PPE

Personal Protective Equipment…..

PPE – Personal Protective Equipment

PPE (Personal Protective Equipment) refers to the protective gear that emergency responders wear to protect themselves when responding to a disaster (CDC website-ref). Healthcare workers (HCWs) are frontline fighters during the COVID-19 pandemic and include those involved in direct patient care (physicians, nurses, respiratory therapists, etc) and indirect support of patient care (laboratory technicians, medical waste handlers, cleaning staff, security, etc). All healthcare workers are at risk of exposure and deserve a safe standard of protection to focus on taking care of patients without fear of getting sick. They rely on PPE, such as N95 respirators, masks, gowns, gloves, and eye protection, to
be able to effectively care for patients infected with COVID-19 without infecting themselves. When HCWs become ill, they risk spreading virus to others and can no longer care for other patients.

PPE is in critically low supply and many HCWs are caring for COVID-19 positive patients without effective PPE. The Coalition supports the Joint Commission’s statement supporting the right of every health worker to wear their own PPE when their institution cannot provide adequate protection commensurate with infection risk.

A top priority of the COVID-19 Action Coalition is to help protect HCWs by advocating for high quality, available PPE for all HCWs. Through these efforts we aim to achieve the following:

  1.  Advocate for reliable, equitable, state and federal supply chain to distribute PPE to every healthcare worker who needs it.
  2.  Centralize grassroots efforts aimed at procuring and distributing PPE to HCWs and assist with the acquisition and distribution of PPE to HCWs in need.
  3.  Share information regarding high-quality PPE based on quality of evidence
  4.  Promote innovation in PPE manufacturing and design and connect innovators with healthcare facilities

NATIONAL GRASSROOTS INITIATIVES TO ADDRESS PPE SHORTAGE

There are nationwide efforts to combat the shortages of effective PPE. These organizations serve to raise funds, to connect groups with PPE needs to suppliers and makers, and to support development of novel, effective PPE. Volunteers and donations are needed!

1. https://getusppe.org/about/ – GetUsPPE.org is a physician and medical researcher-led organization with a goal of building a national, centralized platform to get PPE to healthcare workers in need. They have a wide network to facilitate linking needs with sources. They also raise funds for PPE acquisition and allocation (all funds go to PPE). GetUsPPE.org also has an advocacy arm and is working on ethical guidelines for equitable allocation of PPE.

****Note: Press tool kit for getusppe.org if helpful for website: delete if not needed
https://www.dropbox.com/sh/g0d21814t3rgh3t/AACxn3H_OSpffpvvRT8U7FQra?dl=0

2. https://www.projectn95.org – Project N95 is a national database and clearinghouse for PPE with a goal of transparently obtaining high quality PPE products from suppliers around the globe to supply hospital requests in a coordinated fashion. Project N95 works in conjunction with GetUsPPE.org.

3. https://www.ppecoalition.com – This coalition’s goal is to aid the COVID-19 fight by connecting the networks of sources and needs; bringing together state governments, corporations, manufacturers, non-profits, and individuals to build a unified, organized supply chain. The PPE Coalition includes a telephone and email hotline that connects people in urgent need to people who can help obtain PPE.

4. https://www.mask-match.com/ – Mask Match helps individuals with spare face masks to mail masks directly to HCWs. Individuals with masks to donate can fill out the “I have masks” form and Mask Match will connect them via email with a healthcare worker match so the donor can ship masks directly to the HCW in need. Healthcare workers can fill out the “I need masks” form.


MASSACHUSETTS INITIATIVES TO ADDRESS PPE SHORTAGE

There are state-wide efforts to combat the shortages of effective PPE. These organizations serve to raise funds, to connect groups with PPE needs to suppliers and makers, and to support development of novel, effective PPE.

  1. Massachusetts State Government PPE Portal:
    a. To request PPE from the State:
    https://www.mass.gov/info-details/personal-protective-equipment-ppe-during-covid-19#requesting-ppe
    b. To donate or sell PPE to the state:
    https://www.mass.gov/info-details/personal-protective-equipment-ppe-during-covid-19#donate-or-sell-ppe-The Department of Public Health has published their guidance on how PPE is allocated.
  2. Massachusetts PPE Coordination Effort: https://tinyurl.com/MassPPE. The MA PPE Coordination Effort is a collaborative document with MA hospital donation information, PPE buyers, PPE vendors, and business outreach. The goal is to promote collaboration and decrease duplication of efforts among the various Massachusetts PPE initiatives.
  3. Massachusetts Frontline Resources: https://www.frontlinema.org – COVID-19 Resources for frontline health care workers, from the Attorney General’s office. Links to: PPE access request form.
  4. Massachusetts Medical Society: http://www.massmed.org – Massachusetts Medical Society COVID-19 Resources center has comprehensive resources for physicians, including testing centers, telehealth, PPE, practice and payer resources and more.
  5. Harvard Medical School PPE Shortage Initiative: https://covidstudentresponse.org/campaigns/ppe/. The Harvard Medical School (HMS) PPE Shortage Initiative has been working to improve access to PPE for medical workers and facilitate collaboration with the various Boston PPE initiatives. The initiative is part of the larger HMS COVID-19 Student Response team.
  6. PPE Production: for Massachusetts business who are interested in adapting your business to support PPE: https://masstech.org/M-ERT

 

DIRECT PPE PROVISION TO FRONTLINE HEALTHCARE WORKERS

The lack of a reliable central supply chain has led to many frontline health care workers being without critical PPE to conduct their work safely. While the COVID-19 Action Coalition continues to strongly advocate for implementation of a dependable PPE supply chain throughout Massachusetts, the Coalition has been bridging this gap by actively supporting frontline health care workers and the institutions in which they work, including local hospitals, nursing homes, clinics, rehab facilities, and homeless shelters.

