Medical staff describe shortages and rationing of masks as White House assures they’re available ’now’

By Alice Miranda Ollstein

Doctors and nurses across the U.S. say shortages of masks and other safety gear are putting them and their coworkers at risk, despite White House assurances that the supply gaps from the coronavirus pandemic are being addressed by policy fixes and donations from good Samaritans.

As health providers take to social media to plead with the federal government to make more gear available, and state officials hold press conferences begging other industries to donate masks to their local hospitals, President Donald Trump and Vice President Mike Pence insisted from the White House podium Thursday that plenty of masks are available now.

“We put a priority at the president's direction on making sure health care services through America have the protection to keep themselves and their family safe,” Pence said, saying that the bill Congress approved this week lifting legal liability for masks not previously approved for hospital use will allow tens of millions produced by the company 3M and others to be sold for the treatment of coronavirus patients.

“We vastly increased the supply of medical masks and we'll continue to put a priority on making sure we are calling on industry at every level, calling on major suppliers that the president met with this week to make sure those equipment are there,” he said.

Guidance from the CDC released Monday that bluntly acknowledged the shortages tells another story. That advice, which health care workers tell POLITICO they consider dangerous, includes reusing respirator masks between different patient visits, using masks that have passed their expiration date, and even constructing “homemade” masks out of a bandana or scarf.

With medical workers already getting sick and dying from the disease in Washington state and other coronavirus hot spots, health care workers tell POLITICO they’re terrified for themselves and their patients.

“It’s the scariest thing about going to work every day,” said Sean Petty, a pediatric ER nurse and member of the New York State Nurses Association. Petty told POLITICO that his public sector hospital in the Bronx implemented what he described as “extreme rationing” of masks this week.

Petty also noted the shortage has forced his hospital to only provide masks to patients who have severe enough symptoms to qualify to be tested for coronavirus — which could be risky because the transmission of the virus from asymptomatic patients is not fully understood.

Despite the ramped-up domestic production the Trump administration touted Thursday, those on the ground say it's unclear when those supplies will make it into medical providers’ hands.

The 500 million masks the federal government ordered this week, for example, may not be delivered for another 18 months.

Jamie Lucas, executive director of the Wisconsin Federation of Nurses and Health Professionals, said Thursday that none of his members have heard from their employers that more masks are on the way.

“They're preparing as if what they have is what they’ll have," he said, including rationing and reusing masks in potentially unsafe ways.

A 2006 report by the National Academies of Sciences’ Institute of medicine both predicted the current shortage and warned against the repeated use of a single mask.

“These devices will be in short supply if a pandemic strikes,” the report found. “And there is currently no simple, reliable way to decontaminate these devices that would enable people to safely use them more than once.”

A registered nurse at a large nonprofit hospital in Manhattan, who spoke on condition of anonymity for fear of losing her job, told POLITICO she was given an online training last week about the protective gear she needed to wear when caring for potential coronavirus patients and that the training stressed the use of an n-95 respirator mask.

But when she was called in this week to assist with a patient showing flu-like symptoms, she was told by management that a regular surgical mask was adequate protection — echoing the recent shift in the CDC's guidelines. Despite deep misgivings, she spent hours in the room with the patient.

“I’m worried about myself and my colleagues being put at risk, and I’m also worried that we’re not doing nearly enough to prevent transmission from infected patient to staff to other patients who may be immunocompromised,” she said.

Nurses and doctors are not the only ones at risk.

Lucas told POLITICO that hospital cleaning staff have been directed to clean rooms that held coronavirus patients without a mask in order to conserve them for medical providers. Even with new data showing the virus can survive on surfaces for hours, the unprotected cleaners are expected to turn over the rooms for new patients much more quickly.

As of Thursday afternoon, hundreds of thousands of health care workers had signed an online petition demanding the government do more to ensure an adequate supply of masks and other protective equipment.

Yet federal aid has been slow to arrive.

On Wednesday, the Trump administration invoked the Defense Production Act to ramp up production of desperately needed hospital equipment. Though the White House had discussed taking this step for weeks, it has not yet done the required assessment of what supplies are most in need, meaning those items may take months to actually make it to the front lines. Trump also indicated he was in no hurry to move forward, tweeting this week that he only signed the act “should we need to invoke it in a worst case scenario in the future.”

Many states say that “worst case scenario” has arrived.

On Thursday, Massachusetts lawmakers wrote to the Trump administration saying they had only received 10 percent of the 750,000 masks and other equipment they requested weeks ago, and warned that the state's hospitals are "facing or are imminently anticipating shortages."

The office of Washington Gov. Jay Inslee, whose state has more than 900 confirmed cases, said Thursday there are still "substantial shortages" of protective gear despite two shipments from the Strategic National Stockpile. Inslee's office said the federal government hasn't filled the state's most recent request for tens of thousands of additional N-95 respirators, surgical masks and face shields.

The stockpile of medical equipment, originally designed for use during a nuclear disaster or biological attack, was never intended to last during a prolonged pandemic.

Officials in Ohio say what they‘ve received from the stockpile falls far short of hospitals' needs.

“Ohio has received our full allocation from the national strategic stockpile,” Tamara McBride, the chief of the Bureau of Health Preparedness at the Ohio Department of Health, told reporters earlier this week. “If we do not take conservation steps now, we will not have health care workers that are protected to care for the most sick.”

Like other states, Ohio’s leaders have asked veterinarians and dentists to donate masks and other materials to hospitals. They have also asked food service workers to donate latex gloves. A hospital in Atlanta has even had to rely on a donation of masks, gloves, and gowns from a TV medical drama being filmed nearby.

Pence lavished praise Thursday on the construction industry for responding to the federal government's call to donate masks, but did not say how many have been obtained that way. And as recently as Tuesday, the Association of General Contractors said the administration had not consulted with it about this request, and the group worried that the loss of masks would put their own workers at risk.

"Without those masks, they would be immediately out of work, because they can‘t work without masks," said Vice President of Public Affairs Brian Turmail.

AGC added Thursday that HHS had asked the group to send an inventory of all their members' available safety equipment, including masks and protective suits, but no donations have yet been made. "We are going to ask our chapters tomorrow morning to collect this information and share it with HHS,” Turmail said.

In the meantime, all sectors of the medical community are doing whatever they can to conserve masks. Medical students, for example, have halted their clinical rotations, and hospitals have suspended elective procedures.

Janis Orlowski, chief health care officer at the Association of American Medical Colleges, told reporters on a call Thursday that the lack of masks and other personal protective equipment remains the “number one issue” she’s hearing from teaching hospitals battling coronavirus.

“Are we worried about this? Yes, we are,” she said. “We are really going to have to push to get more PPE into the hands of our health care workers.”

Gavin Bade contributed reporting.