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Where Are All the Masks? Where Are All the Masks?
(about 11 hours later)
As the heath care system strains to accommodate the unprecedented challenge of the coronavirus outbreak, many medical professionals on the front lines do not have adequate protection.As the heath care system strains to accommodate the unprecedented challenge of the coronavirus outbreak, many medical professionals on the front lines do not have adequate protection.
Some are reusing masks and gloves. Others have taken to social media with public pleas for help using the hashtag #GetMePPE, an acronym for personal protective equipment. Without proper covering, every new bedside visit might prove fatal, especially for older physicians and their families.Some are reusing masks and gloves. Others have taken to social media with public pleas for help using the hashtag #GetMePPE, an acronym for personal protective equipment. Without proper covering, every new bedside visit might prove fatal, especially for older physicians and their families.
And already, dozens of health care workers across the country have fallen ill. Hundreds more have been forced into quarantine.And already, dozens of health care workers across the country have fallen ill. Hundreds more have been forced into quarantine.
“The sky is falling,” one doctor wrote in an opinion piece for The New York Times.“The sky is falling,” one doctor wrote in an opinion piece for The New York Times.
“We’re heading into the abyss,” wrote another.“We’re heading into the abyss,” wrote another.
The short supply of masks in particular is dire.The short supply of masks in particular is dire.
The coronavirus is transmitted by droplets from coughing or contaminated surfaces, so properly applied protective gear can go a long way toward keeping doctors safe.The coronavirus is transmitted by droplets from coughing or contaminated surfaces, so properly applied protective gear can go a long way toward keeping doctors safe.
At minimum, doctors should be wearing gloves, gowns, eye gear and masks. But for weeks, hospitals have been running dangerously low on essential supplies.At minimum, doctors should be wearing gloves, gowns, eye gear and masks. But for weeks, hospitals have been running dangerously low on essential supplies.
Many doctors said they were being given just one mask, to use indefinitely. Between patients, they spray it down with a disinfectant or wipe it off, hoping for the best. But they feared that being forced to reuse a mask might infect patients who did not yet have the virus.Many doctors said they were being given just one mask, to use indefinitely. Between patients, they spray it down with a disinfectant or wipe it off, hoping for the best. But they feared that being forced to reuse a mask might infect patients who did not yet have the virus.
In part, a widespread buying of masks by anxious citizens limited commercial supply. Experts say masks and respirators are not effective for protecting the general public, but are crucial for health care workers.In part, a widespread buying of masks by anxious citizens limited commercial supply. Experts say masks and respirators are not effective for protecting the general public, but are crucial for health care workers.
Also, the prolonged outbreak in China dwindled supply. Even before the coronavirus emerged, China produced about half of the world’s masks. During the outbreak, it expanded its mask production by nearly 12-fold.Also, the prolonged outbreak in China dwindled supply. Even before the coronavirus emerged, China produced about half of the world’s masks. During the outbreak, it expanded its mask production by nearly 12-fold.
(The outbreak also comes after a particularly mask-intensive few months. Wildfires in California and in Australia had already diminished the supply of some humanitarian organizations.)(The outbreak also comes after a particularly mask-intensive few months. Wildfires in California and in Australia had already diminished the supply of some humanitarian organizations.)
On Friday, President Trump said at his daily White House briefing that the Centers for Disease Control recommended that all Americans use basic “non-medical, cloth” masks on a voluntary basis.On Friday, President Trump said at his daily White House briefing that the Centers for Disease Control recommended that all Americans use basic “non-medical, cloth” masks on a voluntary basis.
“You can do it. You don’t have to do it. I’m choosing not to do it,” Mr. Trump said. “It’s only a recommendation.”“You can do it. You don’t have to do it. I’m choosing not to do it,” Mr. Trump said. “It’s only a recommendation.”
The federal C.D.C., like the World Health Organization, had advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. (The New York Times and other news outlets had been reporting the C.D.C.’s previous guidance.)The federal C.D.C., like the World Health Organization, had advised that ordinary people don’t need to wear masks unless they are sick and coughing. Part of the reason was to preserve medical-grade masks for health care workers who desperately need them at a time when they are in continuously short supply. (The New York Times and other news outlets had been reporting the C.D.C.’s previous guidance.)
The C.D.C. now recommends that everyone wear face coverings in public settings, like pharmacies and grocery stores, to avoid unwittingly spreading the virus. Public health officials have continued to stress, however, that N95 masks and surgical masks should be saved for front-line doctors and nurses, who have been in dire need of protective gear.The C.D.C. now recommends that everyone wear face coverings in public settings, like pharmacies and grocery stores, to avoid unwittingly spreading the virus. Public health officials have continued to stress, however, that N95 masks and surgical masks should be saved for front-line doctors and nurses, who have been in dire need of protective gear.
