Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Please protect all health care workers: Make PPE a priority

Raagini Jawa, MD, MPH and Amal Jawa, MBBS, MPH
Conditions
March 20, 2020
Share
Tweet
Share

For most of us, we have never experienced a pandemic as unique and widespread as COVID-19 during our lifetimes. There is ample data suggesting that the novel coronavirus is not only more infectious (R-naught 2-3) but also associated with increased severity of disease (average case fatality rate of 2.3 percent) than the seasonal flu. We are slowly understanding how intelligent and damaging this virus can truly be given the varying length of its incubation period of 2-14 days, viral shedding before symptom onset, and its ability to survive on surfaces. Because the virus is spread via droplets, and can be aerosolized, frontline health care workers (HCW) need to wear personal protective equipment (PPE) such as N95 respirators, surgical masks, gowns, gloves, and eye protection to keep themselves safe from getting infected. If the United States continues to have wide community spread and exponential increases in the number of cases of COVID-19, this surge of patients will not only place increased demand on hospitals beds/critical care resources but will require urgent federal and state support to ensure adequate PPE for all frontline HCW to keep them safe.

While all health care facilities have been preparing for weeks-months stockpiling supplies for the possible surge of patients infected with COVID-19, most health care administrators have been struggling to order basic supplies due to global production and distribution delays and are concerned about the realities of dwindling inventories. In Washington state, an institution that was following World Health Organization PPE guidelines, after 2-3 weeks of their local outbreak, there were severe shortages of PPE, with rationing of N95 masks, reusing of disposable face shields after cleaning, and staff burnout around PPE. Other hospitals across the US are facing similar shortages, and we are concerned that with the rising cases, and quickly dwindling supplies of PPE, health care facilities will need to adopt varying guidelines to accommodate PPE rationing, or possibly reusing and repurposing in ways manufacturers never intended, potentially putting front line HCW at risk of getting infected. As health care facilities are rapidly evolving to ensure they provide exceptional care for the most number of patients, it must be the priority of local and federal government to ensure frontline workers are properly equipped, kept safe, and can continue doing their job. Multiple professional medical and public health groups including emergency medicine, infectious disease physicians and nursing unions have already appealed to their community leaders and congress for emergent action, conservation, and access to PPE but despite emergency budget increases, the exceedingly concerning federal response to date is for state governments is to “try to get it yourself.”

Why is the protection of health care workers’ health important? We know that during the SARS outbreak in 2002, 1/5 of all cases were in HCWs. If a HCW is exposed to a person under investigation for COVID-19 without adequate PPE, they must be quarantined to monitor for symptoms or in the worst case, will get sick themselves. This would prevent them from being able to provide clinical care to the exponentially rising number of critically ill patients. If many HCWs are unable to work either due to quarantine or illness, who will take care of you or your family members if they were to get sick?

Based on the summary report from the Chinese Center for Disease Control and Prevention, 3.8 percent of all infections were health care personnel (1,716 of 44,672 patients), of which 14.8 percent had severe/critical illnesses, and five died. Looking at integrated surveillance data out of Italy, earlier in their outbreak 1,116 health care workers infected with COVID-19 out of 13,882 cases. Because of this, in order to protect and preserve hospital staff, some Italian hospitals recommended a higher level of protection than current WHO recommendations, including FFP2 masks, N95 masks, and above, waterproof gowns, and full cover. The HCWs getting infected with COVID-19 are not only seen internationally, but domestically we are seeing increasing numbers of HCW exposed, infected, and some of our colleagues are unfortunately in critical condition. Thus, an adequate supply of PPE is essential, and both state and federal support are needed.

In most of our lifetimes, we have never witnessed a war against a virulent viral infection that has affected so many across the globe.  Similar to military battle, we could never fathom sending our soldiers to war grounds without proper protection, armor, and weaponry.  Our HCW will be on ground zero in their hospitals, and adequate PPE will be crucial and necessary in keeping them safe. We appeal to our political leadership to ENSURE that there are adequate PPE stocks available in every single health care facility, NOW, so that 1-2 weeks from now, when we are seeing a higher volume of patients, we are keeping frontline HCW safe.

