Amid ongoing PPE crisis, doctor-led efforts focus on needs of smaller healthcare entities

In March 2020, along with reports of hospitals being overwhelmed amid the Covid-19 pandemic came news of the facilities being woefully under-resourced as well. Not only were hospitals struggling to get access to equipment like ventilators, but they were also lacking basic personal protective gear like masks and gloves.

Though dire reports, like healthcare workers being forced to use garbage bags as personal protective equipment, have died down, groups on the ground report that the problem has not gone away, with smaller healthcare facilities and physician offices still struggling to get the PPE they need. In fact, requests to one collection group, Get Us PPE, increased by more than 200% between November and December, Dr. Shikha Gupta, executive director of the group said in a phone interview.

“The PPE crisis is certainly something that is still happening, in fact it is raging and escalating as Covid cases escalate,” she said. “But it’s not being discussed in those terms by those who have the power to make large-scale change.”

Get Us PPE’s origin story is unique to 2020. It was born out of a Twitter hashtag used by healthcare workers to show the materials they were using as PPE in lieu of the real thing. A group of six practicing emergency room doctors, Gupta included, started the initiative to connect healthcare workers to those in their community who may have masks or gloves that they could use.

It was meant to be a short-term endeavor, Gupta said. But more than 10 months later, the group is still going strong, having delivered 6.4 million pieces of PPE at no-cost to facilities across the country.

Initially, the requests coming in included big-name academic medical centers and urban health systems. Get Us PPE declined to name the facilities as they make request confidentially, but some hospitals chose to share their stories publicly through the group, including Kaiser Permanente’s San Rafael Medical Center in California.

But now, the requests are coming mostly from non-hospital facilities, such as community clinics and rural health centers, though there is some need among community hospitals as well, Gupta said.

The group developed proprietary platforms and algorithms to make sure the process of connecting clinicians to PPE is both efficient and equitable. But, the most effective tool in the group’s arsenal is getting information directly from the healthcare workers themselves about where the need for PPE may be most pressing.

“We are getting a lot of conflicting reports about PPE supply and demand and availability, but we have found that our best source is really talking to people on the ground at those facilities,” Gupta said.

Dr. Marcelo Hochman, co-founder of another collection and distribution group, Action PPE, echoed her sentiment. This grassroots, physician-led initiative was also formed in March of last year by the Charleston County Medical Society, which Hochman leads as president.

The initiative was born out of a need for PPE among physician offices and independent practices in South Carolina that did not have the buying power to contend with larger health systems also looking to purchase the same gear, he said in a phone interview. The idea was that if a group of physicians ordered their supplies together, they would have the aggregate buying power to be able to engage suppliers.

Hochman shared the idea with his friends and colleagues in other states, who took to the idea, engaged their own state medical societies and joined the PPE buying collective.

“For me personally, I’m a very strong believer in the notion that the people experiencing the problem are the best people to come up with the solution,” Hochman said.

Since its founding, ActionPPE has shipped over 3.4 million units of personal protective equipment, including masks, gloves, gowns and sanitizer, to 2,606 practices.

Initially, the collective was focused on the PPE possessions most prized early in the pandemic — masks and gloves. But more recently, Action PPE has been looking at acquiring syringes and needles.

Though the physician practices that place orders via the collective are likely not going to be distributing the vaccine themselves, there may be a shortage of these items as the Covid-19 vaccine roll out picks up speed, Hochman said. Since syringes and needles are required for all types of medical care, Action PPE has started organizing to ensure physicians have access to those items amid a potentially stressed supply chain.

“The key idea is that bottom-up [initiatives] work best and local problems are best solved locally,” he added.

The United States’ response to the Covid-19 pandemic has been widely panned, with many across the nation, and indeed across the world, pointing out that with the country’s wealth and resources, it should have been better prepared to manage this one-in-a-century crisis. Both Hochman and Gupta said that the pandemic has revealed the deep, systemic cracks in U.S. Healthcare system, including the breakdown in supply chain when it is most needed.

The focus now is to not only solve the current PPE crisis but also work to prevent a future crisis like this from happening, Gupta said.

Photo credit: FabrikaCr, Getty Images