The PPE Shortage Crisis and Rationing 

At the beginning of the COVID-19 pandemic, hospitals around the US, especially hard-hit areas along the east coast, had an insufficient supply of medical-grade personal protective equipment (PPE) to adequately protect clinical and support staff as they treated patients with COVID-19. Stories of healthcare workers’ utilizing garbage bags for protection and re-wearing surgical and N95 masks for multiple shifts were mentioned throughout the media. In a recent cross-sectional study published in the Annals of Emergency Medicine, emergency medicine physicians and resident physicians were surveyed from April 2020 through May 2020. The study analyzed the combined stressors of caring for a high volume of critically ill patients, reduced protective and medical resources, and increased personal risk. In hotspots, healthcare providers reported rationing medical resources at 86% compared to 56% of respondents from non-hotspots. However, it is noted that 93% of all respondents, regardless of geographic regions and case numbers, reported reusing medical PPE.

Since last spring, the shortage and rationing of PPE have not disappeared. Healthcare providers are repeatedly sounding the alarm as PPE is continually rationed at increasingly unsafe rates. 

How is the PPE Shortage Crisis Currently?

In December 2020, the WHO released a guideline for rational utilization of PPE in health care facilities during “acute pandemics,” and considerations during severe shortages. It discusses that while extended utilization or re-use of PPE is not desired, in times of crisis and acute shortages: these are realities facing many health systems. Recommendations for safe, extended use of PPE and storage, and re-processing PPE for re-use were outlined. Unfortunately, at 10 months, this pandemic is no longer “acute”. At Get Us PPE, requests for PPE rose 260% in December from requests made in November. 87 million pieces of PPE requested to fulfill just one week of need. The increasing volume of requests underscores the current PPE shortages nationwide.

What are Healthcare Workers Saying?

One healthcare professional in a large hospital in the midwest reported, “I must obtain an N95 mask for my shift from my supervisor. Our department’s PPE is stored and locked in my supervisor’s office. We can only have one surgical mask and one N95 per shift.“ When asked how this differs from the pre-pandemic environment, they responded, “I could easily get an N95 or surgical mask when I needed one. In fact, PPE was one-use per patient. It was easily accessible in storage rooms on each floor of our hospital that was accessible to all employees to safely perform their jobs.” School nurses are another group reporting PPE shortages. A school nurse said, “As a district, nurses have asked for proper PPE and were told that, ‘There’s nothing available; there’s a nationwide shortage’.” In our district, each nurse received three masks, which were marketed for construction-use only, and we’re required to reuse these supplies or provide our own.” The rationing and reuse of PPE are profound and continue to be utilized among many facilities, placing their frontline workers at risk. 

What Do Healthcare Facilities Need Now?

In our December Index, we outlined our most requested PPE items amongst requesting facilities: including nitrile gloves, disinfecting wipes for medical equipment, and hand sanitizer. Surgical and N95 masks followed closely behind. In addition to limited production to meet the current high demand nationally, there is limited medical-grade, NIOSH-approved PPE to provide appropriate protection for front line workers. This only compounds the availability of appropriate medical-grade PPE and has led to this disturbing—but currently necessary—trend of rationing and re-use by frontline workers nationally, as we come upon one year since the beginning of the COVID-19 pandemic in the US.

This is part of a series highlighting the current, top-requested types of PPE, which include nitrile gloves, disinfecting wipes, and hand sanitizer.

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