In this photo taken Saturday, June 27, 2020, medical personnel prepare to test hundreds of people lined up in vehicles in Phoenix's western neighborhood of Maryvale in Phoenix for free COVID-19 tests organized by Equality Health Foundation, which focuses on care in underserved communities. (AP Photo/Matt York) Healthcare workers report PPE shortages continue
In this photo taken Saturday, June 27, 2020, medical personnel prepare to test hundreds of people lined up in vehicles in Phoenix's western neighborhood of Maryvale in Phoenix for free COVID-19 tests organized by Equality Health Foundation, which focuses on care in underserved communities. (AP Photo/Matt York)

Frontline health workers have long warned that reusing such equipment leaves them at higher risk of becoming infected.

Nearly four months after the shortage of personal protective equipment (PPE) became a national crisis, the U.S. still has not resolved the issue, which is once again reaching a tipping point as the country sets new daily records for coronavirus cases.

Despite months of promises that the PPE shortage would be resolved and supply chains strengthened, hospital workers are still forced to reuse masks and gowns amid growing demand

#GetUsPPE, a national volunteer-run organization focused on donating PPE, said they have received a huge surge in requests from new COVID-19 hotspots, especially in Texas, which has paused its reopening plan after seeing record increases in cases and hospitalizations over the past week. Texas’ seven-day average of new cases increased by more than 52% compared to a week ago, according to data from the Johns Hopkins Coronavirus Resource Center.

Dr. Megan Ranney, an ER doctor and researcher at Brown University in Rhode Island who co-founded #GetUsPPE, said that as cases in Texas surged, requests for PPE from health facilities in the state increased last week from less than 2,000 pieces of equipment requested to more than 220,000. “Overall the need for N95 masks, and to a lesser degree surgical masks, are still the top requests and they consistently have been,” Ranney told The Guardian.

The continued demand and lack of stable supply chains has forced some workers to reuse N95 respirators and gowns for days, even though they’re supposed to be changed in between patients. A recent Society for Healthcare Epidemiology of America (SHEA) survey of its network hospitals found that 52% of respondents said they had to ask healthcare workers in certain hospital units to use the same disposable N95 respirator for an entire day. 

Frontline health workers have long warned that reusing such equipment leaves them at higher risk of becoming infected. In recent weeks, they have once again begun to sound the alarm over a PPE shortage. Nurses at Riverside Community Hospital in Riverside, California, are currently engaged in a 10-day strike to raise concerns over a PPE shortage they say leaves themselves and their patients at risk. 

Healthcare workers in Corpus Christi, Texas, have also protested, demanding their hospital’s parent company provide more PPE. “We need to be aware that this virus is all around us,” Ian Northrup, a Corpus Christi Medical Center ER Tech, told KRIS 6 NEWS. “It’s dangerous to work in a hospital on a good day, let alone when there’s a global pandemic going on.”

The shortage has had particularly catastrophic consequences for nursing homes, as facility residents and staff currently account for more than 54,000 (43%) of the nation’s COVID-19 deaths. Nursing home operators have reported receiving plastic gowns fashioned like trash bags, paper-thin bags, and gloves too small for most adult hands. 

Some victims’ families believe the PPE shortage is part of the reason why nursing home outbreaks have been so horrific. Appearing before a special House subcommittee hearing on nursing homes, Delia Satterwhite said she believes the lack of PPE at her brother’s Austin-area nursing home is why he died from COVID-19.

“I don’t blame the workers. They were doing their job. They should have been given the PPE to keep them and their patients safe,” she said. “My brother should still be alive. I will continue to share his story so other families don’t have to go through this.”

According to experts, the shortages are being driven in part by a supply chain “mismatch,” in which small hospitals and healthcare providers struggle to obtain PPE because suppliers require minimum orders for tens of millions of masks, and normal distributors have no supply.

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The Federal Emergency Management Agency (FEMA), which is in charge of distributing medical supplies such as masks to the states, said this month it distributed millions of pieces of PPE. Some nursing homes that received the products, however, said they were defective and unusable. The shortages remain dire in many states, such as Florida, where one in five nursing homes still do not have a one-week supply of masks or gowns, according to the Centers for Medicare and Medicaid Services.

“It’s completely unacceptable that nearly four months into this pandemic, healthcare workers in hospitals, nursing homes and in the home care profession are still being put at risk due to a lack of personal protective equipment,” SEIU International President Mary Kay Henry told The Guardian.

State officials across the country have pleaded with the federal government to help provide PPE, but the Trump administration has largely left that responsibility up to the states, setting off a chaotic battle royale where states are forced to compete with each other to purchase PPE from domestic and foreign suppliers. 

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Washington Gov. Jay Inslee highlighted the issues with the current approach earlier this month in a letter urging the Trump administration to lead a national mobilization effort.

“We remain participants in an unnecessary, chaotic, 50-state scramble to secure badly needed PPE,” Inslee wrote to Vice President Mike Pence. “It is akin to fighting a war in which each state is responsible for procuring its own weapons and body armor. Our current situation will only become more dire as more businesses reopen and more Americans head back to work — putting additional strain on a system that is already unable to meet demand.”

Inslee’s warning, issued on June 10, has proven prescient, as demand has indeed increased as states began to reopen and eased stay-at-home orders. Val Griffeth, an emergency and critical care physician in Oregon and another co-founder of #GetUsPPE, expressed her concern about the supply chain in a recent interview with Vox.

“I worry there hasn’t been a true fix to the supply-chain issues,” Griffeth said. “Our government has basically said that we’re going to allow the free economy to fix the issues. Unfortunately, it takes time and capital to ramp up production, and because the government has not devoted capital to helping solve the situation, we’re seeing a delay in its resolution.”

Both Inslee and Griffeth called for Trump to invoke the Defense Production Act (DPA) widely in order to compel private companies to increase production of PPE. 

Griffeth has first-hand experience with the shortages. She currently has to get through each day with only one N95 mask and one face shield. “Both masks and respirators continue to be an issue,” she told Vox, “despite falling out of the nightly news cycle.”

Even as the Trump administration has largely pushed responsibility onto states, it appears to be cognizant of the issue. An internal FEMA report released earlier this month suggests “[t]he demand for gowns outpaces current U.S. manufacturing capabilities” and that the government’s plan to increase supply in June and July relies on medical staff to continue reusing N95 masks and surgical gowns, increasing their risk of contracting COVID-19.

Nearly 127,000 Americans have died of COVID-19. Included in that count is nearly 700 healthcare workers—a number that is likely to rise as the PPE shortage persists and America’s outbreak gets worse.