For clinicians without access to other options for PPE, the Coalition has been donating face masks, face shields, care packages, scrub caps, and isolation gowns. Thousands of PPE supplies have been sent all over Massachusetts through the collective work of the group in our efforts to protect front line health care workers. All donated or purchased supplies are collected at a central location and a team of volunteers mail or hand-deliver the supplies. Care packages for healthcare workers are made and shipped on a daily basis. Any front line health care worker in need of a care package may contact our group to see how best we can facilitate getting the PPE they need. If you wish to donate funds or PPE supplies to assist in this effort, please contact covaction19@gmail.com.

To date:
4,000 FFP2 masks distributed
>3000 face shields distributed
>1100 cloth masks distributed (probably much more adding in Nandana’s care packages!)

 

NOVEL PPE DESIGN AND PRODUCTION INITIATIVES

Many efforts and initiatives to address ongoing PPE shortages as well as cases where healthcare workers may not have access to PPE. The COVID-19 Action Coalition has listed below only resources that have been specifically designed for use by health care workers to prevent viral transmission and are currently being used by healthcare workers in hospital/healthcare provider settings. These products are in various stages of  development and testing to prove their effectiveness against viral transmission, which is critical to ensuring their appropriateness for use in the health care setting.

IMPORTANT NOTE: These products should only be used if healthcare workers do not have access to FDA-approved PPE. The listing below is provided for information purposes and does not imply endorsement by the COVID-19 Action Coalition over other innovative PPE prototypes. Please contact the manufacturers directly for further information.

List of initiatives:

  1. Mass General Brigham Center for COVID innovation: https://covidinnovation.partners.org/. The MGB Center for COVID Innovation’s mission is to facilitate the development of new innovations that flatten the COVID-19 curve and protect front line clinical staff across the MGB community and beyond. They have brought together researchers, physicians, engineers, makers, and industry all in the collective effort to develop and validate PPE designs that could help protect medical workers. Their working format is very open; they welcome the collaboration with other makers and innovators in this space.The MGB center has dedicated working groups for design of face shields, full body protection, N95 respirators, reuse, surgical masks, swabs, validation, and ventilators. You can see updates of each of these projects on their website, as well as who to reach out to if you want to get involved or have technical questions. Contact: https://covidinnovation.partners.org/wg-info/
  2. MasksOn.org: This initiative provides clinicians face mask kits free of charge, when they do not have access to FDA approved personal protective equipment (PPE). These face mask kits consist of a snorkel mask and a custom-made adapter which attaches to a viral/bacterial air filter. The initiative has partnered with Lightspeed Manufacturing which has an ISO9001 certified facility and is assembling and shipping the mask kits. At this time 500 mask kits are being produced per day. The masks have passed fit tests at multiple sites and are undergoing further testing with NIOSH testing equipment for quality control purposes and to monitor quantitative work of breathing. Since this device is not FDA approved, it is recommended for use only in situations where FDA approved PPE is not available. Contact: https://maskson.org/
  3. Artisans Asylum: https://artisansasylum.com/: Artisans Asylum is a maker space in Somerville, MA who are now dedicating all resources to focus on the production of PPE including masks, face shield, and disposable gowns. They have received the approval of prototypes and are not set up to take orders at cost, which is variable depending on materials available. We are happy to help you connect with them in order to match your needs
    ●PPE Available:
    Face Shields: disposable and reusable, has been tested and provided to Cambridge Health Alliance,Atrius Health
    Hospital Gown designs (both resusable and disposable) in partnership with Boston Medical School students, Boston Medical Center, South Shore Hospital and Atrius health
    ● Surgical masks: prototype is underway
    ● If interested in any of the above PPE for your hospital or if you would like to provide feedback on their prototypes. Contact: Nicolas Warren, 215-285-8132, nicolas.warren@atrisansasylum.com.
  4. Lowell Makes https://lowellmakes.com/covid-19-response/: Lowell Makes is working on 3D-printed masks and face shields. They are bringing together various makers in the community, working with local hospitals, and sharing their designs openly. The masks have been tested at several local hospitals. Of note: the masks are currently not FDA or NIOSH approved. Contact: info@lowellmakes.com
  5. FormLabs 3d printed swabs: According to the FormLabs website, the nasal swabs have cleared all testing hurdles and are now being produced. Key milestones in testing the swabs were conducted by USF Health faculty researchers in the Departments of Radiology and Infectious Diseases in collaboration with Northwell Health, including validation testing, and rapid clinical testing at Northwell Health and Tampa General Hospital. All testing showed that the 3D printed nasal swabs perform equally to standard swabs used for testing for COVID-19. Contact: https://formlabs.com/covid-19-response/covid-test-swabs/.