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As of 6:00 pm EST on March 23, 2020, over 40,000 people in the US have tested positive for COVID-19. [Editor’s note: As of April 3, 2020, over 250,000 people in the US have tested positive for COVID-19.] The number of cases and deaths will surely increase.
By now social distancing is, thankfully, becoming a norm to slow COVID-19 transmission and help “flatten the curve.” But an equally important task remains: ensuring the safety of those caring for the sick. Many health care settings lack sufficient personal protective equipment (PPEs) for their health care workers, such as face masks, gowns, and gloves. Without PPEs, those who have committed to caring for the health and safety of us all are seriously put in harm’s way.
On March 18th, President Trump issued an Executive Order to start invoking the Defense Production Act, which could direct manufacturers to produce these desperately needed supplies. However, as of this publication, the President has not yet fully acted upon the Executive Order, which leaves it to hospitals and states to negotiate and purchase these supplies, often having to compete with the Federal government in the process.
Meanwhile, with increasing evidence of community spread and rapidly diminishing stocks, health care organizations are having to make difficult and sometimes untested choices to conserve existing supplies. Fortunately, each of us can help.
Everyone can continue practicing social distancing to help “flatten the curve.” Everyone can also call their Members of Congress to urge the President to immediately act upon the Defense Production Act to the fullest extent necessary to ensure adequate supplies of PPEs for all health care settings. For those that have supplies, please donate them and offer to pick up supplies from others as well (while maintaining a safe distance). If you have the skills and proper material (and are asymptomatic yourself), consider making face masks if your local hospitals have requested them. Some hospitals may even have kits available with medical grade material.
Businesses and manufacturers with current supplies of PPEs should donate them. Check out GetUsPPE.org or Project N95 to donate. For companies that hold intellectual property (IP) for certain PPEs, they can release the IP via a limited license and other businesses can be repurposed to produce them. Businesses are also a rich source of innovation and can support growing efforts to open source the design and production of PPEs through various modalities like 3D printing.
Health care organizations may benefit from employing a Restrict, Reduce, Re-Use approach to conserve existing supplies of PPEs. Health care organizations can also encourage the membership and professional societies to which they belong to exercise their considerable political leverage to ensure that health care workers have sufficient supplies of PPEs.
When faced with critical shortages, health care providers are being asked to reuse their masks. The scientific community can help by generating evidence about the efficacy of sterilization and cleansing techniques for re-use, extended use, and other methods of PPE conservation. They can also provide clear recommendations on the best PPE materials, equipment, and recommended uses based on current world experience.
Finally, the White House can immediately act upon the Executive Order invoking the Defense Production Act to the fullest extent necessary to ensure all health care settings have the PPEs they need. The government should also temporarily waive rules that may slow the production of PPEs. And they can act immediately to establish a reliable system for the coordinated and equitable distribution of PPEs based on need.
We know these proposed set of actions are by no means exhaustive, and undoubtedly that the needs will evolve over time. But we need everyone to act, and to do so now. A safe and healthy health care workforce is one of the most powerful and vital tools we have in the face of a global pandemic. Please do what you can so that our health care workforce has the personal protective equipment they need to be healthy and safe while caring for us all.
Saranya Loehrer, MD, MPH, is Head of Innovation and Learning, Institute for Healthcare Improvement. Evan M. Benjamin, MD, MS, is Chief Medical Officer, Ariadne Labs. Donald M. Berwick, MD, MPP, FRCP, is President Emeritus and Senior Fellow, Institute for Healthcare Improvement.
Editor’s note: This piece was originally published by Medium on March 23, 2020. It has been reposted here with permission from the authors.
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