, visitors and family members were starting to steal supplies off of them. Our first policy was, we were locking them up in a manager’s office so that way we only had access to them. Well, then they became even more depleted and so every couple days there's a new policy on what we’re supposed to do.
“Our normal protocol for anything like this, it’s called modified droplet precautions, you wear a mask and a special gown into the room and gloves. You either wear plastic glasses with the mask or a mask with a face shield. Our normal policy is to throw away the mask after every use. And now we use it for the full 12 hours, which is not sanitary.
“It’s not a question of if we're going to get COVID, it’s a question of when, because we’re just not protected with our normal standard precautions we’re supposed to take.”
An attending physician at NewYork–Presbyterian Hospital in New York City:
“Masks are in short supply. We’ve been told we don’t need to wear N95s. Instead, we’re wearing the regular procedure masks. We’re supposed to have face shields with them but honestly only one of the two residents I’m current with has this on. I had trouble finding one and spent the first 10 minutes of my shift scavenging for a mask with a face shield and found an unused one in the nursing station that I was able to get. This is the one and only I’ll likely get all shift, so I’ll be reusing it.”
A nurse practitioner in Providence County, Rhode Island:
“We’ve been very short on PPE for probably a month now. And it was put out by management that PPE was not for health care providers, it was for patients only. So we were not to wear masks. And the issue with that is patients don’t wear masks correctly. Mind you, we have surgical masks, they are not N95 respirators ... We don’t have N95s. We’ve never had them.
“At least half a dozen employees are out sick with suspected COVID-19 ... If any of us test positive, we have to quarantine the staff because we work in such a close area and I imagine our clinic would shut down for two weeks.
“Monday afternoon I had a fever. I had been treating patients all day. There’s the potential I could have exposed people. I don’t know where this goes from here.”
Paige, a nurse at two children’s hospitals near Denver:
“We don’t have enough supplies for people to change out masks as frequently as they’re supposed to. With yellow surgical masks, you’re supposed to wear them for 10 to 20 minutes or they’re not effective. Generally, we’re encouraged to wear them all day. We’re supposed to change them out if we’ve gone into a patient’s room with suspected COVID, but overall we’re supposed to wear them all day. … Having to wear it all day nonstop, it’s gross and it’s just uncomfortable.
“We‘re having to keep all our extra supplies in our manager’s office so that it doesn't get stolen by staff or patients. We’ve had patients stealing boxes of masks or the yellow isolation gowns or even the face shields we use. … We’re the people on the front lines there to take care of them and their loved ones and friends and families. If we get sick from all this, there’s nothing we can do. We have to be out of work for 14 days if we get sick. It’s so important for us to have the supplies so we can continue doing our job and making sure people are staying healthy.”
Carly Brown, a physician in Asheville, North Carolina:
“I have had two patients who called me with symptoms very suggestive of COVID-19 to the point where they have been tested. One of those patients was tested by the Health Department. And one of those patients was tested by myself in a parking spot outside of my office.
“We have a limited amount of personal protective equipment, otherwise known as PPE. And the reason why is because about two weeks ago, when it started becoming really clear to us this was going to happen, the doctors I think were saying, is when we started trying to order and at that time we already could not get much more than what we already had. In fact, there was some price gouging on Amazon. I think for the 40 N95 masks that I have, I paid like $350 for them. To make sure I could protect my team. [Normally, they cost] less than a dollar.
A nurse practitioner in Washington, DC:
“I have only a few simple face masks, lab glasses, and had to buy a disposable lab coat instead of a gown off of Amazon. I’ve been making hand sanitizer at home based on the WHO guide meant to supply remote and austere locations since we can’t get enough. I have many friends in large hospitals who have very limited PPE, friends in primary care with none, and who risk being punished for calling in sick ... We want to protect public health, and if we are sick there isn’t going to be anyone to treat these patients. America has no idea what it’s in for.”
A medic at Fort Belvoir Community Hospital in Alexandria, Virginia:
“We do not have adequate equipment for all of our staff. ... We kind of just have to make do.”
An emergency room nurse in Snohomish County, Washington:
“Since our first community case was discovered, we have had multiple changes in our PPE requirements. Initially, we were told it would be airborne precautions [such as N95 masks with eye protection]. Then it was downgraded to droplet (regular mask and eye protection). CDC recommends airborne but says in light of the shortage of PPE, droplet is ok. But they specifically say that when PPE is available to do N95. So that’s a bit unsettling to lower standards due to not having equipment. We also don’t know enough about it to truly rule out airborne precautions.
“Our hospital will not give us N95s and they are not transparent about a lot of information. We were all fitted for two different N95s at different times. I’m assuming because we ran out of the first kind... We haven’t been given anymore. We are told to keep them in paper bags with our names on them. We ran out of those too. Now we keep them in our pockets or in lab bags. We cover or line N95 with a regular mask to try and protect the N95 and so that management doesn’t see us wearing them. We’ve actually gotten told off for wearing them. Infection control reports that the N95 is good for 5 encounters or 8 hours with the same patient ... We’ve been reusing these masks for several days. Staff are starting to get sick and can’t work until their COVID test comes back.
“In the beginning, they would notify you if you were exposed. Now they don’t do that anymore. We’re all exposed to a positive patient every shift. Usually several positive patients.
“The short version is we do not feel safe and we don’t feel like management is responding to our concerns.”
An internal medicine physician in Providence, Rhode Island:
“We do still currently have [N95] masks, but even there we are trying to reuse with the same person all day long. And the reality is we’re looking at the possibility of running out of those and having to go with the less effective, the less protective masks there.
“Health care workers are already at risk, even with the best of protections. With less than the best of protections, there’s a whole lot of people who quite frankly are walking into harm's way, because that’s what we do, but doing so ill-equipped. That reality is pretty sobering at present.”