Iowa orders hospitals to address shortage of protective gear

Iowa Gov. Kim Reynolds holds a news conference on COVID-19 at the State Emergency Operations Center in Johnston, Iowa, on Friday, April 10, 2020. (Olivia Sun/The Des Moines Register via AP, Pool)

By RYAN J. FOLEY Associated Press

IOWA CITY, Iowa (AP) — Health care providers facing a shortage of personal protective equipment must extend the use of their face masks, use washable gowns and shorten hospital stays for some coronavirus patients, the Iowa Department of Public Health said Friday.

The agency directed hospitals to take extraordinary steps to conserve limited supplies of critical masks, gowns, shields, goggles and respirators.

“We understand the issuance of this order may be unsettling, but due to the global shortage of PPE supply, we have determined that now is the time to take this action,” the department’s deputy director, Sarah Reisetter, said at a news conference.

Gov. Kim Reynolds said the state’s requests for equipment from the now-depleted national stockpile have been delayed and that state and local agencies and providers have struggled to procure adequate supplies.

The order came as the number of people with the coronavirus in Iowa jumped by 118 to nearly 1,400 on Friday. About 20% of those infections have been among health care workers, the testing of whom is prioritized because of the limited number of tests available.
Advocates for health care workers said they were alarmed by the shortage, which comes about two or three weeks before Iowa’s COVID-19 caseload is expected to peak.

“I’ve heard from dozens of medical workers who are terrified to go to work in Iowa’s hospitals, medical clinics and nursing homes,” tweeted Sen. Claire Celsi, a Democrat from West Des Moines.
Iowa has reported 31 deaths due to the virus, including two adults from Linn County whose deaths were confirmed Friday.
Nearly half of the 119 patients hospitalized statewide were in intensive care, and a quarter were on ventilators. Most of the 17 newly hospitalized patients came from the southeastern region that includes Davenport and Iowa City.

The new order directed hospitals to reduce demand for protective gear by limiting contact with patients, canceling all non-essential services and treating more patients over the phone.

Hospitals that have taken those steps but still face shortages were told to have workers use the same face masks for treating several different patients, and wear washable cloth gowns, reusable goggles and face shields.

To preserve respirators, the order directed hospitals to decrease the length of stay for “medically stable patients” infected with COVID-19, the disease caused by the virus.

Hospitals in crisis may also have to consider the use of homemade cloth masks, even though their effectiveness is unknown for preventing virus transmission.

Masks, respirators and other equipment beyond their expiration dates should also be used and re-used in limited situations under the order.
While hospitals are facing PPE shortages, they have sufficient intensive care unit beds and ventilators to manage their caseloads, the governor said.

Reynolds, who has closed schools and businesses but refused to implement a stay-at-home order, said her team is “continuing to do everything we can” to provide protection to health care workers in a challenging environment.

State agencies have been ordering supplies, and a Department of Corrections program that uses inmate labor has made 2,800 gowns and planning to expand production, she said. The governor also praised manufacturers and individuals who have started making masks.

“It’s an all-of-the-above approach,” she said. “We are looking at every available opportunity.”

Representatives of the Department of Administrative Services and the homeland security department didn’t respond to inquiries Friday about the status of the orders the governor said they made.
Soldiers and airmen with the Iowa National Guard have made 309 deliveries of personal protective equipment since March 24, a spokesman said.