Updated: May 19, 2020 11:13 PM
Created: May 19, 2020 10:50 PM
Three letters - PPE - have dominated the conversation around COVID-19. It stands for personal protective equipment, which includes masks, gowns and gloves. Each item is essential for those on the front line of the pandemic.
Health care workers have been sharing concerns since the beginning of the pandemic about the lack of PPE, which they say has created unsafe working conditions and increased the risk of exposure.
On Tuesday, many nurses brought those frustrations to state lawmakers during a virtual House hearing.
"I dread the day that I have to stand in front of the media to report out the first death of a Minnesota nurse because they weren't properly protected at the bedside," said Mary Turner, president of the Minnesota Nurses Association.
5 EYEWITNESS NEWS spoke with the commissioner of the Minnesota Department of Administration, Alice Roberts-Davis. She oversees the orders and keeps track of the inventory.
"Right now, we are in relatively good shape," said Roberts-Davis. "We're feeling a lot better than we did two months ago entering into this situation. The supply chain again is stabilizing, opening up and we're feeling really good about getting this PPE into Minnesota."
The state has a 24 day supply of gowns, a 71 day supply of gloves and a 209 day supply of masks, according to Roberts-Davis. She said they are sending out 30 to 40 shipments daily from the warehouse.
"We are very concerned about the people on the front lines of health care," she said.
According to Roberts-Davis, health care providers have their own suppliers of PPE. If they run low, however, providers can request help from the state.
Previously, they had to wait until they only had zero to three days left of PPE before they could ask for state assistance.
Now, with the state getting more equipment into its warehouse, providers can ask for help when they have a four to seven day supply left.
"A little bit more inventory, a little bit more cushion," said Roberts-Davis. "We hope that hospitals are being conservative because we do need to be conservative because we're not at peak yet. But we also are procuring it in expectation that when peak hits, they will have everything they need to supply their needs."
We asked what she means by "conserving."
"Historically, they may have used a mask per patient or they may have used a mask per shift," said Roberts-Davis. "We're asking them to use a mask for longer periods of time so they're not disposing of them as quickly so we don't have to replenish them as quickly and we can have the inventory we need when the peak hits Minnesota."
5 EYEWITNESS NEWS asked how the state can supplement the hospitals' supply more effectively so health care workers don't need to re-use equipment for as long.
Roberts-Davis replied, "I think that the hospitals are following CDC and Minnesota Department of Health guidelines for PPE usage, which they should, and I think those standards are conservative because we don't want to be in a position where when the peak hits we don't have the PPE that we need."
Models predicting the number of cases, deaths and estimated peak of the outbreak in Minnesota have been changing since the start of this pandemic. The latest information released last week by MDH and the University of Minnesota shows a possible peak from late June to early July.
Commissioner Roberts-Davis told us health care workers across the state are already using about 73,000 masks every day. For gloves, the number is higher at about 719,000 per day. Health care workers are also using 8,000 face shields per day, 38,000 gowns per day and 11,000 N95 respirators each day.
"The burn rates are high, which as you can imagine means that we're ordering millions and millions of PPE for replenishment for the hospitals," she said.
According to data from the state's dashboard, it's been at least a month since they received a shipment of masks or gowns.
Roberts-Davis said the delay in gowns is due to challenges finding manufacturers who produce the water resistant and repellent fabric required for the gowns.
"The face masks have been difficult only because fabrication of those didn't start until a little bit later," she said. "We were looking for those in mid-March and they just weren't anywhere to be found and now we're seeing a much more steady supply of face masks and we've started to see those trickling in. I think we have several million on order of these masks and we're confident we'll get those."
The commissioner told 5 EYEWITNESS NEWS Minnesota competes with other states and, in some cases, the federal government for PPE supplies.
We asked if there's been a bidding process for equipment.
"We have not engaged in any bidding processes," said Roberts-Davis. "We've been able to just create purchase orders with vendors and work out through our negotiations for timing for delivery."
She told us they're working with companies around the globe, including some in Europe and Asia.
They're ordering new supplies every day, according to Roberts-Davis. She said they're relying on the models to make sure they have enough for the peak.
"We feel fairly well situated right now, of course nobody knows how long the event will last and what the severity of it will be," she said. "But even in a four times usage scenario we feel like we'll have the PPE in the state that we require."
She said they are getting reports from hospitals twice weekly, which show most have at least a three-week inventory of all items.
State officials also told reporters during the Tuesday briefing that they have requested, and hope to get, equipment to decontaminate N95 masks for re-use. They also said the state is now distributing washable gowns.
The Minnesota Hospital Association told 5 EYEWITNESS NEWS on Tuesday that there have been challenges acquiring and replenishing PPE from suppliers.
During the House hearing, Mary Krinkie, vice president of government relations for the Hospital Association said, "This shortage of personal protective equipment is not just here in Minnesota, it's not just in our country, it is global so yes there are probably decisions that have been made somewhat based on the supply chain. So when the nurses say why can't we get an N95 every day? And that's what they used to be able to get, they're right - that was pre-pandemic and we're doing things differently than we used to do. I hope we can go back to the days when a nurse can get a new N95 every single day. This is not about the money, this is about being able to physically get our hands on this personal protective equipment."
Dr. Rahul Koranne, President and CEO of the Minnesota Hospital Association, also issued a statement which read in part:
"Minnesota's hospitals and health systems continue to be concerned about supply shortages overall and the need to protect our front-line workers. Individual hospitals and health systems are closely monitoring their PPE use for COVID-19 patients under their care now, under a surge or hot spot and the increased use of PPE as additional procedures for other patients increase. In keeping with national and state guidelines, we will continue to have to practice conservation to protect workers and at the same time provide care to all patients. Minnesota's hospitals and health systems are following MDH and CDC guidance for the conservation and extended use of PPE. We know the state of Minnesota is working hard to acquire additional supplies and to improve the supply chain. Our top priority remains having the spaces, staff and supplies necessary in our hospitals and health systems to continue to provide high-quality care to all of our patients and fully support our care team members."
When asked about their PPE supply Allina Health said in a statement:
"We continue to acquire the necessary PPE equipment through our suppliers and are well positioned in almost every product category. We have built a predictive model that allows us to forecast the number of PPE products we will need for short-term and long-term ranges based on expected patient volumes and shifts in our supply chain.
We have deployed safe conservation practices among a few of our PPE categories including N95 respirator masks where there are national shortfalls across the country. These practices along with the use of regulated endorsed reprocessing of masks will help sustain the very needed set of PPE products required to protect our patients and caregivers.
We have created a dashboard that shows our supply of PPE. The dashboard is available for all staff to review. As part of our commitment to the safety of staff, Allina Health created the new role of PPE Champions, who receive training to provide peer coaching and mentoring on the safe use and conservation of PPE. Feedback from our critical frontline staff has been the foundation to add this additional level. of support. We are proud that to date, over 300 employees have been designated as PPE Champions across the Allina Health System."
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