Dawn Canova, clinical manager for outpatient wound care at Carroll Hospital, prepares to take samples from people to test them for the coronavirus at a drive-thru station in Westminster, Maryland.
Chip Somodevilla/Getty Images
I am a doctor in the very, very beginning of this COVID19 epidemic, and I am here to tell you that we are wildly unprepared. Yes, we have the best training, we work with the most dedicated people, we have all sorts of fantastic organizational plans, but you know what none of us have, in hospitals around the country? Enough personal protective equipment—PPE.
All the people you know who work in healthcare (1 out of every 10 people in this country, it turns out) are all doing the scariest thing we can do right now, which is go to work, because that is where the sick people go. We are doing it every day, with vacations cancelled and time off disallowed; we are generally doing it now without any childcare. And soon—and for some, even now—we are being asked to do it without protection.
Most urgently, there is a dire shortage of N95 masks, face shields, and other protective equipment. N95 masks are the most widely used masks that prevent coronavirus from getting into a provider’s lungs when we are doing things like making sure you can breathe. N95 masks are made, largely in China; and for the last few months, China has needed every single one they have made (and even ramped up production significantly in order to meet demand); they seem to have allowed few exports during that time since domestic need was so high.
We are short on other stuff too—gowns, gloves, face masks. There’s a shortage in the U.S., and around the world, just as COVID-19 is hitting all of us, all at once. And we, here in the US, don’t seem to have a viable backup plan. The CDC liberalized protection, meaning most of us are now utilizing plain surgical masks for most work. That is generally fine for people who aren’t getting up close and personal with intubation. (Do you like working with the word “generally” in that sentence? Me neither. But I digress.) But intubation and respiratory support is essential for COVID-19 critical care—and people who do that need to be protected while they do that work. Even now, doctors are being told to reuse masks that were designed for one-time use; in fact, many are getting dispensed just one, for the duration of the pandemic, however long it lasts.
When such suboptimal protection is provided, we are leaving those skilled and precious providers with two options: either we can’t do our jobs to take care of you; or we do our jobs, get sick, and don’t take care of you.
We need a third option, and we need it fast. Current supplies may run out within a month.
Though I would be happy to have someone sew or hack or 3D-print a solution (and please, do go ahead), I think any quick sustainable answer needs to be urgent, massive and systemic. The only institution that has been able to do that at the scale needed is generally the federal government. And I don’t have the sense that the federal government has a plan; is making a plan; or knows that we need a plan today.
I don’t have the bandwidth to plan; that’s not my job right now. I’m busy doctoring, and trying to keep the world in front of me—my patients, my hospital, and when I get a few minutes, my family—safe.
So please: you may have some free time right now. Call your senate and house and local government. We need to mobilize, and we need to do it now. Call your elected officials, then call them again. Hit them hard with all that quarantine energy you’ve got bouncing around your house. We are 10 days behind Italy, and we will run out of masks; and then we will run out of doctors.
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