By NANCY FOWLER
March 30, 2020
The COVID-19 pandemic is prompting hospital organizations to seek supplies from a wildly unorthodox source: the public.
Some health care systems and individual hospitals are appealing directly to their communities for donations of unused and traditionally manufactured or homemade masks, as well as goggles, face shields, gowns, hand sanitizer and alcohol wipes. Others are accepting an outpouring of unsolicited items. And hospitals aren't the only ones on the hunt for personal protective gear. More than 90 percent of cities recently surveyed by The United States Conference of Mayors reported they do not have enough face masks to protect their first responders.
Although it is not short on masks for its hospitals and clinics, Sioux Falls, South Dakota-based Avera Health said so many individuals have volunteered to sew masks, it put a pattern and instructions on its website, along with instructions for specific materials to use and drop-off locations. Bon Secours Mercy Health of Cincinnati and its member institutions are receiving donations of masks, goggles, face shields, latex gloves and Tyvek suits. Providence St. Joseph Health, a large system based in Renton, Washington, initially asked the public to contribute to a 100 Million Masks campaign before contracting with manufacturers.
Minnesota-based Essentia Health is requesting unopened packages of medical-grade gowns, eye protection and gloves, along with N95 respiratory masks and cloth masks. It's an extraordinary shift in the health care world, according to Dr. Peter Henry, Essentia's chief medical officer. The Duluth, Minnesota-based system has facilities that are members of CHA.
"I have been practicing medicine for 37 years and I will tell you, this is unprecedented," Henry said.
Essentia facilities are not yet experiencing shortages, but are anticipating the need based on predictive modeling tools. The organization has received thousands of items, including hand-made masks. To ensure donors' safety, Essentia is asking them to wait outside the St. Joseph Medical Center in their vehicles for hospital staff to collect their items. The possibility of staff becoming infected from touching the masks is "exceedingly low," Henry said.
But at least one health care system is no longer accepting hand-made masks. Trinity Health, a large ministry based in Livonia, Michigan, cites concerns about whether unstandardized materials can provide safe barriers from COVID-19, and the prospect that health care providers might have an allergic reaction to them. It is accepting traditionally manufactured personal protective gear in the original packaging. It said dental offices, veterinary practices, construction companies and hair and nail salons may have these items on hand.
Henry said Essentia recognizes that traditionally manufactured masks are preferable to the home-made substitutes. But Essentia ultimately decided to continue taking the masks, relying on mask-makers to follow publicized guidelines about using only high-density cotton.
"If we were to get into a worst-case scenario … then something is better than nothing," Henry said.
A worst-case scenario might also include a shortage of ventilators. Henry, who declined to say if Essentia facilities have any COVID-19 patients, said Essentia is working to get more ventilators from vendors and the state of Minnesota. Another possibility is for its hospitals to repurpose anesthesia machines for use as ventilators, a less than ideal solution, Henry said. Other hospitals report they are modifying existing ventilators to support more than one patient per machine.
Some non-medical businesses are converting manufacturing capacity to fill the gaps in health care inventories of gear and equipment. Providence found a local business to make masks. Hanes is making face masks, although not the gold standard N95 respirator masks, and Anheuser-Busch and other breweries are producing hand sanitizer. According to The New York Times, General Motors expects to ship its first ventilators by the end of April.
Essentia has contracted with Lindar Corporation, a manufacturer of heavy-gauge plastic parts and food packaging, to make face shields.
"It's a new normal," Henry said.
Scarcity, competition and contributing to the common good
A month after the United States' first COVID-19 death, health care decision-makers including those at Wisconsin-based Franciscan Sisters of Christian Charity Sponsored Ministries are giving serious consideration to a variety of "what ifs?"
"What if we have three sick patients, all of whom need ventilators, but I only have one machine — what do we do?" said Scott McConnaha, FSCCM president and chief executive.
"But we're not to that point," McConnaha emphasized. As of March 27, the system had one COVID-19 patient. If the situation demands it, he envisions health care organizations sharing equipment.
"Competition needs to be thrown out the window," McConnaha said.
But competition and scarcity are already a reality at a time when households and businesses are stocking up on the same protections that hospitals need, like hand sanitizer and even N95 respirator masks. Two weeks ago, McConnaha stumbled upon more than 100 N95 masks at a hardware store.
"It was like striking gold," he said. "There were no limits then; I put every single one in my cart."
McConnaha distributed half the masks to one system hospital and to the Franciscan Sisters for use by staff of St. Rita's, a nursing home for members of the congregation that is inside their motherhouse. The rest are earmarked for whichever member facility needs them first. Genesis HealthCare System Zanesville, Ohio, which also is sponsored by the Franciscan Sisters of Christian Charity congregation, is working with several manufacturers to create prototypes of masks closely resembling the N95.
Eddie McConnaha is at the sewing machine while his mother, Colleen McConnaha, works with the fabric and patterns to make protective masks for St. Paul Elder Services in Kaukauna, Wisconsin. Celia Tellenbach a foreign exchange student from Switzerland, who lives with the McConnahas, and the family's dog, Finn, round out the group. Colleen's husband, Scott, is president and chief executive of the Franciscan Sisters of Christian Charity Health System.
FSCCM's St. Paul Elder Services, a long-term care facility, is collecting wipes and sanitizers from schools and other organizations that are temporarily closed. Staff will pick up the items or ask donors to drop them at the door.
After St. Paul appealed to the public to sew and send cloth masks, McConnaha's wife, Colleen, got out the sewing machine. She and their teenage children and the family's Swiss exchange student all worked together to make masks in their Plymouth, Wisconsin, living room. Between the McConnahas and their friends working in their own homes, the group produced 30 masks.
"Teenagers are, by nature, self-centered," McConnaha said. "It was a good lesson in the way that we really are part of a larger community, and it gave them an opportunity to contribute to the common good during a national emergency."
Family assembly line
The Pfitzer family of St. Louis is also crowding around their sewing machine. Shannon Pfitzer cuts the cloth and elastic, her 5-year-old daughter combines two layers, her husband pins the pieces and their 8-year-old double-checks the work before helping her grandma with the sewing.
Nathan and Shannon Pfitzer and their daughters, Reagan, left, and Abigail model masks they made as a family. Shannon cut the material, Reagan matched the cotton and flannel material together, Nathan pinned the material, and Abigail did the sewing. The girl's grandmother, Barbara Schwerb, also pitched in.
The Pfitzer family assembly line helps the girls pass the time during what would have been their spring break trip to Disney World. So far, they've made 50 masks and their work continues.
"It feels good to make a difference," Pfitzer said.
The Pfitzers have personal connections with the recipients of their masks. They mailed most of them to the girls' pediatrician and some went to a paramedic who's in the family. Pfitzer wants to send a message to her daughters based on the words of late TV show host Fred Rogers, who advised children to find hope in a crisis by paying attention to the helpers.
"I don't want to teach my kids to just look for the helpers," Pfitzer said. "I want them to be the helpers."
A world in which hospitals need help even from children reminds McConnaha of a 20th-century wartime mentality.
"Households being asked to contribute toward a war effort is something most of us have not seen in any of our lifetimes," McConnaha said. "This is something we never thought we'd have to do."
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