A recent survey by the U.S. Department of Health and Human Services’ Office of the Inspector General across 323 hospitals highlighted the absence of adequate personal protective equipment (PPE) necessary to attack the novel coronavirus pandemic.
When people hear of the PPE shortage, most think of the risk to nurses and doctors. It is true that we are disproportionately affected by the virus, some even requiring hospitalization, ICU care or passing away from the illness. Protecting those taking care of COVID-19 patients so they can continue their work should be reason enough to demand adequate PPE for health-care professionals. However, it is short-sighted to think that the lack of PPE affects just doctors and nurses. It takes many more people at the frontlines to keep a hospital functioning. And the repercussions of not having adequate PPE extend from health-care workers to patients and to the community at large.
A lack of PPE also affects respiratory therapists overseeing a patient’s oxygen supply, medical aides who check patients’ blood glucose levels and vital signs, and tend to their requests, getting the attention of nurses and doctors when a patient takes a turn for the worse. A PPE shortage also affects environmental service workers who keep patients’ rooms cleans, and food service workers who provide our patients meals and remove their trays once they are done.
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An infected patient has delays in showing symptoms due to an incubation period, and many are asymptomatic throughout. For those not yet showing symptoms, or those who are asymptomatic carriers, unaware that they are infected, taking care of patients without adequate PPE would also increase the risk of a health-care worker inadvertently spreading the infection not only to co-workers and loved ones back at home, but also from an infected patient to a non-infected patient. This would violate the health-care professionals’ duty to first do no harm. Furthermore, increasing the numbers of infected individuals would increase the incidence of new infections not only where they work, but also where they live, and, for a city that requires public transportation, all the way in between.
Specifically for doctors and nurses, some may say “it’s what they signed up for.” Many aspiring doctors and nurses are driven by the desire to help those in need. However, even for those driven by altruism, I can assure you that medical students and nursing students did not have taking care of patients during a pandemic without adequate PPE anywhere on their radar. Some health-care workers would refuse to take care of patients without adequate PPE. This would lead to further shortages in staffing and increase the burden of care for the remaining healthcare workers. Increasing the patient caseload on top of the massive influx created by the pandemic would stretch our health-care workers too thin. This would negatively affect the quality of care of our patients.
Finally, leaving health-care professionals to flounder on their own inappropriately places the burden of having adequate PPE on them and their institutions when there is more to be done at the city, state and federal levels.
Adequate PPE is not only about personal protection. It is not about an individual nurse or doctor. Rather, it is about protecting the entire health-care system and larger community. Recent increases in PPE supply are heartening, and it is important to bolster them further to maintain an adequate supply. This will protect not only the nurses and doctors taking care of your loved ones, but also your loved ones in the hospital themselves, as well as the community at large.
Dastidar is a physician and clinical ethicist at New York Presbyterian-Columbia.