Why are healthcare workers still short of personal protective equipment?

Written by: Akhila Thirumala

August 3, 2020

COVID-19 is not disappearing anytime soon and healthcare workers are struggling every single day to keep themselves protected while treating the infected. Especially in the United States, healthcare facilities are fighting to provide their workers with equipment. 47 states have stated that they are lacking the necessary amount of PPE to combat COVID-19. As of April 14, the Centers for Disease Control and Prevention (CDC) estimated that 9,200 medical professionals had been infected in the US and it is not known how many have died.  According to WCNC Charlotte, North Carolina was low on masks and gowns in May, getting only 99,000 of the 27 million N95 masks it had ordered. PPE shortage is a serious issue, but why is it happening?

 

The problem with FEMA

As most people already know, The Federal Emergency Management Agency has been inefficient with delivering PPE to healthcare facilities. Some of the problems include slow delivery time, shortage of supplies, and bad organization. With the second wave of COVID-19 rising rapidly, the demand for PPE has only increased. According to an internal report from FEMA, “the demand for gowns outpaces current U.S. manufacturing capabilities.” As more and more cases arise, healthcare facilities are being populated at a quicker rate and without FEMA delivering on time with enough equipment, healthcare workers are increasing their chances of being infected. Along with the outpacing problem, FEMA’s deliveries are not effective either. FEMA is leading a program to increase supplies to nursing homes that was announced in April by President Donald Trump, but nursing homes say they are receiving items such as gowns that have no holes for hands and paper-thin surgical masks, CNN reported

“Too often, the only signs of FEMA’s much-hyped promise of PPE shipments—an allotment of gowns, gloves, masks and goggles based on staffing size of the provider—are scattershot delivery with varying amounts of rag-tag supplies…as FEMA’s own deadline for shipment approaches, many nursing homes still don’t know if and when they’re going to receive anything,” said Katie Smith Sloan, president and CEO of LeadingAge, an association of nonprofit providers of aging services, in a statement. 

An example of exactly how deadly a shortage of PPE can be is seen through the nursing home community. Nearly 26,000 nursing home residents have died from coronavirus, according to a recently released report. One quarter of nursing homes had at least one case, and one in five had at least one death, according to the Centers for Medicare and Medicaid Services. Not only is FEMA delivering less PPE than needed, the PPE they deliver is low-quality and practically unusable. Front-line workers are essential during this time and according to The Washington Post, nearly two-thirds of all healthcare workers are still reporting a PPE shortage and “roughly 8 in 10 [workers] reported wearing one mask for an entire shift, and more than 7 in 10 had to wear the same mask more than once.” Considering that The US Food and Drug Administration recommends that N95 respirators and disposable masks aren’t shared or reused, the 7 out of 10 essential workers are putting themselves at a large risk. Healthcare workers are constantly complaining both in private and public about the moral conflict of risking themselves with the ineffective supplies to save others. According to NBC news, “Right now, nurses don’t feel like heroes. We feel expendable.” The combination of increasing cases due to shortage of PPE in the general public, because of FEMA, and the shortage of PPE for front-line workers, also because of FEMA, many workers have decided to put their lives first. They feel that because FEMA cannot provide them with the equipment needed yet they are still forced to work with the infected, their lives are not valued. FEMA is indirectly hurting the chances for patients to recover by driving healthcare workers to quit out of fear for their lives. These are just a couple examples of how FEMA is ineffective during this pandemic and why it is up to us individuals to our community. 

