In the war against COVID-19, U.S. hospitals have become the trenches and our health care workers are on the front lines. All physicians take an oath, and we embrace our duty to care for the sick, but we and the rest of our nation’s health care workers are unable to do so safely, given the government’s lack of preparation and support.
This is not the first pandemic to threaten the United States in the 21st century. SARS, MERS, H1N1, and Ebola all provoked rapid mobilization to combat their threats. But this pandemic has exposed irresponsible planning and a lack of foresight by state and national governments.
The Strategic National Stockpile of equipment and medications was created to respond to events such as this, but it is turning out to be embarrassingly insufficient. To highlight this, our stockpile contains 17 million N95 masks, about 5 million of which are expired. We need 500 million masks. These have been ordered but may not arrive for 18 months. We are rationing equipment to a dangerous level, and reusing equipment beyond its intended shelf life, placing health care workers and patients at risk.
The most recent recommendations from the Centers for Disease Control and Prevention (CDC) give guidance for what we should do in the absence of required personal protective equipment, which describes the current situation at many large hospitals. Forget specialized masks, respirators and hazmat suits. We should use scarves and bandanas, as a last resort, to protect ourselves from a known aerosolized virus. Private organizations picked up on this and published templates so that our nation’s hobbyist sewers can make these for hospitals. Most cotton fabric will filter out only 3 percent of virus-sized particles, making this recommendation akin to wearing nothing at all. It is as if our government has condoned sending our front lines into battle without helmets or bullet-proof vests.
Our federal leadership knew that we were in for a medical and economic catastrophe. The CDC clearly recognized COVID-19 as a threat by Jan. 24, when our first domestically-produced screening test was developed. That test later was found to be defective. By mid-February, the Senate Intelligence Committee began holding daily briefings on the severity of the expected impact from COVID-19. But our government acted too slowly. We did not take meaningful steps to try to contain the outbreak until Feb. 29, the date of the first reported death in the U.S.
We should have been ringing the alarm bell and preparing our armory. COVID-19 exposure in health care facilities is an inevitable reality — and we cannot adequately shield our workers, let alone our patients.
Government officials must prove that they care about supporting the front lines of this pandemic and get health care workers the protective equipment that our jobs demand. In Italy, more than 3,600 health care workers have tested positive. If that happens in the U.S., we will lose the ability to staff our hospitals. Our health care workers are an irreplaceable resource that is in short supply. If we get sick, we can’t help anyone.
It is too late to be proactive. We can only hope to mitigate the catastrophe. Our doctors and nurses and other hospital workers are getting COVID-19. Many likely will die; some already have. We can minimize that number by prioritizing the provision of protective equipment.
We must ensure that this never happens again. Our state governments must establish their own central supply for protective equipment and entrust it to our states’ National Guard units. Our federal government must recognize that our inability to domestically produce personal protective equipment is a failure of national security. The elected officials who neglected their duty to the public should resign.
If we are going to fight this war effectively, we need to start by providing our health care workers the protective equipment that this pandemic demands. In the meantime, we will continue on with the faith that our nation can rise to the occasion.
John Guzzi is a physician at Yale New Haven Hospital, working in the Emergency Department and Intensive Care Unit. Follow him on Twitter at @GuzziMD. The views expressed here are his alone and do not reflect those of the institution.