Protective gear shortages coming

Supplies of masks, gloves and respirators are running extremely thin in Lorain County, with weeks or months still to go before the coronavirus crisis ends. Protective gear crucial to keeping doctors, nurses, paramedics, police and firefighters healthy will have to be rationed and reused, according to Tom Kelley, director of the Lorain County Emergency Management Agency. "The issues we had with 9/11 are small compared to what we have with this," he said Thursday. Kelley wouldn't say how much protective gear was on hand. He said he's not panicking, but it is clear the equipment won't be enough to last the duration of the pandemic. Lorain County already received one shipment from the Strategic National Stockpile, a federal supply cache held ready against a widespread threat. "It will be something for a week or two, and then we'll see what we get," Kelley said. Another shipment is expected Friday, but it probably will be only be half as large as the last one, he said. The hard part, he said, is deciding who will get what supplies. The stockpile shipments are being divvied up by representatives from local police and fire departments, ambulance districts, hospitals, Lorain County Public Health and senior care facilities. Some personal protective equipment — often referred to as PPE — has been handed over by dentists and veterinarians to bolster supplies, Kelley said. But filling the needs remains challenging. Police officers and firefighters usually need large and extra large gloves, for example — "We have some big guys out there," Kelley said — but those sizes are in short supply. "We have thousands of small and extra small. We have a lot that was donated, but we can't use a lot of it," he said. That leaves the question of whether cloth-sewn masks can be used. Kelley was emphatic that cloth masks aren't effective, but he said it will be up to the hospital systems to decide whether they're put into use. A study conducted after the 2009 swine flu outbreak found cloth masks have significantly higher infection rates than surgical masks. In tests with more than 1,600 health care workers, it found penetration of cloth masks by particles was almost 97 percent, compared with 44 percent in medical masks. Kelley said emergency management workers have been averaging 16- to 18-hour days since the coronavirus crisis began. He said the work has been hard, but it has resulted in good communication between elected officials, first responders and medical facilities. State officials also have been open, sharing daily briefings and being honest about supply shortages. "At least it's not hearsay. They tell us what the issues are with the PPE," Kelley said. The state's unprecedented stay at home order, meant to contain the spread of the disease, have bought hospitals significant time to prepare for a surge in cases and hospitalizations, according to Dr. Amy Acton, director of the Ohio Department of Health. She predicted Thursday that there will be 6,000 to 8,000 new cases per day in Ohio by late April. The state's stay-at-home order and business shutdowns will make PPE last longer. Without them, Ohio frontline workers would have needed 65 times the gear they normally use — with the restrictions, they'll still need 40 times the normal equipment, Acton said. "Millions" more items will be needed, she said, especially N95 medical face masks. Gov. Mike DeWine's office issued a statement Thursday afternoon warning of "the oncoming shortage" of protective gear. Taking care of a patient who is in intensive care for a 24-hour shift requires 36 pairs of gloves, 14 gowns, three pairs of goggles and 13 N95 face masks, it said. At the same time, Ohio likely will have to double the number of hospital beds available, Acton said. The good news is that for now, Lorain County's hospitals are operating well under capacity, according to Kelley. It fluctuates, but he said to the best of his knowledge they are running around 60 percent full. In regular calls to coordinate the county's response, hospital heads have not voiced worries they are approaching the limit, he said. "We're still in a climb-the-mountain mode, but we'll get over the top at some point," he said. Acton said the state hasn't been hit yet by the surge due to how long it takes COVID-19 to manifest. It takes five to 14 days for symptoms to present, up to 12 more to determine whether hospitalization is needed and another week to land in the intensive care unit, she said. Asked about PPE on hand, Mercy Health spokesman Jonathon Fauvie wouldn't say outright whether his company's hospitals have enough. "To ensure the continued health and safety of patients and associates, Mercy Health regularly monitors current supplies and began planning early. We have plans in place to support our needs and remain committed to the appropriate and responsible use of supplies and equipment, at this time and always," he said in a written statement. "This applies to COVID-19 tests, personal protective equipment (PPE) ventilators and other resources. We are resourcing from around the globe and following Centers for Disease Control and Prevention guidelines on appropriate usage. In addition, we are working collaboratively with other health care and government agencies through this unprecedented event." University Hospitals did not respond to a request for comment. Contact Jason Hawk at (440) 329-7122 or news@lcnewspapers.com.