The Federal Government’s actions

Although FEMA is handling the pandemic poorly, the federal government is taking both positive and negative actions. With COVID-19 came many extra problems other than the obvious sickness: economy, education, employment, and more. On May 15th, The Centers for Disease Control and Prevention issued reopening guidelines for businesses and workplaces, including bars and restaurants. Although this helps keep the economy running and lowers the risk of small businesses from suffering, cases will only spike without government interference. That same day the U.S. House passed a $3 trillion coronavirus relief package which the U.S. Senate passed as the Health and Economic Recovery Omnibus Emergency Solutions (HEROES) Act. In summary this plan, according to a NPR report, includes another round of direct cash payments to Americans, extends unemployment benefits to the end of January, and adds hazard pay for front-line workers. It also expands virus-testing efforts, contact tracing and treatment. It directs nearly $1 trillion to state, local and tribal governments, including $500 billion in direct, flexible aid for state governments and an additional $357 billion for local governments and counties. And it adds $200 billion in pandemic hazard pay for essential workers and $75 billion for coronavirus testing, contact tracing and treatment efforts. In addition, the plan sets aside $3.6 billion to protect federal elections, $25 billion to support the U.S. Postal Service, $100 billion for low-income rent support, $75 billion for a homeowner assistance fund and $100 million for the Violence Against Women Prevention and Prosecution Programs. It also expands funding for small-business loans, enhances an employee-retention tax credit program and boosts worker protections. Although the HEROES plan is working to help the American public, many are still struggling. As of right now, around 37 million Americans have been laid off due to the effects of COVID-19. The HEROES plan’s overarching objective to address this issue is to keep people on payrolls and provide financial relief to those who have become unemployed. Before the HEROES act, the Coronavirus Aid, Relief, and Economic Security (CARES) act of 2.2 trillion was implemented. In general the CARES act provides fast and direct economic assistance for American workers, families, and small businesses, and preserves jobs for our American industries. It is predicted that “the CARES Act will produce around 1.5 million additional jobs by 2020 Q3.” There are six acts: (1) keeping american workers paid and employed act, (2) assistance for american workers, families, and businesses, (3) supporting america’s health care system in the fight against coronavirus, (4) economic stabilization and relief to severely distressed sectors, (5) coronavirus relief funds, and (6) miscellaneous provisions. With the combination of these two acts passed by the federal government, the American public has been greatly impacted. CARES and HEROES has done more than FEMA for the pandemic situation, but still has a long way to go. The state of the American public is not great, and could use a lot more help. 

Healthcare Professionals facing a huge problem 

As discussed before, front-line workers face problems like low-quality and shortages of PPE all the time during this pandemic. It has become their number one issue and local grassroot organizations are trying to fill the holes FEMA leaves. Unfortunately, lack of PPE creates other problems as well. An example of this was discussed briefly previously. Many healthcare professionals have decided that without proper personalized protective equipment to keep themselves safe, their lives are at stake and being disregarded by the government. FEMA is not providing what is necessary to save lives, which is a low bar. Healthcare workers feel like they are being taken advantage of and are being overlooked. Because of these reasons, many have quit their jobs in fear for their life. With the number of professionals fighting the pandemic decreasing and the number of cases only increasing, the pandemic is not leaving anytime soon. Along with the moral conflict of saving lives by risking their own, healthcare workers’ mental health is also being negatively impacted. In a recent study it was discovered that “Frontline medical staff surveyed…were found to have considerable rates of depression (50.4%), anxiety (44.6%) and insomnia (34.0%); 71.5% of participants reported non-specific symptoms of psychological distress.” More specifically, healthcare workers are suffering from PTSD and heavy burnout during the pandemic. An anonymous report from New York Times details the event of a traumatic experience for a young nurse. The coronavirus patient, a 75-year-old man, was dying. No family member was allowed in the room with him, only a young nurse. In full protective gear, she dimmed the lights and put on quiet music. She freshened his pillows, dabbed his lips with moistened swabs, held his hand, and spoke softly to him. He wasn’t even her patient, but everyone else was slammed. Finally, she held an iPad close to him, so he could see the face and hear the voice of a grief-stricken relative Skyping from the hospital corridor. After the man died, the nurse found a secluded hallway, and wept. A few days later, she shared her anguish in a private Facebook message to Dr. Heather Farley, who directs a comprehensive staff-support program at Christiana Hospital in Newark, Del. “I’m not the kind of nurse that can act like I’m fine and that something sad didn’t just happen,” she wrote. Medical workers like the young nurse have been celebrated as heroes for their commitment to treating desperately ill coronavirus patients. But the heroes are hurting, badly. Every day they become more susceptible to post-traumatic stress, mental health experts say. And their psychological struggles could impede their ability to keep working with the intensity and focus their jobs require. 

“As the pandemic intensity seems to fade, so does the adrenaline. What’s left are the emotions of dealing with the trauma and stress of the many patients we cared for,” said Dr. Mark Rosenberg, the chairman of the emergency department at St. Joseph’s Health in Paterson, N.J. 

Mental health wellbeing is crucial for healthcare workers to perform at their best for hours on end to help save lives, and this pandemic combined with the lack of PPE, increasing cases, and deaths makes it very difficult.

