Theresa Brown is a clinical faculty member at the University of Pittsburgh and author of “The Shift: One Nurse, Twelve Hours, Four Patients’ Lives.” The views expressed here are hers. Read more opinion on CNN.
(CNN)Last week, I returned to the US from a family vacation in Spain, and am now completing 14 days of self-isolation, as required by my employer, the University of Pittsburgh. When these 14 days are up, I want to go back to bedside nursing and join the frontlines in fighting the coronavirus pandemic.
But when I raised the issue with my family, my 21-year-old daughter cautioned, “Don’t do it if there isn’t protective equipment.”
One might imagine such sage advice is unnecessary in one of the richest countries in the world, but alas, my daughter captured the essence of a frightening problem: Severe shortages of masks and personal protective equipment (PPE) for nurses, doctors, and other health care workers.
I first learned about the seriousness of the mask shortages from Twitter, where nurses shared the disturbing CDC guidance for health care providers (HCP) to use scarves or bandanas
as a last resort if medically approved masks are not available.
The more efficient N95 respirator masks, which filter out 95% of airborne particles, are in short supply. If N95 masks are limited and surgical masks are not available as backup, the CDC advises
that “it may be necessary for HCP to use masks that have never been evaluated or approved by NIOSH or homemade masks,” adding the ominous warning that “caution should be exercised when considering this option.” In Georgia, at least one hospital has already started sewing homemade mask coverings
out of surgical sheeting to extend the life of N95s.
President Donald Trump has not expressed an appropriate sense of urgency about getting American health care workers the supplies they need. Earlier this week, he punted the responsibility to governors, saying
, “The federal government is not supposed to be out there buying vast amounts of items, and then shipping. We’re not a shipping clerk.”
And while Vice President Mike Pence said 35 million medical masks were available to hospitals after an increase in production by Honeywell and 3M, health care professionals across the country remained uncertain when hospitals would see those supplies. Dr. Megan Ranney appeared on CNN and said
, “The President may say that things are being produced, but they sure as heck are not showing up in my state or in the state of all my colleagues across the country. We need those masks and gowns now.”
The current administration’s sluggish response to the pandemic has put an enormous pressure on our health system. The resulting surge in coronavirus cases has led to unnecessary shortages and growing panic. We still aren’t up to speed when it comes to testing large numbers of people, we still don’t have enough ventilators
to handle the patient load if the number of people who are infected continues to increase, and we still don’t have even close to the amount of masks and PPE
needed to keep medical professionals safe.
The general public needs to understand the importance of protecting health care professionals amid the Covid-19 pandemic; If they fall ill, who will be left to treat the sick? We are attempting to limit the spread of the disease through social distancing and self-isolation. But the infection rate and severity of Covid-19 cases in other countries suggest that the sickest patients will need intensive care and long-term respiratory support to even have a chance at surviving. This could easily overwhelm our health care system.
If this happens, and a significant number of health care professionals are infected due to a lack of masks or other protective equipment, patients with Covid-19, not to mention heart attack patients, trauma victims from car crashes, or those newly diagnosed with cancer — just to name a few — will not be able to receive the care they need. I hate to say this, but if our medical workforce is depleted, many more people will die from Covid-19 and other serious health issues than would have otherwise.
I am surprised at the Trump administration’s apathetic response to this shortage, but my re-entry into the US after being in Spain gave me a taste of just how little the administration seems to understand what all of us are up against. When we landed at John F. Kennedy International Airport in New York last weekend, all the passengers were herded together, along with others flying in from Europe, and seated in an unventilated room for an hour. We had our temperatures taken before we were sent on our way with a postcard telling us what to do if we became ill (call your provider; do not automatically go to the emergency room, it read).
It was a mess, but the amateurish response was not nearly as troubling as the lack of concern from the US Customs agents I encountered. We overheard agents saying, “Everyone has a different idea of what’s going on,” and “There were only three flights for them to check and they missed a whole f**king flight.” They gave us paper forms to fill out that looked like they had been photocopied from dot-matrix printers from two decades ago, and they didn’t even have enough for the 50 or so people in the room. None of the customs agents seemed to take the “enhanced screening” seriously. Fundamentally, no one seemed to care — at least not nearly enough.
The level of incompetence, combined with indifference, scared me. If the government had so poorly planned for the return of thousands of Americans due to travel restrictions the government itself put in place, what would that mean for its ability to confront other challenges during the pandemic? What we saw at JFK
seemed like a harbinger of worse things to come, like the shortage of masks and PPE.
I still want to return to the bedside when my 14 days of self-isolation are up. But will I be able to do that with all possible assurances of safety? On Wednesday, President Trump invoked the Defense Production Act, which would allow him to direct manufacturers to produce much-needed medical equipment. But hours after he signed the measure, he waffled and tweeted
that he would only use it in a “worst case scenario.” On Friday, Trump claimed the measure had kicked into “high gear,” although he failed to clearly convey what that would mean
Meanwhile, health care providers have taken to social media for help, but that is no way to fight a pandemic. Nurses and doctors are the frontline soldiers in this war against the coronavirus. For medical professionals to do their jobs and effectively care for others, the government must make it possible for us to safeguard ourselves.