Healthcare Education :: PPE and Ventilators
As we’ve seen over the past weeks, we are all interconnected in the fight to slow the spread of COVID-19 and save lives. Social distancing was our first crucial step. As we continue to maintain social distancing protocols, if we do it right, we can “flatten the curve” of infection. This buys us precious time to ramp up our efforts on the second vital step: increasing the capacity of our hospital systems.
As exponentially more people get sick, emergency rooms and hospitals will need far greater numbers of personnel and equipment. Frontline responders in hospitals across the country are already reporting shortages of essential equipment. This is taking place on a systems level, meaning manufacturing systems, supply chain systems, and coordinated government efforts are our best tools to confront shortages of PPE and ventilators.
What is PPE?
PPE stands for personal protective equipment. This is what medical staff use to keep themselves safe from exposure to viruses. PPE includes medical-grade products such as:
- Masks (N95 and surgical)
- Gloves (examination and surgical)
- Face shields and eye goggles
- Surgical gowns
This equipment is manufactured in sterile environments and designed to meet federal safety standards to protect healthcare workers. Without PPE, first responders and hospital staff will be directly exposed to the coronavirus.
Why do we need more ventilators and trained staff?
Hospitalization patterns show that COVID-19 critical-care patients require mechanical respirators or ventilators. These machines deliver air to the lungs in an effort to maintain a vital supply of oxygen to the entire body. Hospitals will need an increased supply of ventilators to treat COVID-19 infections as well as, crucially, enough trained medical staff to operate them.
Here’s what we know so far:
- Currently, in the US, 12% of COVID-19 cases have resulted in hospitalization (CDC, March 16). This number will likely fluctuate over time.
- The number of cases is rising sharply — from 116,505 confirmed cases on March 28 to 161,807 confirmed cases on March 30 (Johns Hopkins). Remember, confirmed cases does not include a) symptomatic people who were denied tests or b) any untested asymptomatic cases.
- Public health experts estimate that if we are able to contain the spread of the virus to a moderate level, we will need 200,000 ICU beds (Johns Hopkins School of Public Health). Remember, beds = bed + machinery + nursing staff.
- The U.S. healthcare system has only enough trained critical care staff to provide respiratory care to a maximum of 100,000 patients daily (New England Journal of Medicine, March 23).
As the number of cases surges, more people will need access to ventilators. For me, this is where the COVID-19 pandemic hits close to home. Hospital systems are currently working out plans for what to do when there are more patients than ventilators. This means choosing who will get life-saving care and who won’t. Current plans include strategies like this one: People who are “otherwise healthy” and who are deemed to have “social usefulness” will be prioritized above people with underlying health conditions or lack of perceived social usefulness (NPR, March 21). With my chronic illness, I likely would not make the cut. If I am hospitalized, I may be denied life-saving care based on my disability status. Hospitals are preparing to implement these plans despite the fact that they violate civil rights laws. This is the part that weighs on my mind. If we don’t have enough PPE to keep our healthcare workers functioning and if we don’t have enough ventilators, doctors will be placed in the unwinnable position of allocating treatment to only a percentage of the patients who need it.
What can you do?
- Visit GetUsPPE.org.
- #GetUsPPE is a coalition of medical providers who are coordinating efforts to get PPE to the places it’s needed most.
- On their website you’ll find:
- An open letter and petition from physicians
- Instructions on how to help
- Encourage your senators, representatives, and governors to support coordinated donations and manufacturing of PPE from industry leaders.
Carmen Cutler is a member of Mormon Women for Ethical Government. Carmen has a graduate degree in human rights and is a PhD candidate in disability studies.
Sources
- Matthew Cortland, disability justice lawyer
- New York Times, March 18, There Aren’t Enough Ventilators to Cope With the Coronavirus
- CDC, Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020
- New England Journal of Medicine, March 23, Fair Allocation of Scarce Medical Resources in the Time of Covid-19
- Johns Hopkins, Coronavirus COVID-19 Global Cases by the Center for Systems Science and Engineering (CSSE)
- Johns Hopkins School of Public Health, Center for Health Security, February 27, 2020, What US Hospitals Should Do Now to Prepare for a COVID-19 Pandemic
- NPR, March 21, U.S. Hospitals Prepare Guidelines For Who Gets Care Amid Coronavirus Surge
- NPR, March 23, People With Disabilities Say Rationing Care Policies Violate Civil Rights
