I am a doctor in the very, very beginning of this COVID-19 pandemic, and I am here to tell you that we are wildly unprepared. Yes, we have the best training, we work with the most dedicated people, we have all sorts of fantastic organizational plans, but you know what none of us have, in hospitals around the country? Enough personal protective equipment—PPE.
All the people you know who work in health care (1 out of every 10 people in this country, it turns out) are doing the scariest thing we can do right now, which is go to work, because that is where the sick people go. We are doing it every day, with vacations canceled and time off disallowed; we are generally doing it now without any child care. And soon—and for some, even now—we are being asked to do it without protection.
Most urgently, there is a dire shortage of N95 masks, face shields, and other protective equipment. N95 masks are the most widely used masks that prevent the coronavirus from getting into a provider’s lungs when we are doing things like making sure you can breathe. N95 masks are made, largely, in China, and for the past few months, China has needed every single one it has made (and even ramped up production significantly in order to meet demand); it seems to have allowed few exports during that time since domestic need was so high.
We are short on other stuff too—gowns, gloves, face masks. There’s a shortage in the U.S., and around the world, just as COVID-19 is hitting all of us, all at once. And we, here in the U.S., don’t seem to have a viable backup plan. The CDC liberalized protection, meaning most of us are now utilizing plain surgical masks for most work. That is generally fine for people who aren’t getting up close and personal with intubation. (Do you like working with the word generally in that sentence? Me neither. But I digress.) But intubation and respiratory support are essential for COVID-19 critical care—and people who do that need to be protected while they do that work. Even now, doctors are being told to reuse masks that were designed for one-time use; in fact, many are getting dispensed just one, for the duration of the pandemic, however long it lasts.
When such suboptimal protection is provided, skilled and precious providers are left with two options: Either we can’t do our jobs to take care of you, or we do our jobs, get sick, and don’t take care of you.
We need a third option, and we need it fast. Current supplies may run out within a month.
Though I would be happy to have someone sew or hack or 3D-print a solution (and please, do go ahead), I think any quick sustainable answer needs to be urgent, massive, and systemic. The only institution that has been able to do that at the scale needed is generally the federal government. And I don’t have the sense that the federal government has a plan, is making a plan, or knows that we need a plan today.
I don’t have the bandwidth to plan; that’s not my job right now. I’m busy doctoring and trying to keep the world in front of me—my patients, my hospital, and when I get a few minutes, my family—safe.
So please: You may have some free time right now. Call your Senate and House and local government representatives. We need to mobilize, and we need to do it now. Call your elected officials, then call them again. Hit them hard with all that quarantine energy you’ve got bouncing around your house. We are 10 days behind Italy. Shortly after we catch up to them, we will run out of masks, and then we will run out of doctors.