We recognize that there have been global shortages and our hospital administrators have been doing everything to help us stay safe, but given the magnitude of our pandemic, it is time for the federal government to step up and help each state develop a sustainable mechanism so they can have a steady supply of PPE to keep their HCWs safe.  An example of best practices being done in Thailand includes ramped up domestic manufacturing of N95 masks. Other possible ideas could include providing access to federally regulated Strategic National Stockpiles or seeking alternative non-medical suppliers for assistance.

As HCWs, we have taken an oath to care for all patients and are ready to fulfill our responsibility by spending long hours to save our community from this COVID-19 pandemic. As we have seen in other countries and domestically, we know that many of our colleagues or I could get sick caring for patients, despite adequate PPE. But, if HCWs run out of PPE, the basic tools that we use to protect ourselves, society will have to face the horrible consequences of mass quarantined staff who are unable to provide medical care, and put our most valuable and selfless medical community at highest risk of infection, or death. We call for United States federal and state government support to expedite mechanisms to ensure every frontline HCW and health facility has adequate PPE now.

Raagini Jawa is an infectious disease fellow. Amal Jawa is a hospital administrator.

Image credit: Shutterstock.com

Prev

Physicians need to step into their calling, even if it's not directly in medicine

March 20, 2020 Kevin 0
…
Next

Corona together: Say "I love you" a little bit more to those you love

March 20, 2020 Kevin 0
…

Tagged as: COVID, Infectious Disease

Post navigation

< Previous Post
Physicians need to step into their calling, even if it's not directly in medicine
Next Post >
Corona together: Say "I love you" a little bit more to those you love

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

Related Posts

  • How social media can help or hurt your health care career

    Health eCareers
  • Health care workers should not be targets

    Lori E. Johnson
  • What makes health care workers superhuman

    Eric Tian
  • Major medical groups back mandatory COVID vaccine for health care workers

    Molly Walker
  • An apology to frontline health care workers

    Michele Luckenbaugh
  • The epidemic of violence against health care workers

    Marlene Harris-Taylor

More in Conditions

  • Finding healing in narrative medicine: When words replace silence

    Michele Luckenbaugh
  • Why coaching is not a substitute for psychotherapy

    Maire Daugharty, MD
  • Why doctors stay silent about preventable harm

    Jenny Shields, PhD
  • Why gambling addiction is America’s next health crisis

    Safina Adatia, MD
  • How robotics are reshaping the future of vascular procedures

    David Fischel
  • How the shingles vaccine could help prevent dementia

    Marc Arginteanu, MD
  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • 2 hours to decide my future: How the SOAP residency match traps future doctors

      Nicolette V. S. Sewall, MD, MPH | Education
    • Why removing fluoride from water is a public health disaster

      Steven J. Katz, DDS | Conditions
    • When did we start treating our lives like trauma?

      Maureen Gibbons, MD | Physician
    • In a fractured world, Brian Wilson’s message still heals

      Arthur Lazarus, MD, MBA | Physician
    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • How doctors took back control from hospital executives

      Gene Uzawa Dorio, MD | Physician
  • Past 6 Months

    • Why tracking cognitive load could save doctors and patients

      Hiba Fatima Hamid | Education
    • What the world must learn from the life and death of Hind Rajab

      Saba Qaiser, RN | Conditions
    • The silent toll of ICE raids on U.S. patient care

      Carlin Lockwood | Policy
    • Why shared decision-making in medicine often fails

      M. Bennet Broner, PhD | Conditions
    • My journey from misdiagnosis to living fully with APBD

      Jeff Cooper | Conditions
    • Why we fear being forgotten more than death itself

      Patrick Hudson, MD | Physician
  • Recent Posts

    • When your dream job becomes a nightmare [PODCAST]

      The Podcast by KevinMD | Podcast
    • Finding healing in narrative medicine: When words replace silence

      Michele Luckenbaugh | Conditions
    • Why coaching is not a substitute for psychotherapy

      Maire Daugharty, MD | Conditions
    • When the white coats become gatekeepers: How a quiet cartel strangles America’s health

      Anonymous | Physician
    • Why doctors stay silent about preventable harm

      Jenny Shields, PhD | Conditions
    • Why interoperability is key to achieving the quintuple aim in health care

      Steven Lane, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...