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Health workers face equipment shortages, risks amid COVID-19 outbreak

Karen Bouffard
The Detroit News

As COVID-19 cases explode across Michigan, hundreds of health care employees are working without adequate personal protective equipment — placing themselves, their families and the public at risk, workers tell The Detroit News. 

Michigan Nurses Association President Jamie Brown, a critical care nurse at  Ascension Borgess Hospital in Kalamazoo, said nurses have each been issued one N-95 face mask — the kind recommended by the federal Centers for Disease Control and Prevention. 

The masks are designed to be used once, but they're being used time after time and stored in paper bags between shifts, Brown said.   

Dr. Chris Port, M.D. stands outside the emergency room at Spectrum Health in Grand Rapids Friday, March 20, 2020.

Ascension Michigan, a Catholic health care system with 15 hospitals across the state, insisted the health and safety of patients and workers alike is its top priority.

"We are following the updated CDC guidelines regarding suspected and confirmed COVID-19 cases and the use of personal protective equipment," Ascension said in a statement. "The safety of our caregivers and patients is our utmost priority as we all work to slow the transmission of COVID-19 and care for all those in need."

Nurses reached out to The Detroit News from across the region to talk about what's going on inside their hospitals but requested anonymity about themselves and their places of employment for fear of losing their jobs for speaking out. One said his health system sent a letter to staff threatening termination for unauthorized comments.

Many nurses complained they don't have the personal protective equipment they need to care for suspected and confirmed COVID-19 patients. They said they fear they will get sick and expose their children and elderly relatives to the virus. The equipment needs include masks, face shields, gowns, shoe covers and more, they said. 

Michigan Medicine, the University of Michigan's health system, has said it has enough equipment to deal with COVID-19 patients but acknowledges other hospitals aren't so fortunate. It's accepting donations of medical supplies to share around the state. 

Gov. Gretchen Whitmer said Friday that some Michigan companies have collaborated with the state to secure additional masks for health care workers. Whitmer said she was not certain of the exact count but was confident it was “in the millions.” 

West Michigan hospitals have enough personal equipment to meet current needs, said Dr. Chris Port, chief medical officer for a group practice of emergency physicians that staff emergency departments at 13 hospitals across the west side of the state. But they are conserving the supply in anticipation of shortages as the pandemic expands, he said. 

"We’re hopeful for better containment, but we’re preparing for a larger number of those patients, yes," Port said. "We have not run out of things — we would like to have more, but we’re putting policies in place on how we will (conserve) so that when we have more patients we'll have what we need."

Sanitation workers, phlebotomists, X-ray technicians, hospital transportation workers and countless others also are putting themselves at risk, said Larry Roehrig, president of AFSCME Council 25, the Federation of State, County and Municipal Employees. 

"It’s also all the janitors and the people who drive buses, cleansing hospitals and public buildings and everything else," Roehrig said. "They’ve been face to face with people all these weeks. 

"I haven’t seen anything like this since 9/11, where people in spite of their personal possibility for harm have said 'This is what I do, and if I don’t do it, somebody else is going to get really, really sick.'

In Kalamazoo, labor leader Brown said nurses at many hospitals across the state are working without appropriate personal protective equipment.

"There are several of the nurses that believe they have been exposed because of the personal protection equipment not being available," she said.   

Michigan Medicine has been a leader in adopting policies — such as hazard pay and creating an additional 120 hours of paid leave — to give financial protection to nurses who care directly for COVID-19 patients, Brown said. But nurses at many other Michigan hospitals have no such protections, she said. 

"The nurses' concerns are that we don’t have enough equipment to keep us safe — and if we do get sick, if it's going to impact us financially or not," Brown said.

Nurses describe conditions

Six nurses working at different hospitals across lower Michigan said they're not wearing the protective equipment recommended by the CDC and are worried they'll catch COVID-19. 

They're worried they'll bring the infection home to their small children, elderly relatives or immune-compromised family members.

Some are wearing surgical masks, which don't keep out shreds of the coronavirus that are expelled when a patient coughs or sneezes while getting their throats swabbed for a COVID-19 test. Others have been issued a single-use N-95 face mask that they wear for an entire day. 

Security personnel check potential patients for COVID-19 symptoms outside the emergency department at Spectrum Health Hospital in Grand Rapids on Friday, March 20, 2020.

Henry Ford Health System, one of Michigan's biggest hospital systems, has indicated that it's keeping a close eye on its protective equipment.

"We are monitoring our supply inventories closely including masks, gowns, face shields, wipes and other products to keep our patients and team members safe," Henry Ford said in a statement. "Like all health systems, our concerns will increase as the number of positive cases arise. We are in constant communication with our suppliers and continue to take measures to extend the life of our supplies." 

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Several nurses, meanwhile, complained their hospitals are rationing COVID-19 tests, and many people are not being tested who are seriously ill and might have the coronavirus.

"People are coming in with shortness of breath and looking like they’re going to die, and we can’t give them a COVID-19 test," one nurse said. 

Another intensive care nurse said she was home on quarantine when she spoke with The News by phone. She said she didn't care directly for a COVID-19 patient, but patients with the coronavirus were being cared for in her unit. 

After coming down with the symptoms of COVID-19, she had to wait several days to be tested and was still waiting Friday for the results. 

Wayne State University, the Wayne State University Physicians Group and the community group ACCESS have begun curbside testing for health care workers and first-responders and tested 362 on Friday and Saturday. 

