by CHRIS ROGERS
There are ample supplies now, but if a massive surge of COVID-19 patients comes, local health care workers and emergency responders will need every respirator and face mask they can get. Officials are working hard to secure more personal protective equipment (PPE), local businesses are developing new ways to manufacture masks, and citizens are even volunteering to sew makeshift masks as a last resort.
“If we don’t have any cases, it could last a couple months. If we have [the virus] get into a nursing home or somewhere, it could be a week,” Winona County Emergency Management Director Ben Klinger said, describing how long local first responders’ supplies of PPE might last.
“Currently, we do not have a shortage because we had prepared for H1N1,” Klinger stated, referring to masks and respirators. There was a local stockpile of PPE left over from that 2009 swine flu scare, and while some of the gear is now past its expiration date, Klinger explained that local authorities have been able to work with federal agencies and the manufacturers to ensure it is still good to use. Overall, “We’re doing OK right now, but we also haven’t had any cases. If we get to the point where we have cases, we’ll go through them quickly,” Klinger stated.
Winona Health Chief Administrative Officer Rebecca Lamberty said Winona Health has already received an order of PPE from Minnesota’s emergency stockpile and is requesting supplies from federal caches, as well. Currently, she said the health system has “several thousands” of respirators and thousands of surgical masks.
How long will the current supply last? “It could be weeks,” Lamberty answered. “If it’s not a big surge, we would have PPE for months. But if it’s a massive surge, it could be less than a week.”
Respirators, masks, plastic gowns, and face shields or goggles — PPE are key defenses in the fight against COVID-19 because they allow health care workers to give potentially life-saving treatment to sick patients without getting infected themselves. They also help limit the spread of disease from people are infected or might be.
There are two kinds of masks. Respirators — such as N95 masks — need to be properly fitted to form a seal around the face. Respirators filter what the wearer is breathing in. Surgical masks are used to catch what the wearer is breathing out. Respirators protect the wearer from others, and surgical masks protect others from the wearer.
That is how respirators and face masks are meant to be used. However, the U.S. Centers for Disease Control (CDC) advised emergency responders, given the current nationwide shortage of respirators, “Face masks are an acceptable alternative until the supply chain is restored. Respirators should be prioritized for procedures that are likely to generate respiratory aerosols, which would pose the highest exposure risk to [health care personnel].”
Lamberty reported that Winona Health staff are currently implementing a number of steps to conserve PPE, including the extended use and reuse of respirators and masks. “They can be actually used for days as long as they are not soiled, damaged, or difficult to breathe through,” Lamberty told the Post. Typically, PPE are discarded after use, but the CDC guidance on how to stretch PPE supplies that are at-risk of running out suggests reusing masks or wearing the same mask throughout a shift. Lamberty said that Winona Health staff throughout the organization are wearing face masks. In Winona Health’s units dedicated to potential COVID-19 patients, health care staff are wearing respirators only for procedures that may produce aerosols, Lamberty said — such as inserting a ventilator tube. “It’s not necessary unless they’re doing some kind of an aerosolizing treatment,” she stated.
Businesses, citizens step up to make masks
Marty Renk’s sister texted him the link on Sunday. In Billings, Mont., doctors used 3D printers to make face masks. Renk is the engineering manager at Alliant Castings, a Winona foundry with several 3D printers. By Monday morning he was making prototypes.
“The design the doctors came up with in Billings is exactly what we created,” Renk said. “They have the electronic digital file of that mask on their website. I just downloaded that, and within 20 minutes we are printing that exact mask.”
The mask is plastic with a piece for a filter to be inserted. Initially, the Montana inventors cut out pieces of surgical masks to insert into the plastic mask — getting multiple uses out of a single mask — and then later used a hospital-grade filter material. The plastic portion can be sanitized and reused. The filter is changed out with uses.
“We’re still trying to get some answers from the folks in Billings on exactly what they used to seal the mask,” Renk said. He is working on how to get a respirator-quality seal around the mask, but at a minimum the masks could potentially be used to boost supplies of surgical masks.
“It certainly might be of interest to us,” Lamberty said when asked if Winona Health would be interested in using those masks. “As of today, we have not asked them to produce those for us on our behalf, but it’s certainly top of mind.”
Across the country, some health agencies — including Blue Cross Blue Shield of Minnesota and Allina Health — are calling on ordinary citizens to help sew makeshift masks as a last resort for health care providers and nursing homes. These homemade, cotton masks are not respirators and they are not medical-grade surgical masks, but they might be better than nothing, local officials said.
“When I saw these efforts that were coming, I thought, ‘I don’t want to send masks to Indiana. I want to send masks locally,’” Winona Area Quilt Guild member Kathy Seifert said of seeing efforts in other states. She and friends helped organize a system for care facilities to request homemade masks, for volunteers to produce them, and the Winona Friendship Center to act as a hub for distribution. “We’ve got orders for 340 masks,” Seifert said.
Separately, Autumn Ellenbecker saw a post calling for Winona-area people to sew masks. “I thought, ‘Oh, that would be easy enough,’” she stated. Now, Ellenbecker has made 190 masks and keeps getting requests for more. “It’s kind of hard to say no to people who are requesting things for their elderly great-grandparents,” she said. It’s a little nuts, she admitted. “My living room is completely full of fabric and elastic and irons and threads. It’s turned into a little sweat shop here, but it feels good that we’re able to do something from our house that’s helpful,” Ellenbecker said. “It’s something I can do that’s helpful while I’m sitting at home instead of going crazy,” she added.
Lamberty said Winona Health appreciated the offer for homemade masks, but does not need them currently. “They should really only be used in the complete absence of PPE. Right now, we’re not allowing our staff to use those. Of course, in a crisis situation, those decisions may be updated. But as of right now, we’re not allowing our staff to use those,” she explained.
After all real PPE is exhausted, the CDC advised, “In settings where face masks are not available, [health care personnel] might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort.”
Klinger also said first responders do not need makeshift masks currently. However, he added, “I subscribe to the old adage. Anything is better than nothing.”
The most basic and most important thing citizens can do to help right now is follow guidance to stay home except for essential errands and isolate at home when sick, except to seek medical care, Lamberty said. “I want everyone to realize how these small actions will absolutely save the lives of people we know and love. If I could put a plea out to anybody, it’s ‘stay home,’” she said.
For a link to a recommended pattern for homemade masks, visit blog.bluecrossmn.com/covid19masks/ or visit the Winona Area Quilt Guild’s Facebook page.