As a third surge of the coronavirus pandemic threatens Midwestern states that were spared in the spring, healthcare providers are scrambling to build stores of personal protective equipment from scratch. “When we look at all of our data, what’s really unfortunate is that 80% of the facilities that have asked for supplies have no supply left of at least one of those types of PPE,” Dr. Ali Raja, co-founder of the organization Get Us PPE, which procures protective equipment for healthcare providers, said.
Small hospitals and long-term care facilities across the Midwest, especially those in rural states, have not experienced an outbreak such as New York and New Jersey saw in the spring. Large hospital systems in New York City saw an acute scarcity of personal protective equipment, forcing doctors and nurses to improvise. They wore trash bags to replace gowns and disinfected and reused single-use masks several times each week.
Now, as infection rates in Midwestern states rise into double digits and hospitalization admissions tick up, small hospital systems that were spared from such a surge seen in large cities earlier this year now find themselves in the same predicament. “They’re completely 100% out of masks or gloves or wipes or gowns or something, so the need is definitely dire,” Raja, who is also the executive vice chairman of the department of emergency medicine at Massachusetts General Hospital, said. Raja told the Washington Examiner that the most requested PPE from hospital systems are disinfecting wipes, N95 respirator masks, and disposable gloves. Other items on the list include surgical masks, gowns, face shields, disposable booties, coveralls, and body bags.
The number of people with COVID-19 being admitted to hospitals has been rising since the last week of September, COVID Tracking Project data show. On Oct. 21, the number of people admitted to the hospital that day reached 40,271, the highest daily rate since Aug. 21 when 40,951 new coronavirus patients were admitted to hospitals.
States recording the highest test-positive rates in the past month are now reporting record hospitalizations, suggesting the cases reported in these states are severe enough to warrant constant care. States that recorded the highest number of COVID-19 hospitalizations this month, including South Dakota, Iowa, Nebraska, and Wisconsin, have simultaneously reported exceptionally high infection rates. South Dakota’s average test-positive rate is nearly 35%, Iowa’s is 21.4%, Nebraska’s is 19.2%, and Wisconsin’s is 14.3%.
When COVID-19 infection rates in New York and New Jersey hovered at about 40% in the spring, the federal government struck deals with private companies to manufacture masks and respirators for healthcare workers. “Larger hospitals with established supply chains definitely got hit early in the pandemic but have since had time to recover and actually stock up on PPE,” Raja said. “Larger hospitals are, in general, doing well.”
New hot spots in the Midwest, meanwhile, have close to nothing. “In the month of October … 94% of our requests came from everybody from nursing homes to rural hospitals and clinics,” Raja added. “We’ve really seen that those large hospitals and health systems have been able to get their PPE back, but now, we need it for everybody else.”
As the cold sets in, people spend more time indoors in close proximity to other people, which healthcare experts say will increase community spread. “When spread in the community is high, this puts additional pressure on our ability to acquire much-needed resources,” the American Health Care Association/National Center for Assisted Living said. “More providers and businesses require PPE, nursing homes must test more frequently, and our staff are at greater risk of catching the virus.”
Nursing homes and other long-term care facilities are at exceptionally high risk of a devastating outbreak. According to the AHCA/NCAL, many nursing homes have less than a one-week supply of N95 masks, gowns, and surgical masks.
“They don’t have enough PPE for even a relatively full hospital,” Raja said about small, rural hospitals. “They’re going to run the risk of potentially having to reuse PPE or just not using PPE at all.”
“We’re definitely getting ready for [a surge],” Raja added. “We have contingency plans for our contingency plans.”
