While the AMA has called on the Federal Emergency Management Agency to take charge of the effort to acquire and distribute personal protective equipment (PPE) where it’s most needed in the frontline battle against COVID-19, some physicians and medical students are taking matters into their own hands.
How are physicians and medical students doing it? Stories from the front lines offer some insight.
Fund-raising for face masks
“There was a time when we were told we would only get one N95 mask a week and we had to put it in a paper bag and do our best to keep it clean,” said Chris Clifford, MD, an emergency medicine resident in New York’s Mount Sinai Health System, during a recent edition of the “AMA COVID-19 Update.”
That reality changed, but it was due to interventions by Mount Sinai’s own resident physicians; a GoFundMe campaign by Alicia Lu, MD, one of Dr. Clifford’s co-residents, helped raise more than $75,000 to buy PPE. With that money, residents were able to purchase masks and full-body “bunny suits.”
“It was a real game changer,” Dr. Clifford said. “They are washable. We are able to wear them multiple times.”
Schools, students sacrificing
As the urgency around the pandemic grew nationally, in mid-March things hit a critical mass, and medical schools were forced to acknowledge that reality and adapt to it.
On March 17, the Association of American Medical Colleges (AAMC) called for a suspension of activities that involve students interacting with patients, effectively putting clinical rotations on hold. That suspension remains in place.
One of the reasons behind the suspension was a lack of adequate PPE for physicians. Medical schools with a surplus of PPE made sure it went to good use. One such school was Ohio University Heritage College of Osteopathic Medicine, a member of the AMA’s Accelerating Change in Medical Education Consortium. Its three campuses across the state collectively donated about 30,000 gloves and 1,000 masks to hospitals across Ohio.
“We certainly realized that patient care was a priority over medical education, especially during the initial phases of the pandemic,” said Isaac J. Kirstein, DO, dean at the medical school’s Cleveland campus.
“As our health system partners across the state of Ohio, this was first and foremost a PPE preservation strategy on their part.” The suspension of clinicals, which could have far-reaching impacts, has been a source of some frustration for students. Adequate PPE supplies are essential to getting students back into direct patient care roles and back on track with their training.
“Students signed up to be physicians,” Dr. Kirstein said. “They know there’s an infectious risk of being in an in-patient care environment. It amazes me how much of our education was predicated by PPE availability. It continues to be a primary driver of what we are able to do.”
Calling on the community
Even with most being removed from patient care, medical students have a strong desire to rise to the occasion during a once-in-a-generation health crisis, as highlighted in a recent AMA Accelerating Change in Medical Education webinar.
The webinar offered some examples of added-value roles students are playing. One such example was the local sourcing of PPE carried out by students at the University of Michigan Medical School, also a member of the AMA consortium.
“To combat the strain of supplies COVID-19 has created for the supply of PPE in health care, students are asking for donations as well as sort donations at various donations sites in the community,” said University of Michigan medical student Susan Carlson.
In a matter of weeks, according to Carlson, she and her classmates had collected 25,000 masks, 2,000-plus N95 masks, 1,300 face shields, 140,000-plus gloves and 500 lab coats.
“Students report feeling energized seeing this community come together during this pandemic,” Carlson said.
Slides and an audio recording of the webinar are available in the “Resources” section of the AMA Accelerating Change in Medical Education digital community (registration required).
Working with wunderkinds
When you ask a learned mathematician and a body of physicians to find solutions, that’s a lot of brainpower at work.
The problem was well-covered: PPE is in short supply. The solution? As a director in the 3D printing lab at the University of Southern Mississippi, Anna Wan, PhD, an assistant professor of mathematics, was uniquely qualified to find it.
Working in a partnership with Hattiesburg Clinic in Mississippi and Forrest General Hospital, Wan successfully created 1,600 “Hub Masks” for physicians and other health professionals at Forrest General Hospital and Hattiesburg Clinic, said John Fitzpatrick, MD, a nephrologist and president of Hattiesburg Clinic, the largest private multispecialty clinic in Mississippi and an AMA Health System Program Partner.
“Combining Wan’s work with the production of cloth face masks and gowns by the Hattiesburg community, has reduced health care workers’ anxiety regarding potential personal protective equipment shortages in Hattiesburg as we face this crisis,” Dr. Fitzpatrick said.
Knowing your network
Sometimes it’s good to have friends in high places.
Anna Yap, MD, is a second-year resident in the UCLA-Ronald Reagan/Olive View emergency medicine program. She has been spending many of her rotations in makeshift COVID-19 evaluation areas, where patients who are showing symptoms are evaluated for the virus. During her off-time, she has been working to fight the pandemic as well by connecting hospitals with needed supplies. It all started with a Facebook post. One of Dr. Yap’s friends, working in tech, had access to non-invasive BiPAP machines, which can be converted to ventilators, but was struggling to get them to where they were most needed. “They were talking to [hospital] CEOs and [people working in hospital administration], but they didn’t necessarily have the clearest knowledge of how many ventilators a hospital is down to or when physicians on the ground think they are going to need these machines,” Dr. Yap said. “In my little way, I’ve been helping to connect physicians to them.”
Dr. Yap was able to connect her tech industry contact with three hospitals in New York to which the machines were donated. Through another friend who works in merchandising, she was able to get face masks donated to facilities in New Jersey. “Friends and people who want to help are in all sorts of unexpected places,” she said. “Everyone right now is really eager to be able to give in their own way. “I would have never been able to make those connections without my AMA relationships, which is just one example of why I value my AMA membership. To be able to chat and work with so many inspiring physician members who move medicine is why all physicians should be an AMA member,” Dr. Yap said.
The AMA has curated a selection of resources to help residents, medical students and faculty during the COVID-19 pandemic to help manage the shifting timelines, cancellations and adjustments to testing, rotations and other events at this time.
