As community spread of the coronavirus that causes COVID-19 began to take hold around the country in March, Fort Worth, Texas, allergist-immunologist Susan R. Bailey, MD, turned to her practice’s supply cabinet for personal protective equipment (PPE).
“The only masks we had in our office when the pandemic started was one box of 10 N95 masks that I had bought during the H1N1 pandemic in 2010, and I was amazed we still had them,” said Dr. Bailey, who was inaugurated as the AMA’s 175th president in June. “There are—just coincidentally—10 people in our office, and everybody got one and we said, ‘This is all you get until we can find some more.’”
That search for more PPE has proven extraordinarily frustrating, and added yet one more administrative burden amid a time of great stress for Dr. Bailey’s three-physician independent specialty practice.
From the very start of the pandemic, Dr. Bailey and the AMA’s other leaders have fervently advocated to the White House, the Federal Emergency Management Agency and other key players the need for a Manhattan Project-style effort to ensure that the necessary quantities of PPE are produced and distributed where they are most in demand.
Now the AMA is stepping in to help keep physicians and their patients safe, collaborating with the nonprofit Project N95 to reserve quality certified PPE exclusively for AMA members to purchase with no minimum. Sign up for more information on when the next offer will be available. Available equipment includes:
- Makrite 9500 N95 surgical respirator; FDA 510(K) cleared, CDC NIOSH approved, sizes small and medium/large.
- Disposable isolation gown; AAMI Level 1.
Since launching in March, Project N95 has become the leading rapid-response nonprofit addressing the COVID-19 pandemic and PPE shortage crisis. Its mission is to deliver critical equipment to front-line workers as quickly as possible by driving transparency in the market and procurement best practices.
While great attention has rightly been lavished on the national imperative to properly equip front-line doctors and acute-care health professionals battling to save lives in COVID-19 hot spots, the PPE shortage also has bedeviled office-based physicians such as Dr. Bailey and her practice team.
“It’s been a free-for-all. Many offices have not been able to open as much as they would like because they don’t have enough PPE,” said Dr. Bailey.
“There’s even more competition now for PPE than there was at the beginning of the pandemic because other, nonhealth-related businesses, schools and churches are looking for PPE as well so they can open up safely,” she said.
“Nobody is immune to this. It doesn’t matter who you are. If the president of the AMA is having a hard time finding PPE, that is a clear expression of how incredibly difficult it is for the entire physician population.”
Learn why physician practices are losing out in the scramble for PPE, and how the AMA is advocating on their behalf.
New practice role: PPE procurement officer
A practice partner of Dr. Bailey’s is serving as point-person on the PPE front and, in collaboration with the Tarrant County Medical Society and Texas Medical Association, has obtained more equipment to keep the supply steady after that initial box of H1N1 leftovers was exhausted. That includes face shields, and it was well into the spring before that essential form of protection was procured.
In the early going, the word went out to everyone in the practice to bring whatever PPE they could, wherever they could find it. That led to wasting precious time due to misadventures with online retailers offering overpriced items of dubious quality.
“In a small, independent practice, we are the IT person, we are the HR staff—and now we’re the PPE procurement officers as well,” Dr. Bailey said.
Risks in office-based practice
While aerosolizing procedures such as intubating a patient with COVID-19 carry the greatest risk for doctors and other health professionals, even an office-based setting such as Dr. Bailey’s can pose a potential for spread. The practice is able to accomplish a lot of patient care using telehealth, but allergy testing must still be done in person and that requires up-close contact amid the reality that any patient walking through the door may be an asymptomatic carrier of SARS-CoV-2.
In allergy and immunology, Dr. Bailey noted, pulmonary function testing also poses a risk that requires adequate PPE.
The testing “involves blowing really hard into an adapter, which often makes the patient cough,” she said.
The new reality demands a different approach to planning at all levels, Dr. Bailey added.
“We’re just now starting to look at post-pandemic supply needs. I imagine the days are gone when all we’ll have is one 10-year-old box of masks stuck in the back of a supply closet,” she said. “We’re going to have a need for ongoing supply and a ready supplier of PPE. I think just-in-time ordering—at least for PPE—doesn’t work anymore. Every medical office in the country is going to need to think, ‘How much PPE am I going to need to have on site, physically present in my office, on an ongoing basis?’”
Learn how, in the COVID-19 crisis, the AMA’s powerful voice has rung out to save lives.
Stay current on the AMA’s COVID-19 advocacy efforts and track the pandemic with the AMA's COVID-19 resource center, which offers resources from JAMA Network™, the Centers for Disease Control and Prevention, and the World Health Organization.