Updated at 7 p.m., March 26, with details on SLU Hospital's guidance to employees on protective masks
As hospitals prepare to treat people who become very sick with the COVID-19 disease, doctors and nurses in St. Louis are worried they won't have enough protective gear to keep them safe.
Health care workers say hospitals have directed them to reuse equipment to stretch inventory as global demand during the pandemic has depleted the supply of gear such as N95 masks, which protect people from inhaling the virus.
Doctors and nurses say they have a duty to treat patients on the front lines, but they want the government and hospitals to make sure they’re protected while they’re doing their jobs.
“We’re going to be coming to work regardless of this crisis,” said Meghan Boresi, a nurse at St. Louis University Hospital and member of the National Nurses United union. “All we’re asking for is for the appropriate equipment and training to take care of our patients and keep them safe.”
N95 masks usually cost about $1 each. But the cost of the masks isn’t the issue, said Dr. Hilary Babcock, a Washington University infectious disease specialist at Barnes-Jewish Hospital. If there were more available, the health system would buy them.
“The issue is every hospital in this country needs a lot more equipment than we usually do, and a lot of the equipment that they need is usually manufactured in China, in countries that are heavily hit by this outbreak,” she said.
So far, BJC HealthCare has enough equipment to treat COVID-19 patients in the system’s 15 regional hospitals, Babcock said. But an expected surge in patients could use up that supply.
Healthy members of the public also stockpiled masks as news of the epidemic spread, said Denise Murphy, BJC HealthCare senior nurse executive.
“We certainly understand their anxiety, but them wearing a mask if they are asymptomatic and not infected is not protection,” she said. “I think the epidemic of fear has added to the shortage of masks in general.”
Nurses at SLU Hospital and others around the country have had to reuse their face masks, Boresi said.
In a statement, hospital officials said its personnel have what they need, but personal protective items are in high demand nationwide and supplies are limited. The statement said SLU Hospital is conserving supplies and seeking new supply sources to ensure workers have what they need in the coming weeks.
SLU Hospital spokesman Jason Merrill said administrators have not directed employees to change the way they use protective equipment. But he said under guidelines from the Centers for Disease Control and Prevention, after caring for single patients, health care workers can reuse masks if they are not soiled or wet.
“That is different than widely asking staff to reuse,” Merill said.
Health care workers at other facilities also are worried about having to keep using the same mask.
“Things are changing every day, but currently administration is handing out ONE mask per week,” wrote one staff member at a St. Louis rehabilitation clinic, who asked to not be identified. “They are talking about getting cloth masks to put over the paper masks, but even that is not an ideal solution, plus [they’re] not currently available.”
State Rep. Joe Runions, D-Grandview, called for more protective equipment for the state’s hospitals after he was hospitalized with COVID-19.
“I’ve witnessed first-hand how much of these supplies are being used up treating COVID-19, and I am just one patient,” Runions wrote in a letter to Gov. Mike Parson. “Stocks of that equipment are rapidly running low, and doctors are deeply concerned about whether those stocks will be replenished fast enough.”
Members of the Service Employees International Union, which represents 90,000 workers in health and child care, will ask Parson today to ensure they have enough protective equipment and free coronavirus testing. The union also will call on the governor to issue a statewide shelter-in-place order.
Earlier this week, the Missouri Department of Health and Senior Services announced it received more than 57,000 N95 masks and more than 137,000 face masks from the Strategic National Stockpile, the repository or medicine and equipment maintained by the federal government.
But epidemiologists expect more than 100,000 people to contract the virus in Missouri over the coming months. Workers can go through many masks in a single shift, and that equipment won’t last the entire epidemic.
National Nurses United is calling for President Donald Trump to order emergency manufacturing of personal protective equipment using the Defense Production Act.
Webster University and Washington University have donated equipment from their labs to hospitals in the region.
Community members have also started campaigns to sew cloth masks for health workers.
Cloth masks are “kind of the equivalent of wrapping a scarf around your face, which I do when I’m on a plane and someone coughs near me,” Babcock said. They might keep some germs out but won’t offer the protection of an N95, she said.
Boresi said such efforts are well-intentioned, but workers on the front lines need medical-grade equipment that has been scientifically proven to work.
Instead of sewing masks, concerned people should lobby their federal representatives to ensure safety and order more manufacturing, she said.
“This really is an emergency; we have to keep the public safe,” Boresi said. “If nurses aren’t protected, we aren’t protecting our patients. If we get sick, who’s going to take care of the patients?”
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Correction: An earlier version of this story misstated what SLU Hospital is instructing its nurses to do with protective masks. Under guidelines from the Centers for Disease Control and Prevention, after caring for single patients, health care workers can resuse masks if they are not soiled or wet.
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