It’s getting ugly on the front lines of the battle against the coronavirus.
Medscape Medical News reports the growing shortage of personal protective equipment (PPE), principally masks, is pitting healthcare providers against their employers, management and administrators.
With supplies dwindling, some hospitals and facilities are attempting to severely curtail the use of the masks. Practitioners are being told they may face disciplinary action or even firing if they continue to use gloves, masks, or other gear – even if they bring it in from home.
Hospitals are coming up with a variety of reasons for the action, from the rational — the equipment needs to be conserved — to what seems frankly ludicrous — it scares patients.
Medscape says at one hospital in California, staff were told they could be fired for wearing their own industry-standard N95 mask brought from home. When a nurse asked to see the written policy and administrator told her if she was going to wear her on mask, she needed a note from her doctor.
In the Chicago area, one clinician wearing a heavy-duty P100 mask said he was told by the infection control nurse "You cannot wear this mask in the hallways, you're scaring people.” He said other members of staff who were working unprotected ridiculed him.
An emergency physician in Maryland said his hospital had warned physicians not to walk around with masks or other PPE. When he was spotted by an administrator wearing a surgical mask on the ward, he was told he wasn’t “setting a good example for other staff members," and "it was important during this time to not scare patients."
The situation has ignited discussion on social media among healthcare professionals with one doctor tweeting: I’m tired of hearing stories of docs and nurses getting reprimanded by the “suits” for wearing a freakin surg mask when they are on the unit because it “looks bad”. Do you know how many HCP are admitted in the US? Are you on the wards? I say F that. Protect yourselves.
I’m tired of hearing stories of docs and nurses getting reprimanded by the “suits” for jwearing a freakin surg mask when they are on the unit because it “looks bad”. Do you know how many HCP are admitted in the US? Are you on the wards? I say F that. Protect yourselves. #COVID19— Ali Haider MD (@yourheartdoc1) March 24, 2020
Adding to the CF-ness of this whole situation is the conflicting guidance from the Centers for Disease Control (CDC) regarding masks in general, which includes a recommendation that healthcare providers "might use homemade masks (such as a bandana or scarf) for care of patients with COVID-19 as a last resort.”
But the CDC also acknowledges in the same statement that those ad hoc materials are not considered PPE, since their ability to protect healthcare providers is unknown.
However, as we reported here, the ability of the industry-standard N95 mask to protect healthcare providers is also unknown. Incredibly, the N95 has not been clinically tested against the coronavirus.
The issue is that N95 respirator masks are able to filter out most airborne particles down to 0.3 microns in diameter, but coronavirus particles are even smaller.
According to researchers, the smallest coronavirus particles measure between 0.06 and 0.14 microns, meaning the N95 mask doesn’t necessarily provide complete protection.
But any protection is better than no protection. And the last people who should be worrying about their own safety are those risking their lives to protect us.