Shortage of protective equipment at hospitals threatens health care providers, as numbers of admitted patients rise

One hospital chief considered creative measures, like cutting up paper gowns to make face masks

Erin Clark/Globe Staff

The number of patients possibly infected with coronavirus continues to rise in Massachusetts hospitals, while staff agonize over a more immediate crisis: a lack of protective gear to keep them safe from this highly contagious disease.

In a matter of days, hospital workers have gone from worrying about shortages to rationing, and fearing that they actually could run out of supplies.

The head of UMass Memorial Health Care has started thinking about creative measures, even cutting up paper gowns to create makeshift face masks.

“We made our plea to everyone we can: We need N95 masks, we need gowns, we need gloves, we need surgical masks, and we need quicker turnaround on the testing, because that’s why we’re burning it up,” said Dr. Eric Dickson, chief executive of UMass Memorial. “We’re going to run out.”

Major teaching hospitals have resorted to seeking donations on Facebook, from hardware stores and construction companies — and anyone else who can help. After the president of Massachusetts General Hospital, Dr. Peter Slavin, mentioned the possibility of 3-D-printed masks during press interviews Thursday, several companies quickly offered to supply them, Slavin told the Globe.

The number of patients with confirmed coronavirus continued to increase at hospitals Thursday, while admitted patients awaiting test results shot up more, according to an ongoing Globe survey of the state’s hospitals. Across its 12 hospitals in Eastern Massachusetts, Beth Israel Lahey Health was treating 13 patients who have tested positive, almost double the seven on the previous day. The number of suspected cases at Beth Israel Lahey hospitals rose from 249 to 257.

Brigham and Women’s Hospital had three admitted patients with confirmed coronavirus Thursday, while 40 were awaiting test results. The number of Brigham employees who tested positive doubled from two to four.

Boston Medical Center admitted its first patient with COVID-19 to the hospital Thursday, while the number awaiting test results rose from 50 to 59. At Mass. General, confirmed cases rose from seven to eight, while patients with pending results climbed from 73 to 102.

Hospital officials said it’s unclear how many of the patients waiting for results will ultimately have coronavirus. At Mass. General, some of the patients with potential coronavirus came into the hospital for other reasons such as a stroke or a bowel obstruction, and then developed fever and upper respiratory symptoms.

Slavin said if recent days are any indication, only a minority of patients suspected to have COVID-19 will test positive. Some may have the flu or other respiratory illnesses.

Meanwhile, the extreme shortage of protective equipment is leaving health care workers fearful that they could become ill and pass the virus on to their families.

When health care workers get sick or are exposed to the virus, they must stay home for at least two weeks — a hardship not only for them but for hospitals that desperately need their full workforces to confront the pandemic.

Ellen MacInnis, a nurse in the emergency department at St. Elizabeth’s Medical Center, is worried about running out of masks and gowns. “We will go to work no matter what,” she said. “I just wish that I knew that I was always going to be protected.”

MacInnis is so concerned about contracting coronavirus that she’s stopped seeing her children and grandchildren.

Nurses at Brigham and Women’s have been preparing for the grave possibility that the hospital depletes its stores by purchasing supplies themselves and scouring the Internet for donations.

“I think the nurses at the Brigham have bought out the Home Depots, the Lowe’s, the mom-and-pop stores throughout the state,” said Trish Powers, head of the nurses union at the hospital. Brigham officials said they’ll inspect the donated supplies before distributing them to staff.

“We have to hope that we’re going to have enough,” Powers told reporters this week. “I don’t know if we will. I hope and pray that it doesn’t come to that.”

Claire O’Connell, a recovery room nurse at the Brigham, appealed for supplies on Facebook over the weekend, and now her living room has become a warehouse for hundreds of goggles, face shields, gloves, bottles of bleach, sanitary wipes, surgical masks, and special N95 respirator masks that people have donated or that nurses have purchased with cash gifts or union dues.

N95 respirators are more protective than surgical masks because they block 95 percent of particles when worn correctly.

O’Connell was shopping for her mother in a Market Basket this week when she got a call from one woman who offered to call schools and ask science teachers to donate goggles. Someone else left two boxes of N95 masks on her doorstep. A dental office worker donated leftover masks. “The hospital is in a pinch,” O’Connell said. “We have gone up to the floors and handed out stuff and said to nurses, ‘Hold on to these.’”

Even before they started seeing large numbers of suspected COVID-19 patients, big Boston-area hospitals told doctors and nurses to start reusing equipment that they would normally discard after a single use, including face masks. At Mass. General, workers have been told to wear their masks throughout their shifts, or to store them in bags between patient visits, and throw them away only when soiled.

Mass. General is also urging staff to use surgical masks instead of the N95 masks when possible — in accordance with recently loosened federal guidelines — and to clean and reuse face masks and goggles.

“Obviously, we would prefer not to have to do this,” said Dr. David Hooper, chief of infection control at Mass. General, “but we need to protect the supplies we have ― because no protection would be even more problematic.”

The slow turnaround of test results is worsening the problem. While hospitals are admitting many patients suspected of being infected with the coronavirus, they may have to wait days before learning whether a patient tests positive. In the meantime, health care workers must act as if the patient has the virus ― using up protective gear.

Dr. Ravin Davidoff, chief medical officer at Boston Medical Center, said the hospital is ordering welder shields from Amazon to bolster supplies. The lack of surgical masks and N95 masks is the hospital’s biggest concern now, along with testing delays. Because the state was not able to test quickly last week, the hospital mailed swabs to a company in Utah, and results are taking three to seven days.

Personal protective equipment includes gloves, gowns, masks, and eye protection that health care workers use to guard against infection from coronavirus, which is transmitted through droplets from a sick person’s coughs and sneezes.

Hospitals have been able to conserve protective equipment by canceling elective surgeries. They’re also limiting the number of people who enter a contagious patient’s room and reducing the number of face-to-face encounters. Care providers at Mass. General, for example, are video-conferencing with some patients so they can communicate without having to enter the patient’s room.

But these measures aren’t enough; hospitals also need fresh supplies. They’re ordering equipment from their suppliers, but they don’t know when to expect deliveries. They’re also seeking help from state and federal stockpiles.

State health officials said they received 73,000 pieces of equipment from the national stockpile last week — just 10 percent of what they requested. A portion went to Berkshire Medical Center. State officials said they’re requesting and expect more supplies from the federal government, and will distribute them based on need.

In a conference call with President Trump, meanwhile, Governor Charlie Baker told the president that Massachusetts tried to obtain medical equipment from suppliers, but lost out to the federal government "on three big orders,'' according to ABC News.

“I got a feeling that if somebody has a chance to sell to you or to sell to me,” Baker said, “that I’m going to lose every one of those.”