What U.S. Health Care Workers Need to Fight Coronavirus – The New York Times

As new coronavirus infections accumulate across America, hospitals want to make sure they have everything they need to keep staff safe.

In China, where the virus was first discovered, protecting health care workers was a serious challenge. More than 3,300 nurses, doctors and other hospital staff members across the country were infected, many because of insufficient protective equipment.

In the United States, some hospitals are already struggling with limited supplies, as health officials figure out the best way to protect workers. More than 1,000 cases of Covid-19, the disease caused by the new coronavirus, have been reported across America so far, with the largest outbreak in Washington State.

We need to think about what the right thing is for patients, but also for our caregivers to make sure theyre not exposed, said Amy Compton-Phillips, chief clinical officer at the Providence St. Joseph Health, a hospital network that has treated more than a dozen patients in Washington State.

That means making sure theres an adequate supply of protective equipment for staff members and enough space to isolate patients, while also navigating a flurry of regulations and recommendations that could change at any moment.

Current C.D.C. recommendations for health care workers

Eye protection

Goggles or face shield

Respirator or medical mask

N95 respirator, if available

Gown

Closed securely

at the back

Gloves

Pulled up over

gown sleeves

Current C.D.C. recommendations for health care workers

Eye protection

Goggles or face shield

Respirator or medical mask

N95 respirator, if available

Gloves

Pulled up over

gown sleeves

Gown

Closed securely

at the back

Current C.D.C. recommendations for health care workers

Eye protection

Goggles or face shield

Respirator or medical mask

N95 respirator, if available

Gloves

Pulled up over

gown sleeves

Gown

Closed securely

at the back

There is still some uncertainty about how the new coronavirus spreads, but experts agree it is most likely passed through close contact with people who are infected, and specifically the viral droplets they expel when they cough or sneeze.

The Centers for Disease Control and Prevention has advised health care workers to treat potential and confirmed cases of Covid-19 with the level of precaution usually reserved for high-risk illnesses that spread easily through the air, like tuberculosis or measles.

Workers are required to wear gowns, gloves, goggles and special masks, like N95 respirators, that fit tightly over the nose and mouth to filter out virus particles before they are inhaled. (They can also wear devices known as PAPRs, or powered air-purifying respirators, which cover the entire head.)

With respirator masks in short supply across the country, the C.D.C. recently updated its recommendations for health care workers. If respirators are not available, the agency says standard medical masks can be used instead for most coronavirus patient care. These looser-fitting masks protect against droplet transmission from coughs and sneezes, but do not filter out airborne pathogens.

The change puts the C.D.C. in closer alignment with World Health Organization guidelines, which only require respirator masks during special procedures that may result in the spray of tiny viral particles. Health departments in two of the hardest hit states, Washington and Oregon, have already adopted standards in line with W.H.O.

As the coronavirus continues to spread across the country and more is learned about the disease, these safety guidelines could evolve.

Tight fit; must be specially fitted. Filters out 95% of small particles.

Loose fit around edges. Provides protection from large droplets.

Tight fit; must be specially fitted. Filters out 95% of small particles.

Loose fit around edges. Provides protection from large droplets.

Hospitals across the country are currently facing protective equipment shortages because of increased global demand, as well as supply chain disruptions.

At the moment, we have significant limitations on our high-level N95 masks, and even surgical masks are in short supply, said Dr. Compton-Phillips of Providence St. Joseph Health.

Experts say surgical masks and respirators are not effective for protecting the general public from Covid-19 but are crucial for health care workers who are in close contact with infected patients.

And because respirators and other medical supplies are single-use, hospitals need a large stock for doctors, nurses and other staff members. Representatives from hospitals across the country said they were taking steps to preserve the supply of protective equipment, including limiting the number of people who enter a patients room to essential personnel only.

Some larger hospitals and hospital networks maintain their own stockpiles of respirator masks and other equipment. The Department of Health and Human Services also maintains the Strategic National Stockpile of emergency preparedness supplies, which currently contains 13 million N95 respirator masks and 30 million surgical masks, according to a spokeswoman for the agency.

But Alex Azar, the secretary of Health and Human Services, told Congress that as many as 300 million N95 respirator masks could be needed by United States health care workers to fight the spread of the virus. The agency has said it will buy millions more masks over the coming months.

Under new protocols, the C.D.C. recommends coronavirus patients be isolated in single rooms, behind closed doors, away from other patients. But more severe cases may require the use of a special room with negative pressure, which allows air to move inward but not escape back into general circulation.

Area of lower air pressure