To President Trump and Vice President Pence,
On February 24th, health authorities from China and a team from the World Health Organization reported that 3,387 health workers (1) in China had been infected with the novel coronavirus. In Italy 2,629 health workers (2) have been infected, which reflects 8% of total cases in Italy; hospital doctor union head Carlo Palermo told Italian news (3) source ANSA on March 16 that it was a “frightful number, and this situation puts health facilities in further difficulties.”
In the U.S., where the disease is early but closely following the Italian growth curve (4), our healthcare workers, including physicians, nurses, emergency responders, food service workers and other frontline staff, are frightened – not only because of the impending stress on the healthcare system, but also because of the plummeting supply of personal protective equipment, or “PPE.”
PPE includes respirators, gowns, and gloves that protect workers from viral particles on surfaces and during other situations of close patient contact. When treating patients suspected of having coronavirus, the Centers for Disease Control and Prevention currently recommends contact and droplet precautions, which requires only a procedural mask, gloves, and eye protection. But emerging research (5) demonstrates “that viable virus could be detected in aerosols up to 3 hours post aerosolization” – and prevention of aerosolized (i.e., airborne) spread requires a specific kind of respirator mask (N95) capable of filtering out virus-containing droplets. Healthcare workers simply cannot work safely without these protections.
Right now, across the nation, even the best-prepared hospitals are low on these types of necessary protective equipment. Many clinics have run out of not just respirators but also simple procedural masks. In some hospitals providers are being asked to use a single mask for an entire 8 to 12 hour shift, even though these masks were designed for one time use with a single patient.
Due to the lack of widespread testing, nurses and doctors are sharing warnings: “Did you hear about the motor vehicle crash patient who ended up being put in the ICU with COVID-19? Four of our staff are in quarantine!” Or “The woman who came in with back pain who turned out to have a fever, and her COVID test later came back positive!” Many of us suspect we have already been exposed due to lack of widespread testing and sufficient protective equipment, and we are just waiting to develop symptoms.
Already, in the United States two emergency physicians are in intensive care, and a pathologist has died from the virus. We are all doing our best to protect ourselves and our families. Yet, we must brace ourselves knowing we will likely lose more colleagues in the coming days and weeks, and we are reviewing our own plans should we get sick: who will care for our children and who will provide for our families should we become infected or worse, die.
It doesn’t have to be this way. We still have time to protect our healthcare workforce, and to do so we must act now.