Anticipating onslaught of patients, hospitals strive to preserve protective gear

Hospital officials are trying to preserve their supplies of personal protective equipment, or PPE, in anticipation of a rapid increase in the number of COVID-19 patients in the weeks ahead.

Currently, supplies are adequate, according to doctors at Lawrence + Memorial Hospital in New London and at Hartford HealthCare, whose network of facilities includes The William W. Backus Hospital in Norwich. But preserving supplies while ensuring nurses and other health care workers are properly protected involves striking a delicate balance, they say.

Nurses have expressed concerns in social media posts about the "rationing" of N95 respirator masks — so named because they can filter out 95% of small particles from the air — and other protective gear.

In a recent interview, John Brady, executive vice president of AFT Connecticut, the union representing hundreds of nurses at L+M, Backus and other hospitals across the state, said he's heard varying reports about the severity of the shortage of N95 masks but that it's a statewide as well as national problem.

"They're the gold standard," he said of the respirators. "The CDC (U.S. Centers for Disease Control and Prevention) has issued some interim guidelines about what to do if you're running out of them. ... If you run out, you can use surgical masks with a face shield; even a bandana is better than nothing."

Brady said nurses at Danbury Hospital had pushed back against a directive that they use surgical masks instead of N95s when treating non-COVID-19 patients, while nurses at Backus were preparing to use N95s for only COVID-19 patients.

"We feel that there's enough evidence, although it's not conclusive, that this is an airborne disease and that nurses should be wearing the N95," Brady said.

He cited correspondence published last week in the New England Journal of Medicine in which researchers reported they had found the novel coronavirus causing COVID-19 remained viable and infectious in aerosols for up to three hours. In experiments, it also was detected on surfaces for up to 72 hours and was "more stable on plastic and stainless steel than on copper and cardboard."

Dr. Kevin Torres, L+M's associate chief medical officer, said L+M was intently watching its PPE supplies. "We're trying to be judicious," he said. "We're trying to save our equipment and protect our staff as well. We're trying to be good stewards of PPE."

Torres said a mask, including an N95, can be reused "if the fabric's in good shape, if its integrity hasn't been compromised and if the wearer hasn't had a sick patient cough all over them." He said masks were being used in cases where "it's appropriate and necessary."

"If a patient's symptomatic, we're putting them on," he said.

He also said the N95 must be fitted properly and that wearing one for any length of time can be uncomfortable. While its main purpose is to protect the wearer against disease, it's also meant to prevent a sick wearer from transmitting the disease to someone else, he said.

Other gear, including gowns and especially gloves, are in short supply throughout the Hartford HealthCare system, Dr. Ajay Kumar, Hartford HealthCare's chief clinical officer, told reporters Tuesday. He said the system's hospitals have taken "a very disciplined approach" to the coronavirus outbreak and that PPE supplies were expected to meet demand in the weeks ahead.

Hartford HealthCare, L+M and virtually all hospitals in Connecticut are soliciting donations of gear.

On its website, AFT Connecticut, the nurses' union, has posted its national organization's petition calling for the Trump administration to release the federal stockpile of PPEs and make the production of masks a top priority.

"All (health care) workers should have immediate, free access to being tested (for the coronavirus) to ensure that they are healthy and also not endangering non-infected patients," the petition says. "And the federal government needs to stop watering down guidelines that keep us safe. The minimum standard of protection for a (health care) worker should be N95 masks."

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