Conservation needs to be a national priority, as providers’ product shortages grow more severe and on-hand inventories decline during COVID-19.
Approximately 97 percent of respondents to Premier’s latest survey on hospital supply levels have implemented at least one conservation protocol for personal protective equipment (PPE), as recommended by the Centers for Disease Control and Prevention (CDC). Despite this, hospitals say they are still burning through more N95 respirators, surgical masks, isolation gowns and face shields than can be replaced.
Hospitals are also critically short of viral swabs that are needed to perform COVID-19 testing, with more than 60 percent reporting fewer than 250 such swabs on hand. In addition, 20 percent of hospitals say they are in need of additional ventilators.
These are key findings from Premier’s latest survey of hospitals to assess their supply inventory levels during the coronavirus outbreak, below. As part of our role as a connection point for healthcare providers, suppliers and the government, Premier surveyed our members from March 16-20, 2020, to understand their on-hand inventories to help adapt our nation’s response to coronavirus.
Since Premier’s last survey of hospitals’ supply levels, it’s clear that supply shortages have only grown worse as COVID-19 cases spread, and there are now multiple domestic and international organizations competing with healthcare providers for limited supplies.
At this point, it’s critical to take unprecedented steps to organize healthcare providers, distributors, manufacturers and government to look across the supply chain and get a real accounting of available supply and where it needs to be allocated. It’s also imperative to ramp up American manufacturing, band together and activate every industry possible to help meet this growing challenge.
N95 Respirator Shortage
According to the survey, hospitals ranked the supply of N95 respirators as their top concern. While the largest number of respondents (about 39 percent) reported having more than 1,000 N95s on hand, a plurality of respondents (23 percent) are burning through more than 100 masks a day, meaning that many systems have less than 10 days’ inventory.
Despite these concerns and the fact that nearly all respondents have implemented at least some conservation protocols for PPE, there is still significant room to further improve conservation measures specific to N95 masks, including extending the wear of N95s (a measure followed by 60 percent of respondents), re-using N95s (40 percent), using expired N95s (33 percent) and using industrial N95s (20 percent).
We continue to recommend that healthcare providers follow all of the conservation protocols to stretch PPE supplies, and are concerned that conservation measures for N95s have not been implemented across the board. Many clinicians have learned throughout their careers that the use of expired or industrial masks is not best practice for patient care. We urge the CDC to provide more support for their recommendations, and continue to encourage providers to follow all of CDC’s recommendations.
Hand Sanitizer Shortage
Shortages for hand sanitizer were the second most concerning shortage for survey respondents, with 64 percent reporting an active shortage. An additional 25 percent have less than two weeks’ supply. However, clinicians do have alternatives, as proper hand hygiene with soap and water can be more effective than alcohol-based hand sanitizers.
Surgical Mask Shortage
Surgical mask shortages were the third most concerning shortage for survey respondents. While most respondents (56 percent) reported having more than 1,000 surgical masks on hand, a quarter (26 percent) burn through that amount every day, meaning that the mask supply is generally a day’s supply or less.
Isolation Gown Shortage
Half of survey respondents (50 percent) reported having more than 1,000 isolation gowns on hand, however, about 25 percent also burn through that same quantity each day. In addition, about 17 percent of respondents had fewer than 250 gowns available.
Viral Swab Shortage
Viral swabs are another area of concern, as most respondents (60 percent) have fewer than 250 swabs on hand, while about 21 percent burn through more than 100 swabs a day. The swab shortage was largely due to the fact that one of the top manufacturers is based in Italy, which has been hit particularly hard by the virus. However, the U.S. Air Force has committed to making shipments of the swabs, so the problem may resolve in coming weeks.
According to the survey results, 20 percent of respondents report needing additional ventilators immediately. Approximately 27 percent can take on an additional one to five patients before they require additional ventilators. About 24 percent can accommodate six to 10 more patients, and about 30 percent can take 11 or more patients before they need additional ventilators.
To help healthcare providers manage through the shortages, Premier recommends:
- Premier encourages all members to follow CDC-recommended conservation protocols for PPE and to be judicious with supply orders for the foreseeable future. We have created a free infographic to educate staff on this critical need now.
- Always a market of last resort, we also recommend caution before purchasing from grey market vendors, as products can be of questionable quality and/or counterfeits. Please follow Premier’s guidance for grey market purchases before buying to avoid scams.
- For members having trouble obtaining viral swabs or other testing materials, a testing FAQ from the CDC is available here, which includes guidance on product alternatives. In addition, several labs are in the process validating alternate specimen collection devices, so providers should coordinate directly with those labs.
Premier’s survey was conducted from March 16-20, 2020, and sent to a representative portion of the Premier membership. Approximately 260 health systems responded, representing roughly 990 acute care facilities or 20 percent of the nation’s total hospitals. Not every respondent answered every question. Approximately 41 percent of the respondents reported having at least one confirmed COVID-19 case being treated at their facility.
During COVID-19, Premier continues to act as a trusted connection point for healthcare providers, suppliers and the government. We are working 24/7 to address challenges as they occur and help our alliance of more than 4,000 hospitals and health systems and 175,000 non-acute providers access the supplies they need to serve their communities. We are also partnering with the Administration and private sector to create both short-term and long-term solutions, and sharing our insights to help inform the public understanding.
Access our COVID-19 resources and tools.