In Colorado, health care facilities are conserving gear in order to sustain supplies of the protective equipment needed to keep workers safe. Personal Protective Equipment (PPE) includes items like gloves, goggles and masks. According to the Colorado Hospital Association, masks in particular, both surgical masks and N95 respirator masks, which filter out airborne particles, are "the most concerning piece" of the shortage.
For many doctors, nurses and first responders, access to PPE is changing quickly, as supplies dwindle and the coronavirus spreads across Colorado. As of Wednesday at 4 p.m., 147 people had been hospitalized in the state.
"When people came back from China or other places with travel restrictions and had respiratory symptoms, we were coming in gowned-up, head-to-toe, no exposed skin," Dr. John Cawley, a family physician based in Fort Collins, said of PPE usage a few weeks ago. "Gloves on, masks on, N95 respirators. Full precautions."
Then, in the last week, after taking stock of the clinic’s current amount of PPE, and talking to suppliers and the state’s public health department, providers in Cawley’s clinic have now started conserving what they have on hand.
"We’re wearing masks all the time we’re in the clinic but we’re rationing masks. I have my one allotted mask that needs to last, ideally, this whole week," Cawley said in describing single-use surgical masks.
Cawley explained that he and his colleagues have been trying to clean their masks, sometimes using bags that heat up and sanitize them.
"We don’t know the best way. A partner in our clinic here has been sprinkling his with rubbing alcohol and then trying to have it air dry overnight," Cawley said.
Earlier this week, Colorado received tens of thousands of PPE items from the Strategic National Stockpile, a repository of supplies managed by the federal government for use during public health emergencies, but the state believes these supplies won’t go far. In a statement, the Colorado Department of Public Health and the Environment estimated that "these supplies are sufficient for approximately one full day of statewide operations."
Calls for more PPE are becoming more urgent as the number of positive COVID-19 cases jumps. As of Thursday morning, according to data from the Center for Disease Control and Prevention, testing had identified 68,440 cases across the U.S., resulting in 994 deaths, though numbers are constantly being revised upwards.
Dr. John Cawley feels like he’s going through the six stages of grief, his feelings about the situation in Colorado changing by the hour.
"The things that scare me the most are just the uncertainty as far as what is coming around the corner? Are we waking up tomorrow with 200 people needing medical care in a system that is already at capacity?" he wondered.
Gov. Jared Polis launched a response team that is, in part, working to develop locally-sourced alternatives for critical medical supplies. As part of that effort, Greeley-based plastics company Genesis Plastics recently built a face-shield prototype that health care providers could wear to protect themselves from sick patients' coughs and sneezes.
Various efforts to produce more PPE are ongoing. State lawmakers are holding drives to collect supplies like gloves, goggles, shoe covers and masks. Local public health departments and community centers are accepting small quantities of PPE. The State Emergency Operations Center is coordinating requests for supplies and donations of supplies. Individuals and local groups, like the Arapahoe County Quilters, are organizing and encouraging members to sew face masks and hair covers. The Facebook group "open source covid19 medical supplies" has over 50,000 members. The hashtag #GetMePPE has been trending on Twitter.
The PPE shortage in Colorado has all sorts of small businesses looking at ways they can help.
"It’s better to help and do what you can now rather than horde," said Juicy Wells, shop manager at Denver-based tattoo parlor Think Tank Tattoo.
The shop’s artists donated their entire stock, approximately 200 boxes of medical-grade gloves and masks to area senior centers.
"Those things aren’t going to do us any good for the next six weeks," Wells said. "And if we’re not able to get this under control, they might not do us any good, at all."
Last week, the state ordered tattoo parlors, salons and spas in Colorado to close until April 30 in order to encourage social distancing in response to the Coronavirus.
"I know a lot of us feel really helpless," Wells said. "So being able to help and have that purpose has been big for our shop and I’m sure other tattoo shops in the community in general."
Colorado State University Veterinary Teaching Hospital in Fort Collins sent over two cases of surgical masks to National Jewish Hospital in Denver.
"This isn’t a veterinary or human thing, we all get masks from the same sources so human sources are going to take precedence over veterinary uses," said Dr. Tim Hackett, a veterinarian at CSU Veterinary Hospital.
CSU also donated one of its three ventilators , one of the most critically needed items, to Poudre Valley Hospital. Hackett says if needed, they’ll send the other two.
"If it came down to needing capacity and buildings that were plumbed with oxygen, some of our research buildings, even our hospital, could be converted to human use," he added.
Dr. Emmy Betz, an emergency physician and researcher at the University of Colorado, explains that the urgent need for PPE goes beyond health care providers wanting to avoid contracting the Coronavirus.
"When a doctor, nurse or tech gets exposed or sick, they have to be out for two weeks. And if you keep multiplying that, at some point, we run out of healthcare providers. So that’s part of the reason you need to protect us because you actually need us to be there," Betz said. "The other concern is that if providers are getting sick before they’re symptomatic, they could potentially spread it to other patients."
Dr. Betz acknowledges "the wonderful outpouring" of people making and donating PPE.
"I’m engaged in that myself but that should be a last resort. That we need actual medical-grade PPE and it is crazy to me that in 2020 in the United States we are in this situation," Betz said.
KUNC reporters Stacy Nick and Rae Solomon contributed to this report.
Editor's note: A previous version of this story stated the CDC's numbers of COVID-19 cases and deaths were from Wednesday morning. It has been corrected to state that the numbers were from Thursday morning.