The testing will continue for health workers and first-responders who are showing symptoms from noon to 5 p.m. on Sunday, and from 9 a.m. to 6 p.m. on Monday at the ACCESS health center at  6450 Maple in Dearborn. Testing will also be available from 9 a.m. to 6 p.m. Monday at the WSU Physicians Group headquarters at at 400 Mack  in Detroit.

"Why not have a protocol of prioritizing people who are first-line?" she said. "A nurse should have been able to say I don’t feel well, and get a test." 

Others are frustrated with the time it takes to receive test results, even for seriously ill patients. The Beaumont, Henry Ford and University of Michigan health systems have their own in-house tests, which can be processed in hours.

But many Michigan hospitals are relying on commercial testing companies or the state Bureau of Laboratories in Lansing, and the nurses said it can take days to get results. In the meantime, health care workers are caring for many sick patients without knowing if they have COVID-19. 

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"We’re sending out these samples, and it’s taking up to five days, and the whole time you’re sitting in the hospital and using up all this personal protective equipment," one nurse said.  

Those who care for confirmed COVID-19 cases at one nurse's hospital wear full protective gear, including a gown, gloves and a face special mask that "looks like a gas mask with a filter screwed into it." 

But only a few of the masks are available, the nurse said. So nurses who are caring for apparent COVID-19 patients, whose test results aren't yet available, don't get the protective equipment.

"We only have two for-sure COVID-19 patients in the hospital, but we have upwards of 100 that are hospitalized waiting for results," the nurse said. 

Another nurse at a different hospital said she purchased her own masks at Home Depot.  She hasn't brought them to work yet and doesn't know if her hospital would let her wear them. 

Another nurse said workers at his hospital are making home-made face shields. 

Making masks 

Some nurses are taking matters into their own hands. Nurses at the Henry Ford Innovation Institute created their own design for a mask using nylon jersey fabric, elastic bands, Velcro, tongue depressors and air filter material.

A Henry Ford system spokesperson said they are not being used in the health system's hospitals.

Crafters across Michigan are itching to help out — though it isn't clear where to send masks they create, or if hospitals would accept them.

“Just tell us what they’re made of, give us a standardized pattern and tell us where to send them,” said Karen Dunnam of Grand Rapids. She is part of a Facebook group called Forward Action Michigan that’s “interested in making the world a better place,” she said.

A groundswell of crafters like Karen Dunnam of Grand Rapids want to make face masks for health care workers, but it is unclear whether hospitals would use them.

On another front, the region's health system have begun accepting donations of medical supplies from the public.

Henry Ford Health System is collecting materials at the loading docks at its corporate offices, located at One Place Drive, between Second and Third streets, 3½ blocks south of West Grand Boulevard in Detroit, and at Henry Ford Allegiance Health, 205 N. East Ave. in Jackson.

The Beaumont Health system is accepting donation of medical supplies 24-7 at the Beaumont Service Center, 26901 Beaumont in Southfield. They're looking for everything from face masks, to disinfecting wipes and disposable surgical caps, gown, gloves and shoe covers, but cannot accept home-sewn masks, 3D printed ventilator parts, medicines, blankets or medical equipment. 

Michigan Medicine is also accepting materials that it plans to distribute to hospitals across the state. 

The University of Michigan health system's drop-off donation site is open daily at the North Campus Research Complex, at the corner of Huron Parkway and Plymouth Road in Ann Arbor.

The health system is accepting everything from gowns, shoe covers, facemasks and eye shields to nasal swabs and powered air-purifying respirators and PAPR (powered air purifying respirator) hoods.

The donation center is at 2800 Plymouth in Ann Arbor, which is set back from Plymouth Road and Huron Parkway.

Michigan Medicine is not accepting homemade face masks at this time; "however, if this changes, an announcement will be made," the health system said in a press release. 

“It’s truly incredible what we have heard from local residents and businesses, and people all over the state, in recent days," said Janet Abbruzzese, director of supply chain management for Michigan Medicine.

"We’ve received offers of supplies that they know are needed to care for COVID-19 patients, and our team has ramped up quickly to be able to accept them. We have already had an amazing outpouring of supplies from scientific laboratories across the university, and now we are turning to the broader community.”

Dr. Nasir Husain, director of the Infection Prevention Program at Henry Ford Macomb Hospital, said he’d viewed a video showing how employees at the Henry Ford Innovation Institute made their mask, and thinks it’s a "good innovative design."

“They have all the elements that you need in a good mask,” he said. “They have a nice HEPA (high particulate-efficiency air) grade filter between the two layers of the mask, it’s washable, you can throw it in the washing machine with chlorine.”

It’s only an issue of getting permission from the federal government to use the masks at Henry Ford’s hospital. But he thinks under the circumstances of the pandemic, that might be possible, since the filter used in the masks is already government approved.

“A lot of things that are being done during this crisis that haven’t been vetted through years and years of bureaucratic red tape,” he added. “When we’re in a crisis, there are so many things that we have to do just to make sure we’re able to have the resources, and to be able to provide safe health care to people.

“The hospitals are overwhelmed, the doctors are sick, the nurses are sick, we don’t have masks."

Husain noted that recent guidance from the CDC suggested that in cases of severe lack of resources, health care workers can consider covering their noses with a bandana or whatever is available.

“I’d rather use this mask, whether it’s vetted by a system or not, than put a bandana on my nose,” he said.

kbouffard@detroitnews.com

Twitter: @kbouffardDN

Staff Writer Beth LeBlanc contributed.