One thousand cloth masks, possibly made from T-shirts, arriving in an unmarked box with no return address. Plastic gowns, similar to trash bags, too large for a nurse to wear. Shipments with far fewer masks and gowns than a facility uses in a single week — with no hand sanitizer, N95 masks, or face shields in sight.
Those are just a handful of stories from nursing homes that have received emergency shipments of personal protective equipment (PPE) from the Federal Emergency Management Agency (FEMA), at least according to a Thursday letter to Vice President Mike Pence from the president and CEO of non-profit nursing home trade group LeadingAge.
“In your role as director of the Coronavirus Task Force, I am asking you to personally investigate mounting evidence that FEMA shipments of PPE are deeply delayed, frequently stocked with useless and expired supplies, and delivered in quantities radically insufficient to help protect older Americans from the deadly coronavirus,” Katie Smith Sloan wrote to Pence. “Further, nursing homes across the country have not received clear and helpful communications about what to expect and when to expect it.”
Sloan’s letter came on the same day that multiple outlets — including Kaiser Health News and CNN — reported problems with FEMA’s promised shipments of PPE, from oversized, tarp-like gowns that staffers have compared to trash bags to masks not rated for medical use.
“It would be funny if the stakes weren’t so high,” an official in Washington state told CNN.
President Trump announced FEMA’s nursing home PPE initiative at the end of April, promising to deliver two weeks’ worth of masks, gowns, gloves, and eye protection to all 15,400 U.S. nursing homes — spread across two shipments — by July 4.
The exact amounts would be based on operators’ staffing and PPE usage rates, FEMA administrator Peter Gaynor said at the time.
But according to LeadingAge, several of its members have reported that the shipments have fallen far short of a full week’s supply. A facility in the District of Columbia, for example, uses 14,000 gloves and 3,850 surgical masks per week, but its FEMA shipment contained just 1,800 and 398, respectively — with no N95 masks, face shields, or hand sanitizer at all.
“The amount received was not a weekly supply,” the facility reported, according to LeadingAge.
The trade group compiled a list of sub-standard shipments received at facilities around the country, including a property in Missouri that found its 500 masks to be “too small and tough to breathe through.” In Minnesota, an organization reported receiving a batch of a few hundred masks with Hanes branding, leading management to determine that it was made “from men’s underwear in my opinion” — and unusable in a medical setting.
One Kansas facility wasn’t even sure where its shipment could have come from.
“We received 1,000 cloth masks yesterday with no return address, just a Topeka, KS USPS facility,” the property reported, according to LeadingAge. “No idea where they came from. Nothing we ordered. And these masks are virtually useless. They are made of t-shirt material with non-stretchy ear loops. As CDC likes to remind us too, cloth masks are not true PPE.”
Farther west, a California facility noted that while it did manage to secure N95s in its FEMA shipment, problems rendered them unusable.
“We received masks that had been sitting in storage for years and are past expiration date; we got cloth masks (not PPE): we got N95 masks that were not usable because the elastic broke,” the operator reported, according to LeadingAge. “So we’ve got thousands of masks that are not usable, and we have staff who are stapling elastic to the mask frames.”
A FEMA spokesperson told CNN that all of its PPE met guidelines set by the Food and Drug Administration and the Association for the Advancement of Medical Instrumentation, though the agency also acknowledged that it had received complaints.
“The AAMI-approved gowns came with instructions from the manufacturers,” the spokesperson said, per CNN. “However, due to concerns from those who received them, the contractor is working on a short instructional video about proper use of these gowns which will be shared with the nursing homes.”
In her letter to Pence, Sloan emphasized that the COVID-19 crisis in nursing homes will likely continue for some time.
“On behalf of millions of older Americans who know that the coronavirus threat is not over, I implore you to investigate these reports seriously and thoroughly — and take swift action to ensure they can trust the federal government to serve their interests,” Sloan concluded.