PPE

For physicians, nurses and other medical staff working on the front lines of the COVID-19 pandemic, only one thing stands between them and the virus itself: personal protective equipment.

But, with the number of COVID-19 cases in the United States surging, healthcare facilities across the nation face shortages of personal protective equipment, potentially leaving medical personnel and patients seeking care without protection, according to the Centers for Disease Control and Prevention. 

Dr. David Fleeger, president of the Texas Medical Association, called the shortage of PPE within the state of Texas unacceptable in a written news release supporting Texas Gov. Greg Abbott’s call for PPE donations last week.

“Physicians and the rest of the health care team cannot be thrown into battle poorly equipped,” Fleeger said, according to the news release. “We cannot safely test, examine, or treat our patients without protective masks, gowns, gloves, and other equipment.”

When taking care of patients, physicians do not know if patients have COVID-19 until testing results come back, Dr. Ashley Sturgeon, president of the Lubbock Country Medical Society, said. In the meantime, physicians must protect themselves with PPE to avoid infecting other patients as well as their own families.

For Cheryl Aguas, a second-year medical student at the Tech Health Sciences Center helping to collect PPE, this issue hits close to home, as her father is an emergency room physician in the at-risk age group for COVID-19.

“I heard from my dad that there’s a shortage (of PPE) and I think it’s really scary to know,” she said. “You know, you want workers to be able to come to their job and know (they) are completely safe. Like there will always be enough supplies for (them) to be safe.”

Various solutions to extend or prolong the life of current supplies of PPE are being worked on, according to a statement provided by the City of Lubbock, but the bottom line is more PPE is needed by all healthcare entities.

The supply of available PPE is comparable to the level of a river with water going in and out, Dr. Craig Rhyne, regional chief medical officer for Covenant Health, said in a video provided by Covenant. More PPE is being used now because of the increased number of cases are being seen, he said but there are also multiple sources of PPE.

“So, it’s all about the ratio of inflow and output, so it’s not something you can put a firm number on,” he said. “You can’t say this is the date we will run out of PPE. It just doesn’t work like that.”

Still, concerns regarding limited supplies of PPE in this region have been communicated, Joseph Heppert, vice president for research and innovation at Tech, said.

“We received some input from the leadership at the Health Science Center that in their interactions with hospitals and clinics in the area, they were receiving reports that they were concerned the stocks of PPE were very low and that they would need additional resources, especially given that everybody in the country right now is trying to apply to the normal supply chain to get more personal protective equipment,” Heppert said.

The process for facilities to acquire additional PPE begins through existing distributors and supply chains, according to a statement provided by the City of Lubbock. If their needs are unable to be met, then they can submit a request to the Public Health Department. If the department cannot fill the request, it is routed to the Emergency Operations Center. If the same happens there, it is turned into a State of Texas Assistance Request routed to the state.

A State of Texas Assistance Request does not guarantee PPE will be received, according to the Texas Health and Human Services website. Supplies may be insufficient to meet demand. 

With hospitals using PPE in overdrive, the concern across the country is that is it challenging to order additional PPE, Sturgeon said, making it important to be good stewards of existing supplies in Lubbock.

Medical personnel need to be protected, Aguas said. They are the ones taking care of everyone else, and the last thing they should have to worry about is PPE.

“They just need to focus on being able to come there and do their job well and not worry about their risk of getting sick,” she said. 

Local Relief

In response to the lack of PPE, various contingents of the Tech and Tech HSC communities have donated these items or helped source them from the community, collectively providing more than 160,000 gloves, 18,000 masks and more to the Tech HSC and to the Lubbock County Medical Society, respectively.

“The physicians have been extremely grateful,” Sturgeon said regarding donations of PPE. “It’s just such peace of mind for some of them knowing that they might even have one mask.”

Among Tech HSC students, the efforts to collect PPE began with Cameron Ludwig, a second year medical student. As the COVID-19 pandemic began escalating in severity, Ludwig said he found himself essentially kicked out of the hospital as he was non-essential personnel.

