America's PPE Supply Is Running Short, Again

In the first weeks of the U.S. coronavirus pandemic, as case numbers skyrocketed and ICUs swelled to max capacity and beyond, health workers began running out of masks, gowns, face shields and other critical items. For awhile, the situation looked dire. But, eventually, PPE supply caught up as industries mobilized to ramp up production and infection rates began falling in the hardest-hit areas of the country. Stockpiles stabilized. The PPE shortage appeared to be behind us.

That may no longer be the case.

As coronavirus infections surge again in parts of the U.S., health workers are once again sounding alarm bells about inadequate PPE. KPRC, a Houston news station, reported that 30 nurses at an area rehabilitation hospital went on strike over lack of PPE. And, according to the Associated Press, National Nurses United, a prominent nursing union, has expressed growing concern from members over mask reuse.

“We’re five months into this and there are still shortages of gowns, hair covers, shoe covers, masks, N95 masks,” Deborah Burger, president of National Nurses United, told the AP. “They’re being doled out, and we’re still being told to reuse them.”

The Washington Post reported similar conditions:

Nurses say they are reusing N95 masks for days and even weeks at a time. Doctors say they can’t reopen offices because they lack personal protective equipment. State officials say they have scoured U.S. and international suppliers for PPE and struggle to get orders filled. Experts worry the problem could worsen as coronavirus infections climb, straining medical systems.

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For weeks, nurses have posted online testimonials about a lack of PPE, with some given surgical masks instead of N95 masks because of shortages. In a video posted last week, a Florida nurse said she breaks the oath she took “to do no harm” every time she goes to work without protection and worries constantly she may be infecting her patients, co-workers and family.

This time, though, the shortages are slightly different. Major hospitals treating large numbers of COVID cases appear to be adequately supplied with PPE, at least for now. But secondary medical facilities like primary care offices and nursing homes are now reporting the bulk of the shortages. According to The Washington Post, the American Medical Association last week told FEMA that many doctor's offices outside of major medical systems have been unable to reopen due to lack of PPE. Those offices provide critical health services such as chemotherapy and minor surgery.

But even hospitals aren't immune. Even in those where ICUs are well supplied, other departments within them are reporting shortages, especially at smaller community hospitals outside the major systems. The Boston Globe reported that some Massachusetts doctors are wearing construction goggles they bring from home, while one area hospital has asked Facebook followers to donate rain ponchos for use as medical gowns.

And this, via the Globe:

Materials managers at Mass. General Brigham have “literally scoured the world,” and “no penny has been spared,” said Ann Prestipino, a senior vice president who helps oversee the pandemic response for the 14-hospital system. But the supply lines are still “a little fragile, as they are for everybody.”

That squares with reporting elsewhere that sourcing PPE has become exceedingly expensive and difficult. The Washington Post noted that one Maryland hospital that spent $600,000 on PPE last year is on track to spend $10 million this year, and that smaller health systems are struggling to compete with larger ones on securing orders. Couple these existing issues with increasing demand for PPE in other industries such as construction and education as sectors gear up for returns to work, and supply chains could soon be stretched even thinner.

The surge in demand for PPE in the early weeks and months of the pandemic created a massive business opportunity for the promotional products industry, despite sourcing challenges and liability issues. If there was concern that the opportunity was short lived, these recent reports from health workers seem to put that to bed. Though, for their part, federal officials are downplaying the severity of the situation.

“I’m not going to tell you we’re able to meet all demand, but there’s significantly less unfulfilled orders today than in April,” said Rear Adm. John Polowczyk, who oversees FEMA's Supply Chain Stabilization Task Force. “I have not found a hospital system that is in threat of running out. … I don’t have the sense of there being severe shortages.”