The vast majority of nursing homes and assisted living facilities in the country have stocks of the vital protective supplies that they need to blunt the spread of the novel coronavirus, but unless officials and the public take drastic action, those stockpiles could soon run dry.
Without a change, 20% of the nursing homes in the country will run out of masks and gowns by next week, with a further 20% exhausting their supplies by the following week, the American Health Care Association (AHCA) announced Wednesday morning.
So far the trade group, which represents more than 14,000 individual nursing homes and senior living properties throughout the country, has received one report of a facility where frontline caregivers have already been forced to make their own masks while using garbage bags as gowns.
AHCA CEO Mark Parkinson and chief medical officer David Gifford cautioned that while such incidents are isolated at the moment, a radical shift will be necessary to prevent repeats over the coming weeks.
“There just isn’t enough out there in the existing stockpiles and supply, and we have done some of our own surveys that suggest really over the next week to two weeks, we’re going to see that curve go up dramatically,” Gifford said on a morning call with reporters.
Shortages of personal protective equipment (PPE) such as masks and gowns represent one of the biggest dangers as the country looks to prevent the spread of COVID-19. Most of the PPE used in the United States is manufactured in China, which was forced to shut down many of its factories in the early days of the global coronavirus crisis — resulting in a severely limited supply of new items coming into the country.
The rise of COVID-19 also happened to coincide with the traditional flu and cold season, and without widespread reliable testing, many people with similar symptoms began using the masks even though they likely didn’t have the virus, Gifford explained.
That’s created a “perfect storm” for operators as officials and leaders begin to realize that it’s probably not a matter of if COVID-19 enters a given nursing facility, but when — making containment efforts within an individual building vital over the coming weeks.
“Assume it’s in your community and take action now,” Gifford said.
Based on AHCA’s anecdotal tracking of cases, about 20 to 30 nursing homes have reported COVID-19 cases so far, though because the organization has mostly relied on media reports, that number could be higher.
“This virus is incredibly virulent, and it’s going to get into buildings. So the question then is: What can we do to contain it?” Parkinson said.
The reality is stark: Even if federal and state governments were to release all of their emergency stockpiles of supplies, such as they exist, there would not be enough masks and gowns for every hospital, nursing home, and senior living facility in the country, Parkinson said. For that reason, operators must conserve the supplies they already have, with Gifford recommending that staff share masks and reuse gowns over the course of a shift as “a sound practice” if no other alternatives are available.
The Centers for Disease Control and Prevention (CDC) is also set to release updated guidance on how to safely conserve PPE in emergency situations later in the day Wednesday.
But that still won’t be enough.
“We also need people who don’t need equipment to give it up,” Parkinson said.
Parkinson and Gifford praised early efforts to promote the redistribution of equipment from less essential medical providers. Ohio Gov. Mike DeWine and the Ohio Dental Association, for instance, announced plans to help redirect dentists’ PPE supplies to nursing homes after the Buckeye State ordered the cancellation of all non-elective or emergency surgeries that require the equipment.
“There is a lot of masks and gowns and face shields out there that are used in manufacturing and other health care sectors that have shut down,” Gifford said.
Individuals can also donate any gowns or surgical masks that they may have on hand; it’s important to note that authorities, including the World Health Organization, do not recommend the use of masks by healthy people as a preventative measure. Anyone interested in donating surplus PPE directly to a provider should call ahead, as many operators have designated safe drop-off points for donations.
As he has previously during the coronavirus pandemic, Parkinson described the stakes in blunt terms.
“The reaction of the public over the next 30 to 60 days, and how it manages this, will literally decide whether thousands and perhaps tens of thousands of older people — many of whom live in our residences — live or die,” he said.