With Low Supplies, DIY Medical Gear Is On The Rise

IRA FLATOW: This is science Friday. I’m Ira Flatow. Do to COVID-19, hospitals across the country are running low on PPE. You know them as personal protective equipment. This includes the masks, the gowns, and those little booties that covers shoes. PPE is important because it’s the first line of defense health care workers have between themselves and potentially sick patients. Currently, Missouri has reported over 1,300 cases of COVID-19. Barnes Jewish Hospital in St. Louis. The largest hospital in Missouri, is anticipating a tsunami of cases to arrive in the next few weeks. And to get ready, it is watching and taking lessons from the experiences of hospitals in Coronavirus hotspots like New York City.

Joining me today to talk about how his hospital is are preparing for a PPE shortage is Rob Poirier, Clinical Chief of Emergency Medicine at Barnes Jewish Hospital, and the WashU School of medicine in St. Louis, Missouri.

ROB POIRIER: Welcome to Science Friday, Rob.

IRA FLATOW: Thank you, Ira. Give us the status of Coronavirus in your region.

ROB POIRIER: Sure. So each day, we’re beginning to see more patients with COVID-19 showing up in our emergency department. Currently, we’re seeing about 40 to 60 patients a day. This is kind of a little bit of the lull before the storm. We see what’s happening on the coast. Of course, we’re very concerned. But it is giving us some time, crucial time, to prep and get ready, and make sure we can do the best job we can for our community.

IRA FLATOW: And that’s what I wanted to ask you about. How do you actually prep? You see this storm on the horizon. You see it coming. What does the hospital do?

ROB POIRIER: So it’s really getting out the education, and also making sure our staff feel comfortable working in the emergency department. And a big part of that is making sure they feel comfortable with the PPE, or the personal protective equipment, that they’re given. Because that PPE not only protects us as health care workers– and we don’t want many getting sick– it also protects our families, , our colleagues and our co-workers, and definitely protects the patients. So – how do you make sure you’re going to get enough of it? I mean, what are you doing for that?

ROB POIRIER: Yeah, that’s the biggest concern. And we have a lot of PPE on order. And most hospitals purchase through what are called GPOs, or group purchasing organizations. And they’ve run out. A lot of their supply that they get from the major national wholesalers and companies from in the US and around the world, a lot of those supplies are now being diverted to the coasts and where the breakouts are. And so our orders are going unfilled at the moment.

IRA FLATOW: So what do you do to make up for that? I mean, do you have to recycle? Are you planning on recycling some of the PPE that you have?

ROB POIRIER: We do. So we have to conserve and reuse PPE. We are following the CDC guidelines, which are different than what we normally follow, because this is a pandemic, and with the shortages of the PPE. So we’re now learning how to reuse the PPEs.

So for example, the N95 mask, we have to reuse that mask until it gets soiled, until it’s no longer functioning well– we don’t get a good seal with it.

IRA FLATOW: What is visibly soiled mean? What does it look like?

ROB POIRIER: So that we’ll start seeing, maybe there’ll be blood on it. If there’s mucus on it, if somebody coughed and sneezed on us, and mucus came out. So we have to use the device until we see that it’s visibly soiled. We know that if we changed this PPE out between every single patient, with the number of patients we’re seeing the number of staff we have working, we would quickly run out of the supplies in probably a couple of days. By conservation, strategies, and reuse, strategies, we can extend the equipment we have for several more days, until we get a re-shipment or new supply comes in.

IRA FLATOW: Speaking of a new supply, is your hospital accepting homemade masks?

ROB POIRIER: We are accepting donations from both industry and public, and the public. We are accepting homemade masks. But those cannot be used as our primary protection for PPE. We’re still mandated to use the PPE that’s certified and approved by the CDC and FDA. But we always want to have a backup. If, for some reason, we run out if all the hospital supplies, we would definitely use the homemade supplies if it came to that.

IRA FLATOW: What is the morale at the hospital like? Is it like on a war footing? You can hear the guns in the distance, and you’re waiting for it to attack?

ROB POIRIER: Yes, we are banding together. In the emergency department, we face crisis every day, every shift. So we’re used to working in high performing teams, under a lot of stress and pressure. We are doing the best we can to keep morale up with all the staff members. You need to make sure that you give them the confidence that they can do their job safely and appropriately as well.

IRA FLATOW: I know that hospitals watch the goings on of other hospitals, and how other hotspots have handled this crisis. What have you learned? What do you watch it, let’s say New York, or Detroit, or other hotspots? What does your hospital’s staff, and what do you learn, about how to deal best with this? What are the lessons there?