Still trying to help, he reached out to a physician he had formerly shadowed, expecting he could babysit or pick up groceries, he said. Instead, he heard about the need for personal protective equipment.

“He told me that there was a good chance UMC might be running out of PPE by like, the end of the weekend. And he said whatever I could do would be appreciated, just do it,” Ludwig said. “And so at that point I was like OK, let’s see what happens.”

At this point, roughly two weeks ago, Ludwig said began reaching out to friends and eventually his class president, leading to his initial efforts turning into a project with 20 medical students alone. Approximately a 100 medical students in total are working on various projects to help with the crisis, he said.

The initial plan was to just call dental clinics and vet clinics and request any spare PPE that might be available to donate, Ludwig said. However, he expanded it in scope to include physical therapy clinics, nursing homes, schools, restaurants, nail salons and more.

“Honestly with the PPE shortage I knew that (calling dental and vet clinics) just wasn’t going to be good enough, and so I expanded it to every place I could think of that would have maybe even a box of gloves,” he said.

Medical students signed up for categories and reached out to local businesses, Ludwig said. If they had PPE available to donate, the students would collect the items and bring them to the Lubbock County Medical Society, where PPE would then be distributed to local hospitals.

“Our drive has included the N95 masks which are more protective against viral particles, regular surgical masks, which may be at least somewhat protective, gloves, gowns, face shields, that sort of thing,” Sturgeon said.

Over 67,000 gloves, 105 N95 masks, 16,000 surgical masks and 4,000 gowns were collected based on tallies from April 1, Ludwig said.

The response from the community has been incredible Aguas, a second year Tech HSC medical student working with Ludwig, said.

“It’s honestly been the coolest thing to see our entire community step up and just want to be so generous with the resources that they have,” she said. “I don’t think they realize how helpful it is going to be to our doctors and our nurses.”

In addition to donations from local businesses collected by Tech HSC students, another significant source of PPE has come from within the research community on the Tech campus in an initiative fronted by Heppert.

With many of the laboratory functions on campus shutting down due to COVID-19, large amounts of PPE within the labs have become unnecessary for the coming weeks or months of sheltering at home, Heppert said.

As a result, his office sent out several appeals requesting groups lend materials including rubber examination gloves, eye protections and face protections such as googles or face shields, respirator masks and external protective equipment.

Following Heppert’s appeals, over 2,000 masks and 100,000 gloves were collected from laboratories at Tech, with a very large number of the masks being N95 respirator masks, he said. Additionally, face shields and eye protection are also being collected and tabulated.

“Naturally hearing numbers like 2,000 masks and 100,000 gloves, I was overwhelmed by the generosity and the engagement of the Texas Tech research community, and I should emphasize too, it wasn’t only the research community, there were also many academic programs that normally use PPE in laboratory environments that stepped up,” Heppert said.

The collected items will be utilized at the discretion of Tech HSC leadership in hospitals and clinics throughout Lubbock, but also potentially in surrounding regions in need of additional PPE, Heppert said.

Given the demand and potential future demand for PPE, everyone would love to see more available, but the fact that Tech was able to fill part of the need in this initial period of development for the situation is inspiring for everybody, Heppert said, including those at the HSC.

There is likely to be continued need for PPE as the number of COVID-19 cases rise Lubbock, Heppert said, so donations of this kind benefit the community as a whole.

“We’re just so proud of the efforts by the university to pull together not only to keep our students, our staff and our faculty safe, but also to serve the community,” Heppert said. “And I think an important lesson we can all take here, is in addition to the connection we feel to our university, we also need to feel that love and connection to the community that helps support it as well.”

If individuals have any personal protective equipment they are interested in donating or questions regarding donations, they can contact the Lubbock County Medical Society office number at (806) 785-7917. Additionally, Ludwig said people looking to donate can reach him at cameron.ludwig@ttuhsc.edu.

Editor's Note: A clarification was made to better represent a statement in this article. 

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