Local efforts in Georgia

Three nonprofits stand out amongst the rest during this pandemic. Atlanta Beats Covid, GetUsPPE, and Paralink. Atlanta Beats Covid is built around the shared interest in helping Atlanta citizens through volunteer projects. The community ABC has fostered a way for innovative individuals who love to create, invent, and collaborate to showcase their skills by putting it to a positive use. The community is split into groups including healthcare workers, engineers, seamsters/seamstresses, makers/artisans, managers, and teachable “minions.” ABC’s goal is to keep Atlanta healthcare workers and other vital and vulnerable community members safe. Some of the products ABC offers includes everything from face shields to reusable respirators. ABC has delivered around twenty-two thousand personalized protective equipment (PPE). Although GetUsPPE is a national organization, many of their efforts are directly beneficial to Atlanta. Their current focus is to prepare America for the inevitable second wave of COVID-19. Their program is getting volunteers to call into healthcare facilities to find out their current PPE needs. By collecting this data, the organization can easily identify which facility needs immediate attention. GetUsPPE has delivered over one million PPE to healthcare facilities nationwide. Atlanta Beats Covid and GetUsPPE are regional affiliates. Together, they have been producing and delivering various PPE all over the Atlanta community. GetUsPPE has delivered over one million PPE to healthcare facilities nationwide. Paralink, a grassroots organization created by a group of Georgia teens, is a network of manufactures, delivery personnel, and donors fixated on one mission: to replace FEMA and be the first line of defense against domestic threats and disasters. To do this, Paralink is building the world’s fastest and most comprehensive decentralized assembly line, also known as “The Hive”. It allows us to rapidly produce millions of life-saving relief supplies in a fraction of time it used to take. Paralink keeps these supplies stored within “ParaPods”, or a vault of relief items which can be drawn upon by local governments in times of disaster. So far, Paralink has over two-hundred thousand deliveries all over the Atlanta area and South Georgia consisting of face shields, face masks, gloves, and intubation chambers. They have successfully outpaced FEMA locally and are providing healthcare facilities in the area with large amounts of high quality PPE. All three nonprofit organizations are linked as partners and are working vigorously to fill the holes FEMA has created. 

How to help

There are many different methods of donation to help locally. Paralink and Atlanta Beats Covid are two very local organizations that need volunteers and donations. Atlanta Beats Covid has three options: volunteer, donate, and become a sponsor. Volunteering has three different spheres: manufacturing, delivery, and assembly. Manufacturing would include 3D printing, casts/molds, sewing mask/gowns, and running a personal CNC machine. Delivery volunteers would help pick up completed products and deliver them to hospitals and health care workers as well as assist in moving materials/pieces between locations. Assembly volunteers help assemble and sanitize face shields for delivery in locations across the metro Atlanta area. The second option is donations, which includes financial and material donations. The third and final option for ABC is to become a sponsor. One of ABC’s sponsors is Paralink, which is a great organization to go to when wanting to help locally. There are five different ways you can help your community through Paralink. Listed below are details about each, ordered from smallest to largest support methods. (1) Become a volunteer driver: by offering your services to deliver personalized protective equipment, you are the bridge between the healthcare workers in need of PPE and Paralink’s efforts. Drivers are in high demand currently and are very important to the cause. You will deliver PPE all over Georgia, and more specifically the Atlanta area. This is the most direct way you can help your community. (2) Help assemble PPE: putting the PPE together is a key step in getting the deliveries out in the community and the more man power, the better. For example, Atlanta Ballet has a volunteer system in which performers and others assemble PPE after their business hours, from parts that Paralink has sent to them. Once they have successfully assembled the PPE, Paralink picks it up and volunteer drivers deliver them to healthcare faculties. (3) Donate PPE materials/supplies: for those fortunate enough to have access to extra PPE or materials that could be used to make PPE, donating to Paralink is the best way to ensure that those supplies directly help the Atlanta community. Paralink will take the materials or supplies and either make PPE or deliver the PPE to healthcare faculties. Any material is helpful material! (4) Donate money: Paralink’s projects require funding and money to function and continue to serve the community. One of the best ways to help your society is to help keep Paralink afloat. Contributions and donations are greatly appreciated and go directly to helping your community. Your money will not go wasted. (5) Retool manufacturing to make PPE: the most impactful ways to directly help is changing course. Many manufacturing companies and factories have the potential to produce thousands of PPE and help their community. By retooling their manufacturing line, more PPE is produced and more healthcare workers are protected every single day. Along with ABC and Paralink, there are many more ways to help with the pandemic.