ROB POIRIER: I think we’re learning that cohorting some of the patients is more helpful. So COVID and COVID related patients, trying to put them– if you’re in a– working in a large emergency department, putting them in certain parts of the emergency department, making sure the staff in that area– the emergency department– have all the supplies they need, and the supplies are close by for when emergencies come in. We’re learning how to better handle what we call aerosolizing procedures. These are procedures where the virus can be aerosolized or put in very fine particles in the air. And we’re working on using different equipment, and using different techniques, when we have to intubate patients, or put airway tubes into their lungs. That’s a point in time where we could get infected easily.

And so learning various techniques, how to manage the high volumes that we’re seeing is helpful as well.

IRA FLATOW: Well we wish you, you and your staff, all the safety you can have, and all the contributions you can get. And we’ll be checking in with you later on. How about that, see how things are going?

ROB POIRIER: Excellent. Thank you for having me on. And one last thing I wanted to mention– we are crowdsourcing face shields from local 3D printers. So I think there are some innovations out there that the public can help us with. Those do have to be approved by our COVID command center. But being able to crowdsource face shields from our– that we can use in health care– from our local 3D printers is very innovative, and is going to help us as we conserve and reuse our PPE.

IRA FLATOW: Thank you for joining us, Dr. Poirier.

ROB POIRIER: Thank you.

IRA FLATOW: Rob Poirier is Clinical Chief of Emergency Medicine at Barnes Jewish Hospital and the Washington University School of Medicine in St. Louis.

Some hospitals like Barnes Jewish are turning to homemade cloth masks to fill their PPE shortages. Cloth masks are usually only advised as a last resort for health care workers. But an increasing number of hospitals are seeking them out. A homegrown effort called the Million masks challenge has sprung up amidst this crisis. Volunteers are pulling out their sewing machines and extra fabric to make masks that are sent to health care providers. A website has launched to connect crafters and hospitals across the country that are asking for homemade face masks.

Here with us now to talk about it is Jessica Choi, founder of GetPPE.org. Welcome, Jessica.

JESSICA CHOI: Hi, thank you for having me.

IRA FLATOW: Now your organization helps hospitals find PPE they need. There are a lot of hospitals on your website asking for PPE right now, correct?

JESSICA CHOI: That’s right. We actually have close to 500 hospitals that are going to be on our website. And they have requested for PPE, as well as handmaids items, such as masks.

IRA FLATOW: Wow, and so volunteers make this stuff?

JESSICA CHOI: Actually, we have a very large pool of volunteers. So we have about 25,000 volunteers right now across the US. And they are helping. They’re coming together, and we’re mobilizing them to help all these hospitals and facilities in all right now.

IRA FLATOW: And you find there is a big need.

JESSICA CHOI: There is. We’ve seen that a lot of hospitals, when they initially came to our site, they were requesting for PPE, traditional PPE. But over time, and even in the last week or so, we’ve started to see more and more hospitals open up to the idea of accepting these homemade masks. And a lot of health systems have also publicly announced that they are calling on volunteers to come and support them.

IRA FLATOW: And what does the CDC say about these cloth masks? Do they think it’s a good idea?

JESSICA CHOI: The CDC actually said that in cases in which traditional PPE is not available, that health care providers can actually use homemade masks. And in times, they’ve also recommended that these professionals can use bandannas, or even scarves.

IRA FLATOW: And this is a re-evaluation of their former stance?

JESSICA CHOI: That’s right.

IRA FLATOW: Let’s say I have a sewing machine, and I have some extra cloth. I want to make a mask, or a bunch of them. How do I get the pattern to make one, and then get, use PPE.org to make sure that they get into the right places?

JESSICA CHOI: That’s right. So on our site, we have all the information you’ll need– Information about patterns that are accepted at different hospitals. And please note that a lot of different hospitals are requesting specific patterns. So it’s not that there is one pattern that’s universally used by all the hospitals. So we’ve seen about, a good number of five or six different patterns that are floating out there that hospitals are specifically requesting for.

So our website details all that information. I also has general FAQs, tips and tricks, as well as all the locations are accepting these handmade masks. We also will have this feature to match volunteers to different hospitals in need. And so you can you’ll be able to choose whether you want to be matched to a hospital in your local region or a hospital in the hardest hit area.

IRA FLATOW: Are things like sewing circles in the old days? People get together in a circle and start sewing, but they’re doing it in different places?

JESSICA CHOI: Yes, we’ve seen these groups come up all over the US. And we have groups that are smaller. But we also have big groups like city-wide. Altogether, we have about 25,000 volunteers that are part of our network right now.

IRA FLATOW: Are there certain fabrics that we should be looking out for to use?

