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HHS watchdog: Supply shortages put patients, workers at risk amid COVID-19 surge

Hospitals reported using personal protective equipment at a much faster rate than expected as the coronavirus pandemic grew in the U.S., causing widespread shortages that put both staff and patients at risk, according to a federal watchdog survey.

Supply chain issues were also delaying or preventing personal protective equipment from reaching facilities that were running out of the essential supplies, according to a survey from the U.S. Department of Health and Human Services' Office of Inspector General. One hospital administrator told the HHS watchdog that it was facing delays of three to six months to get supplies, including surgical and N95 face masks.

Respondents also cited issues with state and federal stockpiles, saying that they received smaller shipments than what was expected or supplies that were damaged and expired.

"One hospital reported receiving a shipment of 2,300 N95 masks from a state strategic reserve, but the masks were not usable because the elastic bands had dry-rotted," the survey stated. "Another hospital reported that the last two shipments it had received from a federal agency contained [personal protective equipment] that expired in 2010."

Reusing equipment

To ration supplies and conserve inventories, hospitals said workers have resorted to reusing personal protective equipment intended to be used once and using masks that are not medical grade, like handmade masks or cloth masks.

Hospitals also said they were unable to keep up with testing demands due to severe shortages of testing supplies and long wait times for testing results. Both of these issues strained bed availability, staffing and further taxed personal protective equipment inventories, according to the survey.

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The survey, which was released April 6, was conducted March 23-27, with hospital administrators from 323 hospitals across 46 states, the District of Columbia and Puerto Rico, according to the HHS Office of Inspector General.

The availability of personal protective equipment, especially N95 face masks, has been a top concern as the outbreak grows in the U.S.

Supply shortages have also become a controversial issue within the industry. Healthcare workers have posted concerns about the lack of proper equipment on social media sites like Twitter. And hospitals have fired or warned workers of disciplinary action for speaking out about the unsafe conditions they face due to the supply shortages, according to a March 31 report from Bloomberg.

Respondents to the agency's survey said an upcoming shortage of ventilators was a primary concern if they experience a surge in patients with COVID-19, the respiratory disease caused by the novel coronavirus.

President Donald Trump invoked the Defense Production Act on April 2 to help ensure that companies like General Electric Co. and Medtronic PLC can secure needed supplies to make ventilators to combat shortages. Trump also invoked the DPA on March 27, ordering General Motors Co. to produce ventilators for U.S. hospitals.

At least 356,942 cases of COVID-19 and 10,524 deaths have been confirmed in the U.S. as of April 6, according to a tracker from Johns Hopkins University's Center for Systems Science and Engineering.

'An early warning signal'

Premier Inc., a top purchasing organization that helps supply hospitals, released a similar survey on April 1 showing that the hospital industry was burning through personal protective equipment inventories in a matter of days.

Among facilities with coronavirus patients, N95 masks were being used at 17 times the usual rate, face shields were being used at over eight times the usual rate and viral swabs at six times their usual rate, according to the survey.

Premier's data showed that while the average hospital had a 23-day supply of N95 masks, hospitals with active COVID-19 patients had an average of just three days' worth of masks. Hospitals participating in the survey said the lack of N95 masks was their primary concern.

Other items experiencing higher burn rates included isolation gowns and surgical masks, which were being used at five times the usual rate and slightly over three times the usual rate, respectively.

The survey was conducted March 16-20, with approximately 1,591 hospitals in 40 states responding, according to Premier.

Michael Alkire, president of Premier, said in an April 1 press release that data from hot spots like New York show that hospitals need to immediately prepare for surges in supplies.

"Although [N95 mask] supply remains a top concern, backorders for surgical masks, isolation gowns, thermometers and disinfecting wipes are surging and quickly surpassing demand for N95s," Alkire said. "This is an early warning signal of product shortages that may be on the horizon and need to be planned around."