WASHINGTON — Since the coronavirus pandemic hit, Mirah Ippolito has been pulling double duty. By day she submits grants for Johns Hopkins University. At night she makes DIY face shields in a Baltimore warehouse so the university’s hospital workers don’t contract COVID-19.
Hopkins has been soliciting volunteers with the goal of producing tens of thousands of these shields for their five Baltimore-area hospitals. Ippolito and a few dozen helpers at a time toil in a makeshift assembly line hot-gluing thin strips of Amazon-bought foam to rectangular pieces of plexiglass, then fastening elastic bands to each side with an office stapler.
“It was wild. It felt like I was in a third-world country fabricating protective equipment for Ebola. I mean, this is incredibly rudimentary equipment,” she said. “I never thought I would be living in a world where I would work for one of the best medical schools in the country and I would be literally in an empty warehouse, in like, the industrial park wasteland in Baltimore, making equipment because people cannot get their shit together.”
One man could change this. Calls have been increasing for President Donald Trump to invoke the Defense Production Act, a Korean War-era law that could force private companies to manufacture supplies for hospitals.
But so far, he’s shown an ideological unwillingness to use the heavy hand of the federal government, and has been convinced by industry to let businesses sort it out on their own. On Tuesday, FEMA administrator Peter Gaynor announced the administration used the act to move 60,000 coronavirus test kits from one place to another. But Trump won’t yet use it to ramp up production because, as he put it during a Sunday press conference, “We’re a country not based on nationalizing our business.”
“The government response has been absolutely shameful,” Ippolito said. “This is stuff that should be done by machines in a factory. Instead, we are making this stuff.”
The Hopkins system is one of hundreds of others across almost every state in the country leaning on thousands of volunteers to make personal protective equipment, or PPE, for their hospital workers.
Hospitals in New York City and other epicenters of outbreak are already overwhelmed. For hospitals outside of the hot zones, it’s like watching a train wreck coming in slow motion.
Even though Maryland has only identified 350 cases of COVID-19, the number is expected to spike. It has doubled since only last week, with 61 more cases reported just on Tuesday.
A perfect storm of a rapid onset of the virus, a slow national response, rising demand, equipment hoarding and price gouging has led to nationwide shortages of gloves, masks and face shields, not to mention more complicated equipment like respirators. States are competing against each other and against the federal government to buy increasingly expensive basic equipment.
And it’s not just hospitals. The Wisconsin National Guard has said it’s running short of supplies, too.
The shortages have also led to terrifyingly lax protocols at hospitals. At Hopkins, for instance, nurses are being advised to “clean, store and reuse” masks and shields, according to an email sent to staff by hospital leadership, obtained by VICE News.
Only since the coronavirus hit did the CDC and WHO relax their guidelines for reuse of some equipment. Now, in some cases, nurses are facing consequences if they don’t comply. The Oregon State Board of Nursing, for instance, released a statement threatening to punish nurses if they refuse to work in hazardous conditions.
“Nurses are reminded of their social contract with the people of Oregon to care for them at their time of vulnerability,” according to the letter, obtained by VICE News. “The Board has determined that nurses cannot refuse a patient care assignment.”
That comes as reports roll in from other countries whose outbreaks preceded the United States about health care workers falling ill by the thousands. More than 8 percent of all novel coronavirus cases in Italy are healthcare workers.
A patchwork national network of volunteers has jumped in to fill the gap created by federal and corporate inaction. Ethan Garner, a medical researcher at Harvard University, is among a group who created a spreadsheet asking which hospitals need help. It went viral and has now migrated to a website — getusppe.org — to connect volunteers to places that need protective equipment. As of Wednesday, almost 600 hospitals have asked for help.
“We're doing this because we're unprepared for this pandemic. We're doing this in desperation,” he said.
But the network is not an optimal solution, especially as more states institute stay-at-home orders and talk of city or state lockdowns abound. Why should volunteers be expected to put themselves in harms way if there’s a safer and quicker way to produce this equipment? The American Medical Association, for one, has called on Trump to invoke the Defense Production Act to centralize a response.
The desperation is clear. The viral Twitter hashtag #getmePPE and others like it have been trending. In Utah, an oncologist named Mark Lewis posted a tweet-by-tweet instructional thread showing how to sew masks using at-home materials. It went viral, too.
“There’s going to potentially be a massive spike in patients coming in who are infectious,” Lewis said. “If we don’t protect healthcare workers — doctors, nurses, respiratory therapists — and we get sick, we have a workforce problem that snowballs.”
That could lead to a cycle of shortages that could last for months to come. Even the Providence Hospital system in Washington State, where the first known case of coronavirus in the United States was treated months ago, is still struggling to keep up with the demand for personal protective equipment.
They asked the community to step in to help by starting a 100 million mask challenge. Now they send sterile surgical wrap to a furniture factory an hour north of Seattle. On Saturday, the factory churned out 4,000 masks, said hospital spokeswoman Melissa Tizon. But she estimates they would need about 10 million at a minimum to get the 51 hospitals in their system, including eight in the Seattle area, through the pandemic.
“Normally in a three month period for 51 hospitals, we would go through 250,000 masks. Just for one hospital in three months, we've gone through 250,000 masks,” Tizon said. “We've been lucky because shipments always come in just in the nick of time but you just never know when they're going to come in, and there's never enough.”
Emma Ockerman and Alex Lubben contributed.
Cover: Volunteers work in a factory making face shields to be used by health care workers in the Johns Hopkins University Hospital system. (Photo: Mirah Ippolito)