JESSICA CHOI: So our group generally advises us to use 100% cotton. And that’s to ensure that the fabric is able to allow for it to have good breathing.

IRA FLATOW: Do the hospitals generally know that your organization exists?

JESSICA CHOI: Yes, so we have different organizations that we’ve reached out to and are working. We also have different cities that have reached out. And we are actually working on how we can partner to spread the message to bring more volunteers, as well as to have a comprehensive database of all these different facilities and hospitals that are in need.

IRA FLATOW: So tell us, if I’m a hospital, and I’m listening, how do I get your help?

JESSICA CHOI: So please visit our site, GetPPE.org. And on there, you can fill in a request form. You can also email us. And then we, on a regular basis, are adding to our list of facilities that are accepting PPE. We are also making sure– once you fill out that form, we will contact you back to make sure that these are verified requests.

And from then, we will redirect a lot of our volunteers to these different facilities.

IRA FLATOW: This is Science Friday from WNYC Studios. I understand that GetPPE.org is a partner in the Million Mask Challenge. Tell me about that. What is that?

JESSICA CHOI: The Million Mark Challenge is a global sew-athon. And our goal is to hit one million masts across all different countries. And right now, we’re assembling lots of volunteers to join us in that effort.

IRA FLATOW: Is there a way to keep track of when you get to half million, 3/4 million, a million?

JESSICA CHOI: Yes, so on our site, we have this tallying system where different groups can come and tell us the progress that they have made. And this will help us keep track of which hospitals still need more supply, as well as highlight areas where we need more volunteers to focus on.

IRA FLATOW: What kind of responses have you gotten so far from the health care workers?

JESSICA CHOI: We’ve gotten very positive response from them. I was just on the call today where I had told this lady that we have fabric masks for her. And she started crying. Because she had reached out telling us how in desperate need they were for any supply. And now that I was able to contact her, she was so grateful. And I think that’s the story that we’re hearing across the nation, across different countries, where all these volunteers are coming together and helping the local community– even areas that they’re not part of.

IRA FLATOW: Wow, what a story. This is a lot of coordination for a small group of volunteers. Do you think this is something that the federal government should be handling on a larger scale? Shouldn’t the federal government be giving you a hand in something like this?

JESSICA CHOI: One of things that we’d really like for the federal government to help on is if they were to look at all these different patterns that are floating around, if they were to give us more guidance on which one we should all focus on, we’d be a lot more efficient. But what we see now is, we have all these facilities. We have about 500 facilities right now. Each of them are giving us a different pattern that volunteers are supposed to sew. And that causes a lot of confusion. But also, it slows down the process, right? Because we have a lot of volunteers who are willing to help. But just sorting out all these instructions become a bit of an issue.

IRA FLATOW: That’s it. The preparation time could just kill your will.

JESSICA CHOI: Yeah. And so, what we’re trying to do on the site, though, is provide a lot of guidance on that standpoint. Because we’re at we’re able to highlight all the different patterns that are needed, and specific instructions. We also have all these Facebook groups at the national level, as well as regional levels, that are able to give more guidance to volunteers who are willing to sew and help out.

IRA FLATOW: Now I know that GetPPE.org also shares information about blood drives happening across the US. How does blood fit into the Coronavirus crisis?

JESSICA CHOI: So what we’re seeing is that because a lot of people are staying at home, they’re not able to go and donate blood, or they’re not visiting different blood drives that originally were set up. And so what we know is that we’ve had thousands of blood drives that have been canceled. There is a big shortage of blood right now.

And so what listeners can do, they can actually go schedule to do a blood donation. So we have more information on our site as well for that.

IRA FLATOW: So you can feel safe. It will be done, absolutely as safe as you can make it.

JESSICA CHOI: That’s right. And a lot of these facilities are aware of the concerns that people may have. And so they’re doing their part to keep everyone safe.

IRA FLATOW: You know, that’s one of the unintended consequences. Who would have thought, now that I think about it? Yeah, there’s going to be a blood shortage. Because people are in their homes. They’re not leaving.

JESSICA CHOI: Yeah. Yeah.

IRA FLATOW: Well, good for you. Thank you very much for taking time for us. Give us, one more time, the website that we can all visit?

JESSICA CHOI: It’s GetPPE.org. And please come and join our effort to helping all the community health providers out there.

IRA FLATOW: I hope we’ve done our little part for you, Jessica. Thank you for doing what you do, and taking time to tell everybody else about it.

JESSICA CHOI: Thank you so much.

IRA FLATOW: Jessica Choi is the founder of GetPPE.org. And if you want a tutorial on how to make a mask, you can go to millionmaskchallenge.com/information. And also, GetPPE.org will help you out with only for your pattern questions.

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