By Sarah Ovaska with Rose Hoban
The national shortage of personal protective equipment is showing itself in North Carolina, with hospital systems in the state already asking for public donations of gloves and masks.
WakeMed Raleigh and the 11-hospital UNC Health system issued a joint call Sunday afternoon for donations of N95 respirator masks, surgical masks with and without face shields, and nasal swabs. Also needed were items such as disinfectant, disposable gloves and gowns, and hand sanitizer. Later in the day, New Hanover Regional Medical Center in Wilmington made a similar request.
UNC is even accepting handmade masks out of tightly-woven cotton.
“At this critical time, we are calling on our community to donate supplies that will help ensure we can continue to protect our patients, providers, and staff,” said Dr. Wesley Burks, CEO of UNC Health, in a statement. “This situation is unprecedented, and we are asking for extra help.”
Duke Health, with its main hospital in Durham, said its supplies are adequate for now but anticipate their needs will grow as the virus spreads in the state, according to a statement from Duke Health officials. Duke is also asking the public to drop off N95 respirators, surgical and looped masks, and unopened boxes of gloves. [See box below for drop-off locations.]
The Triangle has seen some of the biggest COVID-19 clusters thus far in the state, with 49 confirmed cases in Wake County and at least 40 in Durham. North Carolina has 255 positive COVID-19 cases so far, and at least four hospitalizations, numbers state health officials say they expect to rapidly rise as the virus’ reach expands.
Wake County also on Sunday announced that barbershops and hair and nails salons could no longer operate in light of the pandemic. Also closed were parks and playgrounds other than greenways and hiking trails, and county health officials suggested businesses take the temperature of employees and entering customers.
Why supplies are needed
Coronavirus, or COVID-19, is a new pathogen that first appeared in humans in Wuhan, China late last year. Since then, the highly contagious virus, which can be passed on to others before an infected person even shows symptoms, has killed nearly 13,000 worldwide, according to the World Health Organization. In the United States, the CDC reports more than 200 deaths so far.
Patients with the virus can quickly overload a health care system, with severe cases in need of ventilators and other life-saving equipment. Doctors in Italy have had to make choices of which gravely ill patient to treat while in U.S. epicenters such as Seattle and New York City, doctors and nurses have reported having to ration supplies. Here in North Carolina, Cone Health shut down a drive-up COVID-19 testing site because of worries it would drain the PPE supply.
Meanwhile, the country is dealing with a lack of personal protective equipment as the virus grows.
The lack of N95 respirators marks is of specific concern. The masks used by construction workers and laborers to avoid taking in dangerous or toxic fumes are capable of screening out most particles, limiting exposure to COVID-19.
President Donald Trump on Sunday that Honeywell would be ramping up production of N95 respirator masks and they would be distributed by the federal government. Meanwhile, personal protective equipment was sent by federal authorities to the hard-hit states of California, Washington and New York, and more equipment was promised to other states.
The Gastonia-based Parkdale Mills is working with Hanes, Fruit of the Loom and others to begin manufacturing masks on Monday, with the first shipment going out midweek, according to the National Council of Textile Organizations. They expect to produce up to 10 million masks a week, once the process is fully ramped up four to five weeks from now.
Health care personnel need to be fitted annually for the masks, said M. Bradley Drummond, an assistant professor of pulmonology and critical care medicine at UNC Chapel Hill who works in the ICU at the hospital in Chapel Hill.
“There’s different shapes and we all have different facial structure,” he said. Males cannot wear a beard and effectively use the N95 masks, either.
“I’ve got at least three colleagues who I’ve known for many years, always bearded, who have shaved their beards for the first time this week,” Drummond said.
Some can’t use an N95 mask at all, and those people use something called a powered air purifying respirator, or PAPR.
“It’s more of a mask that blows air around you. It’s got a little hip fanny pack that pulls air in, filters it and then blows it through into a plastic helmet almost, to circulate clean air,” he explained.
Much like the masks and N95 respirators, they’re in short supply,” said David Weber, who heads the infection prevention program at UNC Health. “There are disposable components of the PAPR, that is, part of the face shield and the shrouding are disposable.
“Those are also in short supply but at the moment we do have available supplies for our PAPRs,” he said.
Usually, N95 masks would be used once or twice and then discarded, while the PAPR can be used all day. But Drummond said that when the tide of patients arrives at UNC, they’ll all be placed in single units, which will allow practitioners like him to move from room to room, using the same mask without the risk of cross-contamination
Into battle without armor
The CDC, up until March 10, had called for N95 masks, at least, to be used to treat COVID-19 patients. The federal health service relaxed its recommendations and now concedes, when no masks are available, that health care workers use face shields or even handmade masks out of scarves or bandannas for protection.
Groups such as the American Nurses Association blasted the CDC’s relaxed stance, questioning if the overhauled recommendations had more to do with the supply chain challenges than actual science.
“We are concerned that CDC recommendations are based solely on supply chain and manufacturing challenges,” the ANA said in a statement. “Rationale for changes of this magnitude should be based on evidence that reflects a better understanding of the transmission of COVID-19.”
“At the end of the day all of this hinges on access to effective and available PPE, and you know without that the whole system falls apart,” Drummond said. “That’s why you see so many calls for donations and looking to shift manufacturing because it’s true as you’ve heard, without PPE we’re going into battle without our armor.”
Triangle area hospitals are asking for donations of masks (N95, surgical); disinfectant, safety goggles, disposable gloves and gowns, hand soap and sanitizer greater than 60 percent alcohol), and shoe covers.
- WakeMed in Raleigh asks donors to email email@example.com for information about how to donate. They are only accepting new, unopened packages of supplies and are not accepting handmade items. More information here.
- Duke Health needs N95 masks, surgical and looped masks, and unopened boxes of gloves in particular. Donation site is at 100 Golden Drive in Durham and will be open Monday through Friday from 8:30 a.m. to 4:30 p.m.
- UNC Health will have the following locations open for donations. More information here.
o UNC Health Learning Street, 2001 Carrington Mill Blvd., Morrisville. (Open from 12 to 4 p.m. Monday, after that open from 9 a.m. to 4 p.m. through Friday)
o UNC Wellness Center at Meadowmont, 100 Sprunt St., Chapel Hill (Open from 8 a.m. to 5 p.m. Monday through Saturday)
o UNC Wellness Center at Northwest Cary, 350 Stonecroft Lane in Cary (Open from 8 a.m. to 5 p.m. Monday through Saturday)
o Rex Wellness Center of Raleigh, 4200 Lake Boone Trail in Raleigh (Open from 9 a.m. to 4 p.m. Monday through Friday)
In Wilmington, donations can be dropped off:
- NHRMC Business Center 3151 S. 17th Street, Wilmington (Starting Monday, March 23, 10 a.m. to 5 p.m.)