Ideally, clinicians would be using a new, tightly-sealed respirator, like the N95, with each patient. These are thicker than standard surgical masks, and are designed to fit more tightly around the mouth and nose to block out much smaller particles. The Food and Drug Administration said that neither surgical masks nor N95s should be shared or be reused.Ideally, clinicians would be using a new, tightly-sealed respirator, like the N95, with each patient. These are thicker than standard surgical masks, and are designed to fit more tightly around the mouth and nose to block out much smaller particles. The Food and Drug Administration said that neither surgical masks nor N95s should be shared or be reused.
As the outbreak worsened and there were shortages in medical supplies across the country, the C.D.C. updated its recommendations for optimizing the supply of protective gear.As the outbreak worsened and there were shortages in medical supplies across the country, the C.D.C. updated its recommendations for optimizing the supply of protective gear.
Updated July 15, 2020 Updated July 16, 2020
Now, except in the case of intubations, which involve inserting a breathing tube, the agency says standard surgical masks are acceptable when examining or treating a coronavirus patient. (This aligns more closely with the W.H.O., which advises that surgical masks can be used in some situations, but warns that they are not sufficient on their own.)Now, except in the case of intubations, which involve inserting a breathing tube, the agency says standard surgical masks are acceptable when examining or treating a coronavirus patient. (This aligns more closely with the W.H.O., which advises that surgical masks can be used in some situations, but warns that they are not sufficient on their own.)
Some medical professionals suggested that the C.D.C.’s new recommendations are borne of political expediency instead of science.Some medical professionals suggested that the C.D.C.’s new recommendations are borne of political expediency instead of science.
“We are concerned that C.D.C. recommendations are based solely on supply chain and manufacturing challenges,” the American Nurses Association said in a public letter.“We are concerned that C.D.C. recommendations are based solely on supply chain and manufacturing challenges,” the American Nurses Association said in a public letter.
Now, the C.D.C. also outlines a crisis strategy for wearing the same mask for repeated encounters with different patients. It suggests medical professionals may need to use masks beyond the manufacturer-designated shelf life date, and to prioritize the use of masks for activities in which there may be sprays, splashes or prolonged exposure.Now, the C.D.C. also outlines a crisis strategy for wearing the same mask for repeated encounters with different patients. It suggests medical professionals may need to use masks beyond the manufacturer-designated shelf life date, and to prioritize the use of masks for activities in which there may be sprays, splashes or prolonged exposure.
“As a last resort,” the C.D.C. says “homemade masks” like a bandanna or a scarf can be used, although their protective ability is unknown.“As a last resort,” the C.D.C. says “homemade masks” like a bandanna or a scarf can be used, although their protective ability is unknown.
At a news conference in March at the White House, Vice President Mike Pence said the federal government had ordered “hundreds of millions” of N95s for health care centers across the country, but he did not say precisely when they would be delivered to workers.At a news conference in March at the White House, Vice President Mike Pence said the federal government had ordered “hundreds of millions” of N95s for health care centers across the country, but he did not say precisely when they would be delivered to workers.
The White House also signaled that American companies have been increasing efforts to restock hospitals, citing that Hanes and General Motors will make masks. But it again stopped short of discussing in detail any sort of fulfillment of the more assertive demands coming from some state and local leaders.The White House also signaled that American companies have been increasing efforts to restock hospitals, citing that Hanes and General Motors will make masks. But it again stopped short of discussing in detail any sort of fulfillment of the more assertive demands coming from some state and local leaders.
Some doctors in Oregon and in Washington have recently received gear from the Strategic National Stockpile, a federal repository of critical medical supplies for public health emergencies. But officials in both states said it was far less than what they had requested.Some doctors in Oregon and in Washington have recently received gear from the Strategic National Stockpile, a federal repository of critical medical supplies for public health emergencies. But officials in both states said it was far less than what they had requested.
There have been other efforts to donate masks. In New York, the Federal District Court in Manhattan donated and delivered 1,000 N95s that were in storage to the Hospital for Special Surgery. On Wednesday, some N95s reserved for construction work were temporarily approved for medical use by the F.D.A.There have been other efforts to donate masks. In New York, the Federal District Court in Manhattan donated and delivered 1,000 N95s that were in storage to the Hospital for Special Surgery. On Wednesday, some N95s reserved for construction work were temporarily approved for medical use by the F.D.A.
Individual doctors are looking out for one another, too. Some are shipping supplies to colleagues across the country. Others are just grateful for people leaving donations outside their doors.Individual doctors are looking out for one another, too. Some are shipping supplies to colleagues across the country. Others are just grateful for people leaving donations outside their doors.
Abby Goodnough, Margot Sanger-Katz, Benjamin Weiser and Sanam Yar contributed reporting.Abby Goodnough, Margot Sanger-Katz, Benjamin Weiser and Sanam Yar contributed reporting.