From IV poles in the hallways to ultraviolet-light disinfection of critically needed respirator masks for reuse, Long Island hospitals are finding ways to conserve the equipment that protects their employees from COVID-19.
“Everybody is anticipating the number of patients is going to increase for probably a couple more months,” and there are concerns over the long-term supply of protective equipment, said Dr. Barry Rosenthal, chairman of NYU Winthrop Hospital’s emergency department.
The state needs 20 million N95 respirator masks, but only has 2.5 million in a stockpile, Gov. Andrew M. Cuomo said on Sunday. The state is “shopping literally around the globe” for them, the governor said last week.
N95 masks offer greater protection from COVID-19 than regular surgical masks because of their tight weave and fit. In the past, hospitals needed them only in limited cases, such as patients suspected of having tuberculosis or certain serious viral illnesses, so they didn’t have a huge supply on hand, said Dr. Anthony Boutin, the chief medical officer and interim president and CEO of Nassau University Medical Center in East Meadow.
“We’ve been running at a clip that’s far greater than in the past,” he said.
NUMC and other hospitals separate the rooms of COVID-19 patients from those of other patients, which limits the number of times employees take on and off their protective masks and other equipment, Boutin said.
“These are basically red zones, so everybody would be wearing the same protective equipment all the time,” said Dr. Aaron Glatt, chair of medicine and chief of infectious diseases at Mount Sinai South Nassau hospital.
Mount Sinai also is starting to send its N95 masks to be sterilized for reuse, he said. At NYU Winthrop and the six Catholic Health Services of Long Island hospitals, on-site disinfection of N95 masks with ultraviolet light is beginning, officials said.
Northwell now has sealed, breathable, moisture-resistant bags that employees can store the masks in for use later, although “if the integrity of them goes away or they get wet, then they get a replacement mask,” said Dr. Mark Jarrett, chief quality control officer for Northwell Health.
Goggles and face shields also are worn more than once.
“If they can be cleaned, and we have things to clean them with, then they can keep reusing those as well, so we don’t waste resources at this time when we need more and more resources,” Jarrett said.
The reuses of the equipment follow U.S. Centers for Disease Control and Prevention guidelines, he said.
Outside COVID-19 areas of the hospital, all staff are required to wear surgical masks, to reduce the chance of exposure in case, for example, there is a patient who is asymptomatic but later turns out to be COVID-19 positive, Jarrett said.
There is no major shortage of surgical masks yet, but there could be if the number of COVID-19 cases dramatically rises elsewhere in the country, increasing demand, Jarrett said.
At Long Island Community Hospital, Catholic Health Services hospitals and the three Stony Brook Medicine hospitals, the IV poles of COVID-19 patients are now in the hallways.
That reduces the number of times nurses and others need to enter the room with protective equipment to change IV medications or reset alarms, said Michael DeMasi, director of clinical value analysis at Stony Brook University Hospital. A medical-grade plastic tube runs from the patient to the IV pumps, he said.
In addition, the hospital allows only “essential personnel” in COVID-19 patients’ rooms, which, with rare exception, excludes medical residents and other trainees, he said.
NYU Langone has over the past few weeks encouraged more patients, including those at NYU Winthrop, to use its “virtual urgent care,” a video chat with a care provider for non emergency medical conditions such as flu-like symptoms.
The number of people using the video chat has surged from about 60 a day in early March to 900 to 1,000 a day, NYU Winthrop spokeswoman Anne Kazel said.
The primary reason for the emphasis on virtual care is that “if you’re sick, we want you to stay home” and avoid potentially exposing other patients or health care providers to the virus, Rosenthal said.
“It’s an unexpected benefit that the fewer people who come to the emergency department, the less PPE [personal protective equipment] we need to use,” he said.