Nevada’s recorded outbreak of COVID-19 is projected to get worse before it gets better, yet hospitals throughout the state are already employing special guidelines designed by the Centers for Disease Control to stretch resources, such as protective gear for hospital workers, during a pandemic.
Of Nevada’s 264 known COVID-19 cases, 44 patients in Southern Nevada are hospitalized and in the north, “a majority are self-isolating at home,” according to a Washoe County health department spokesman.
But the state’s hospitals are already judiciously deploying their precious assets.
Sunrise Health System (Sunrise Hospital, MountainView Hospital and Southern Hills Hospital and Medical Center) is conserving supplies, according to spokeswoman Jennifer McDonnell.
As part of a “proactive plan to address future potential supply shortages, our hospitals have begun to collect used masks for potential re-processing, if and when a process is approved by the CDC and FDA,” McDonnell says.
“While we are working tirelessly to ensure this extraordinary step is not needed, being prepared is part of our commitment to our and community,” she said. “Currently, staff are provided personal protection equipment aligned with the current CDC guidelines for use.”
A nurse at Renown Medical Center who asked not to be identified for fear of retaliation says she and her colleagues have been given one N95 respirator mask and told to make it last for three months.
“We are following the CDC’s recommended guidance for extended use and limited reuse of N95 masks,” according to a spokesperson for Renown Medical Center in Reno, who declined to say how long the masks are expected to last.
The CDC says construction workers “routinely use N95 respirators for several hours uninterrupted. Experience in these settings indicates that respirators can function within their design specifications for 8 hours of continuous or intermittent use.”
“Extended use is favored over reuse because it is expected to involve less touching of the respirator and therefore less risk of contact transmission,” the CDC says of N95 masks.
At University Medical Center in Clark County, “following CDC recommendations, UMC has developed comprehensive guidelines for the extended use of specific personal protective equipment,” hospital spokesman Scott Kerbs said via email. “To ensure the protection of staff and patients, these guidelines include clear instructions on when to change masks.”
“This is a marathon, and we want to be prepared for any future influx of patients,” Kerbs said.
“We are still using stock on hand,” said Gordon Absher of Dignity Health, which operates three hospitals in Las Vegas under the St. Rose brand. Absher did not reveal the company’s plans for maintaining a supply of PPE.
UHS, which owns five hospitals in Las Vegas and one in Reno, did not respond to requests for comment.
“I am unable to comment on our current supply levels at this time,” says Scott Burrows of Elko’s Northeastern Nevada Regional Hospital. “I can say that NNRH is following all CDC guidelines.”
“Supplies of N95 respirators can become depleted during an influenza pandemic or wide-spread outbreaks of other infectious respiratory illnesses,” says guidance from the CDC.
“Existing CDC guidelines recommend a combination of approaches to conserve supplies while safeguarding health care workers in such circumstances.”
Those guidelines include:
- Using alternatives to N95 respirators where feasible
- Implement practices allowing extended use and/or limited reuse of N95 respirators, when acceptable; and
- Prioritize the use of N95 respirators for those personnel at the highest risk of contracting or experiencing complications of infection.
“The decision to implement these practices should be made on a case by case basis taking into account respiratory pathogen characteristics (e.g., routes of transmission, prevalence of disease in the region, infection attack rate, and severity of illness) and local conditions (e.g., number of disposable N95 respirators available, current respirator usage rate, success of other respirator conservation strategies, etc.),” the CDC says.
“Some healthcare facilities may wish to implement extended use and/or limited reuse before respirator shortages are observed, so that adequate supplies are available during times of peak demand,” the CDC says.
Prices for masks have skyrocketed from .80 to $7 apiece, according to Gov. Andrew Cuomo, as states compete against one another.
President Donald Trump declined last week to procure and distribute PPE to states in need, noting the government “is not a shipping service.”
SEIU International president Mary Kay Henry on Monday called on Trump to take “coordinated, comprehensive action now.”
“It’s outrageous that states should be forced to ‘outbid’ one another to get supplies to health care workers,” she said. “It’s outrageous that healthcare workers are being asked to make their own masks. Or even worse, reuse them. If we wait, more healthcare workers will be in danger and more lives will be lost.”
First responders, who are being called on daily to transport patients suffering symptoms akin to COVID-19, are engaging local businesses to ensure an adequate supply of PPE.
“Henderson firefighters wear gowns, gloves, goggles and masks when coming into contact with a patient that is exhibiting respiratory symptoms,” says spokeswoman Kathleen Richards.
Richards says the city reached out to Polar Shades, a local business “that has repurposed their facility to manufacture protective gear. This company will likely be able to produce enough protective gear to outfit firefighters regionally.”
The Clark County Fire Department “is exercising a balance of standard procedures, CDC guidelines and common sense,” according to Deputy Fire Chief Jon Wiercinski.
“CCFD’s 911 operators screen each call for potential COVID-19 patients with specific questions about symptoms most commonly associated with the virus (shortness of breath, fever),” Wiercinski says.
In addition to PPE, paramedics are following CDC guidelines when responding to a possible COVID-19 patient, he says.
“For example, paramedics ask people on the scene to wear masks as well as assessing patients in open spaces rather than confined areas,” says Wiercinski.
“The protocol begins with our fire dispatchers,” says North Las Vegas spokesman Patrick Walker. “Callers are asked a few questions to determine whether or not they are experiencing symptoms related to COVID-19. That information is relayed to the firefighters and paramedics responding to the call. Upon arrival, one paramedic puts on personal protective equipment to contact the patient and initiate a preliminary assessment, maintaining an initial buffer of at least six feet, if possible.”
“To minimize risk, if the patient is able to come outside on their own, they are asked to do so. The other crew member(s) keep their distance until the initial paramedic finishes the initial assessment. If the first paramedic determines the patient is exhibiting symptoms consistent with COVID-19, the other crew members also put on their PPE and are able to come over and interact with the patient.”
“The City of North Las Vegas has enough to address our immediate needs,” Walker says of PPE. “But we are working on procuring more, as we expect an increase in the number of calls for service for people who are exhibiting symptoms of COVID-19.”