P.P.E. in a pandemic: The difference between life and death

Illustration by #SaraPaglia. Used with permission
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By Donna Gaffney

By now most people have heard the term “PPE” used in government briefs, television and cable newscasts and the ubiquitous Q & A programming on COVID-19.

It stands for Personal Protective Equipment and is worn by health care professionals caring for patients in emergency departments, ICUs and urgent care centers across the country.

P.P.E. includes: N95 masks/respirators, surgical masks, face shields, surgical booties, safety goggles, gloves, medical overalls, and gowns. This equipment fully covers the scrubs and skin of the professional—in short, the skin, mouth, nose and eyes all must be shielded from the novel coronavirus.

N95 mask.

Let’s start with the protective equipment that is most precious and in the shortest supply, the N95 mask.

The N 95 provides the greatest protection for the health care provider, it fits close to the face and filters out 95 percent of airborne particles and liquids in the air. New research shows that when an infected person exhales, coughs and sneezes, the virus is carried through droplets in the air, aerosolized, for at least six feet and hangs in the air for 30 minutes.

The N95 protects mask keeps these particles out of the health care provider’s nose and mouth. It is not to be worn by members of the public.

Surgical masks.

A surgical mask is a loose-fitting, flat mask that protects others from the secretions or particles from the health care provider, as is used in surgery or dental procedures, but it also protects the wearer from larger droplets or secretions from patients. The surgical mask is not as effective as the N95 and should only be used in cases of absolute dire necessity.

Dire necessity. Unfortunately, that’s where we are now.

Nurses and doctors working at a patient’s bedside or caring for multiple patients may change gloves, gowns and masks many times in one shift. Professionals working in the new drive-through testing centers also are required to wear protective equipment.

Masks are being used so quickly in some hospitals that they cannot keep up with patient demand and run out. As a result, they are forced to rely on less effective equipment, reuse masks or make their own masks. Researchers suggest that not only are these “battlefield” fixes unsatisfactory, they are putting the nation’s health care professionals at greater risk.

Diagnosing and treating actual or potential COVID-19 patients requires the most effective protective equipment. We must guard the legions of nurses, doctors, respiratory therapists, lab technicians and countless others from succumbing to Coronavirus. The only way we can do that is to make sure they have everything they need to do their job.

Over the past week Twitter was ablaze with hashtags pleading for protective equipment. America’s frontline healthcare workers, frustrated with the lack of equipment for their patients and risking their lives took to Twitter to tell their stories in words and images. They want help.

Last Thursday the CDC tried to relax standards of protection and advised that bandanas and scarves could be used by health care workers in place of a mask as a last resort. That response was met with horror and disbelief by many healthcare providers. In a survey by NBC, nurses and doctors reported that their hospitals are asking them to reuse their masks, replace them after using them five times, or rationing them altogether.

Los Angeles podcaster and writer Alison Flierl posted on Twitter Saturday night: “The Emergency Department Chief at Providence St. John’s in Santa Monica is in need of N95 masks and Face shields for his doctors, PAs and nurses. He is willing to drive anywhere NOW to those who are willing to donate.”

Two hours later Twitter answered with hundreds of responses offering masks.

On Monday, Gov. Phil Murphy announced that citizens who wish to donate this equipment should email here:  PPEdonations@NJSP.org

A new website, #findthemasks also was just launched to help provide PPE to health care providers immediately. They spell out exactly where to look . . .

In your basement, your emergency kit, your bug out bag, your workbench for N95 masks.” A listing of state drop-off locations and specific hospital requirements are clearly spelled out.

Another website, Project 95, was launched Sunday. It is the National COVID-19 Medical Equipment Clearinghouse. The website states it will coordinate with manufacturers globally with the capacity to produce. Within weeks, millions of units of personal protective equipment (PPE) should be available for distribution.

According to New York Gov. Andrew Cuomo, the price of N 95 masks is increasing by the minute. As different states place their orders, they outbid each other. A mask that once cost 85 cents now costs $7.

The federal government could solve this problem by ordering companies to manufacture medical supplies under the Defense Production Act that was initiated last week. Placing the orders would increase supply and prevent higher pricing, which would benefit all states. As of Sunday afternoon, orders had not been placed through the DPA. Appeal to your congressperson or senator to put pressure on the White House.

What else can we do?

Check out the websites noted above. Coordinate and donate with people in your community who are raising funds for hospitals. (More to come).  And finally, we need to do our job so they can do theirs. Don’t be a COVIDIOT. . . #STAYHOME

Donna Gaffney of Morristown is an author and psychotherapist who has worked with families, schools and communities in the aftermath of 9/11, the Pan Am 103 and Hurricane Katrina. She is the author of The Seasons of Grief, Helping Children Grow Through Loss. Gaffney is a consultant for the New York Life Foundation and works with families, schools and professionals affected by trauma, loss and violence.

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