From the Frontlines: The Importance of PPE
A shortage of personal protective equipment (PPE), including masks, eye protection, N-95 respirators, and gowns, is hurting medical professionals’ ability to respond to the COVID-19 pandemic. Doctors, nurses and other staff find themselves having to resort to potentially dangerous measures, such as reusing equipment, that could put themselves and patients at risk of infection. We were able to check-in with Dr. MeiLan Han, a pulmonologist at the University of Michigan Health System and national volunteer medical spokesperson for the American Lung Association. She shared that while doctors themselves are mentally prepared, many hospitals are not ready to handle the outbreak because of the shortage of personal protective equipment.
“From the time a medical student steps into the hospital as a trainee, the concept of infection control is emphasized in every aspect of training and practice,” said Dr. Han. “We now are facing a crisis with a highly contagious virus and an inadequate supply of PPE for our healthcare providers, including doctors, nurses, medical technicians and respiratory therapists.”
There are a growing number of cases of healthcare workers in the U.S. who have been infected with COVID-19, including some who are in critical condition. The concern is not only patients who are known to have the virus but the many patients walking into clinics and emergency rooms where their status is unknown.
“In an ideal situation, we’d have PPE for all of these frontline healthcare workers. But we simply do not. The issue is that we’ve got doctors working on COVID-19 cases and they’re having to reuse equipment, which we would never usually do,” said Dr. Han.
The risks to our heroes in healthcare
Nearly 1 in 10 of Italy's infected are healthcare workers, according to recent information from Italy’s National Health Institute. “In the U.S., we’re on track to mirror this trend if we don’t enact something to protect our healthcare workers,” said Dr. Han. “In some hospitals, healthcare workers are being asked to continue working despite exposures. We’re essentially asking our healthcare workers to go into battle without any armor.”
Community spread of the disease is high, so workers take a risk every time they go into a patient’s room. “Sometimes, when you’re doing intubations (a necessary procedure when readying a patient for a ventilator), your face is three inches from a patient’s face,” said Dr. Han. “Doing this knowing their COVID-19 status is like playing Russian roulette every time you do a medical procedure.”
The American Lung Association’s Response
On Friday, April 3 the American Lung Association led a letter – which more than 200 other public health, patient advocacy and medical organizations signed onto – to ask the Trump Administration to take immediate, additional action to alleviate the critical shortage across the nation of ventilators and PPE. In the letter, our organization urges the federal government to do significantly more to facilitate the timely manufacturing and distribution of this necessary equipment. We will continue to advocate for our healthcare providers so that they can carry our nation through this crisis.
What can we do to help?
In order to help protect our healthcare heroes, it’s important that we all follow the strict rules of social distancing and hand washing. Up to one in four individuals infected with COVID-19 might have no symptoms or very mild symptoms, who may be unknowingly spreading the virus. In order to help slow the spread of the disease, consider yourself to be that asymptomatic carrier of COVID-19 and view your decision to stay home as a way you can help protect others, as opposed to a way to just protect yourself.
Additionally, no one should appear at a doctor’s office with COVID-19-like symptoms unannounced, looking for testing or treatment. Healthcare facilities are already being overwhelmed, and you put yourself and others at increased risk of spreading the virus in a crowded situation. If you need to seek treatment, call your provider in advance. Some healthcare systems have dedicated COVID-19 hotlines with nurses ready to discuss your symptoms.
Should I wear a mask in public?
We all know that social distancing and staying at home can help reduce the spread of disease – but should we be wearing masks in public as well? Current guidance from the CDC says that commercially-available masks – like N-95s and surgical masks – should be reserved for people who are already sick and healthcare workers that interact with those patients. And due to the shortage of such masks, we agree!
But the use of a cloth mask – whether that is a handmade cloth mask, bandana or scarf – can help slow the spread of COVID-19. These types of masks are not intended to protect the wearer, but to protect against the unintended transmission – in case you are an asymptomatic carrier of the coronavirus. But a word of caution: Wearing a mask does not mean we should stop other public health measures, including frequent hand washing, staying at home and social distancing when you do have to venture out in public for essential activities. The more that we can adhere to staying home and social distancing if we must be out in public, the more lives we will save.
MeiLan K. Han, M.D., MS, is professor of internal medicine in the Division of Pulmonary and Critical Care Medicine at the University of Michigan Health System and director of the Michigan Airways Program. She also serves as a Scientific Advisory Committee member to the COPD Foundation and the American Lung Association. Read More.
Blog last updated: May 22, 2020