Bill Frist | Contributor
I write today to describe an urgent issue that must be addressed by federal leadership in the next 72 hours. In conversations this week with two highly respected leaders representing hospitals in different parts of the country, I received the same vital message: we must organize a national effort to develop personal protective equipment (PPE), which constitutes the protective masks, face shields, gowns, gloves, and other coverings worn to protect health care personnel from contracting infections like the current novel coronavirus.
One of these health system leaders, a chief medical officer in the western United States with extensive experience responding to the past SARS and Ebola outbreaks, described to me the predicament of countless hospitals across the country. With gaps in COVID-19 testing causing patients in hospitals to wait up to five days for results, PPE is being expended by personnel caring for every individual patient waiting for a test result because the assumption must be made that they are COVID-19 positive until proven otherwise.
In fact, the majority are likely not infected and this PPE is being wasted unnecessarily due to the unusually long wait times to receive and complete testing. And with untimely testing causing patients to wait in the hospital, those who could be discharged to home, nursing facilities, and other locations are forced to wait until a negative result is confirmed. Although hospitals have postponed elective surgery to help conserve PPE, this has not been enough for the spike in demand that has been caused in this crisis.
A shortage of PPE will cause our health care workforce to reach a breaking point very soon, forced to make uncomfortable decisions that could include resorting to “bandanas and scarves” to protect themselves as the CDC suggested in a guidance issued this week. These makeshift methods are not the protection that our health care personnel need nor deserve. If they are unable to protect themselves properly, they will begin to experience increased infection that will cause illness and an inability to work safely. This avoidable reduction in staff would further strain hospital capacity and result in more loss of life.
Hospital leaders have been told that in many states, public stockpiles are now depleted and all attention has now turned to the national stockpiles that will certainly be insufficient to satisfy this overwhelming demand. Similarly, state and commercial testing sites and resources are overrun. Even with more testing platforms, access to reagents is tenuous and there is even depletion of the swabs to collect specimens. The situation regarding both PPE and testing, problems that go hand in hand, are dire.
In addition to scaling up production of PPE and test materials, we need to prioritize who is being tested. Although it would be ideal to evaluate everyone who might have symptoms, we do not have the unlimited resources available to accomplish this. If we are to protect our vital health care workforce, priority must go to these brave men and women who are exposing themselves to the danger of this pandemic every day.
This is where I must call on our national leadership to come together and take emergency action: we need to increase rapidly our own mass production of PPE in the United States immediately. According to these leaders, hospitals across this country are expecting to run out of PPE in anywhere from two weeks to just under three days. If this does happen, personnel including doctors and nurses will no longer be able to report for work as they will have no means to protect themselves against this pandemic.
This is a clear-cut plea from the frontlines for help and for federal intervention that begins at the very top with the President. We cannot even wait one day, as now is the time to act to prevent any hospital from losing their ability to protect employees and patients. When I asked the CEO of one of the largest health systems in the nation, spanning thirty states across our country, if the situation was as severe as portrayed, his answer was unequivocal: “Yes.”
Our physicians, nurses, techs, and hospitals are answering the call to duty that this national emergency and global crisis is demanding, but they need help on both of the following fronts: the mass production of masks and other protective equipment (as well as testing materials) and the prioritization of testing for health care personnel. President Trump made the right decision to invoke the Defense Production Act. Now, he must make the production of needed medical supplies an immediate priority through executive action while Congress focuses on providing concrete support in the uncertain months ahead.