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The prognosis is grim. “We're all anticipating that the situation is going to get worse,” says Elissa Schechter-Perkins, an emergency room physician at Boston Medical Center. As the coronavirus spreads across the United States, health care workers are reckoning with how to protect themselves while helping Covid-19 patients in increasingly harrowing circumstances. Access to personal protective equipment (PPE) is severely limited in many parts of the country, testing remains inadequate, and the likelihood of shortages of everything from masks to ventilators to hospital beds has left many workers stressed out, angry, and, in some cases, resigned to endure bedlam.
“Ideally, we would be wearing full PPE for all patients that we're seeing in the emergency department,” Schechter-Perkins says. Yet, in many cases, they are not. She has witnessed patients come in for unrelated reasons only to later show signs of infection, after they’d already been looked after by hospital staff. “Some of them have gone on to become confirmed cases of Covid-19.” Because the nurses and doctors attending to these patients didn’t immediately categorize them as coronavirus cases, she says colleagues wound up “completely unprotected.”
“We have known, kind of from the beginning, that there is not a sufficient supply of PPE and there's not a confirmed supply chain for getting more anytime soon,” Schechter-Perkins says. “So right from the beginning, we have been placed in really difficult circumstances in which we need to ration our PPE in ways that are potentially quite unsafe.”
Across the country in Los Angeles, an emergency room physician is aghast at the equipment limitations he and his fellow health care workers face. (The doctor asked that his name not be used.) When asked what’s on short supply, he rattles off a list: masks, goggles, face shields, copper equipment, gloves—and disinfectant wipes. “We’re using diluted bleach and a spray can instead,” he says. “Not as effective.” All of this adds up to a hospital staff that is especially vulnerable amid a pandemic. Increasingly, this is the norm at hospitals in cities with surging Covid-19 outbreaks. In California, most ER physicians are classified as independent contractors. This can impact what kind of equipment they have ready access to. The ER doctor says one of the companies contracting him offered a stipend of $250 for personal protective equipment rather than obtaining it for the medical staff. “I went out and bought my own goggles on eBay.”
Even when the correct protective gear is provided, it is often in short supply. Schechter-Perkins is one of several doctors and nurses who told WIRED they’re reusing N95 masks, which are thick, particle-filtering face coverings designed for single use. “We are storing them in paper bags in between patients,” she says. “Then, at the end of the shift, we are storing them in paper bags so that we can use them the next day.”
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