As the number of COVID-19 cases grows in western New York and the Finger Lakes, the supply of protective gear for medical workers is dwindling.
In particular, N95 masks, which health care workers use to protect themselves against the virus in close clinical settings, are running low.
Doctors and administrators at local health care systems have been quick to temper concerns, saying there is not an immediate crisis, but they are worried about running out of important equipment before supplies can be replenished.
“We’ll be in danger of not having enough to fully and safely protect health care workers. That’s not the case yet -- I want to emphasize that. That’s what we’re planning to try to avoid,” said Dr. Emil Lesho, the health care epidemiologist at Rochester Regional Health.
“‘Running short’ is a very good way to put it,” said an administrator at one local hospital system who has knowledge of supply and distribution issues.
“Some people do have some” protective equipment, the administrator said. “Some people don’t have any.”
Overall, “we’re hurting,” said the administrator.
At another local hospital system, doctors “do not have gowns. They do not have masks. They don’t have goggles. Gloves are holding up OK,” an administrator said.
Both administrators declined to be identified by name, saying they were not authorized to speak to the press and feared losing their jobs over their comments.
The risk of sharing this information, they said, is a sick public that is afraid to seek medical care, and doctors and nurses who are afraid to go to work during an anticipated surge in coronavirus infections.
Yet, one administrator said, “I feel like we are in the middle of a very unique crisis. It is a crisis that requires transparency to the community if we are really going to get in front of this thing.”
One senior administrator said without accurate information, that crisis can turn to panic.
“We do not want that panic,” said the administrator, who also was not authorized to speak to the news media. “There are lots of strategies, as you can imagine, being employed to make these masks go as far as they can.
“No one is panicking,” the senior administrator said. “The health system is alive and well and responding to this crisis in incredibly appropriate ways.”
None of the administrators would say precisely what their strategies for stretching equipment supplies were.
Several Rochester-area doctors affiliated with the hospital systems described unconventional methods.
“We got a box of masks that I think came from a hardware store a couple days ago,” said a nurse at one clinic in Rochester. The health care system with which her clinic is affiliated delivered the case of 20, she said.
“I don’t know how they got it,” the nurse said. “We’re on Amazon looking for masks every day.”
Others said they would consider reusing the N95 masks that are in short supply. Staff at hospitals in New York City began doing that last week.
The federal Centers for Disease Control’s guidance says it’s not an ideal situation, but it’s an acceptable method of infection control in a pandemic.
To limit the number of people who need to wear those masks, Monroe County has begun guiding people with symptoms of COVID-19 to either stay home or call ahead to seek treatment at an urgent care clinic or an emergency room.
Andy Ophardt, who manages a doctor’s office in Brighton, said that’s an important way to preserve their limited supplies. “There just aren’t enough masks for every practice to be stocked.”
Ophardt said they screen patients by phone and tell anyone with a fever or a cough that they can’t come in. “We want to see them, but that’s not the situation right now.”
At a small office like his, Ophardt said, that screening is especially important. One person exposed to COVID-19 could shut down the whole clinic at a time when the health care system is already under stress.
The phone screening is designed to avoid that, but it can’t be perfect, he said. A patient might not understand the questions, or might not answer them honestly or fully.
“When the patient presents in the office or is in the exam room ready to see the doctor and kind of spills out some additional history, then we’re like, ‘Oh, my goodness,’ ” Ophardt said.
“We’ve got to go into reaction mode,” he said. “That risks depleting our supplies really fast.”
Many of the masks that local health care staff need are made in China, where production slowed and demand soared as COVID-19 began its spread.
Now, factories in China are getting back to work, retooling production lines that once made diapers or sanitary pads to produce the masks.
In the U.S., President Donald Trump is invoking the Defense Production Act to accelerate production of protective equipment.
But neither of these is an immediate solution, and competition for limited resources is fierce nationally and internationally.
New York state is already dipping into its stockpile of protective equipment, according to the state health department.
“During the current COVID-19 response, the department has already supplied hospitals across the state with N-95 respirators,” spokesperson Jill Montag said.
As cases mount, Monroe County finds itself in the center of a region where supplies are stretched thin.
To the west, In Erie County, which went from zero confirmed cases five days ago to 27 yesterday, health commissioner Gale Burstein said the rapid spread of the virus could overwhelm their ability to protect workers.
“We do have N95 masks now,” Burstein said, but “a very steep curve when many, many people are very sick at the same time, that will be a problem."
To the east, in Ontario County, which reported its first confirmed coronavirus case earlier this week, deputy county administrator Brian Young painted a similar picture.
“We have enough now,” he said. “But the concern is, what’s this look like two weeks from now?”
Monroe County has a “local stockpile” of protective equipment that it has not yet deployed, public health commissioner Dr. Michael Mendoza said in a news conference Wednesday, but several local doctors said they had either never heard of the stockpile or had no idea how to access it.
Mendoza said the health department was “in the process” of deciding how to allocate supplies to places that need them most. The county said clinicians can order supplies through the local COVID-19 hotline, 585-753-5555, or by emailing firstname.lastname@example.org.
“There is enough usable equipment to meet the current demand,” county spokesperson Julie Philip said in an email. The county did not respond to questions about where the equipment might be distributed.
Emmarae Stein contributed reporting.