Coronavirus: Use bandanas and scarves to protect yourself if face masks are not available, says CDC
To tide over the shortage, guidelines issued by CDC also call for re-using facemasks. Trump, meanwhile, has said the federal government is not a shipping clerk and that state governors should buy masks
As the number of confirmed cases and the death toll continues to go up in the US, doctors and nurses are sounding warnings about the shortage of critical supplies such as masks and ventilators.
To tide over the shortage of personal protective equipment (PPE), the US Centers for Disease Control and Prevention (CDC) has now come up with strategies to optimize the supply of face masks and one of them includes wearing homemade masks such as scarves and bandanas as a last resort for healthcare workers.
"In settings where facemasks are not available, healthcare personnel might use homemade masks (for example bandana, scarf) for the care of patients with COVID-19 as a last resort," says CDC guidelines.
Experts, however, caution that homemade masks are not considered personal protective equipment, since their capability to protect healthcare personnel is not known.
"Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face," says CDC.
More than eight weeks after the first US case of the virus was detected in January, the Trump administration continues to struggle in its response to fight the pandemic. So far, over 14,200 cases have been reported from across 50 states in the US and at least 205 have died.
According to a report, for example, the Open Cities Health Center at St Paul in Minnesota is considering stopping services altogether as they running "dangerously low" on face masks that they need to protect themselves.
"There's a huge likelihood that we will have to stop services altogether," Dr Cynthia Woods, medical director of the federally-backed health center, told Pioneer Press.
"There's absolutely no way to protect myself. Not only can I not protect myself, but I also can't protect my patients," Dr Faezah A Bux, an anesthesiologist in central Kentucky told the New York Times.
The report says that in recent times, Dr Bux had to intubate several elderly patients in respiratory distress without the respirator masks and protective eye gear recommended by the CDC.
CDC guidelines also call for re-using facemasks
The CDC is calling for limited re-use of face masks. The guidelines say that limited re-use of facemasks is the practice of using the same facemask by one healthcare personnel for "multiple encounters with different patients but removing it after each encounter."
"As it is unknown what the potential contribution of contact transmission is for SARS-CoV-2, care should be taken to ensure that healthcare personnel does not touch outer surfaces of the mask during care, and that mask removal and replacement be done in a careful and deliberate manner," says the CDC.
The instructions stipulate that healthcare workers should leave the patient care area if they need to remove the facemask. It says that facemasks should be carefully folded so that the outer surface is held inward and against itself to reduce contact with the outer surface during storage.
The folded mask can be stored between uses in a clean sealable paper bag or breathable container, it adds.
Experts say that the facemask should be removed and discarded if soiled, damaged or hard to breathe through. They, however, caution that not all facemasks can be re-used.
"Facemasks that fasten to the provider via ties may not be able to be undone without tearing and should be considered only for extended use, rather than re-use. Face masks with elastic ear hooks may be more suitable for re-use," say the guidelines.
The CDC has also suggested implementing extended use of facemasks. "Extended use of facemasks is the practice of wearing the same facemask for repeated close contact encounters with several different patients, without removing the facemask between patient encounters," it says.
The facemask should be removed and discarded if soiled, damaged, or hard to breathe through. The CDC warns that medical personnel must not touch the face mask and if they do touch or adjust their facemask, they must immediately wash their hands.
The CDC has asked hospitals to selectively cancel elective and non-urgent procedures and appointments for which a facemask is typically used by healthcare personnel.
Experts say that when in a severe crunch situation when no facemasks are available, options include excluding medical workers who may be at higher risk for severe illness from COVID-19.
This includes those of older age, those with chronic medical conditions, or those who may be pregnant, from caring for patients with confirmed or suspected COVID-19 infection.
"Use a face shield that covers the entire front (that extends to the chin or below) and sides of the face with no facemask. Consider the use of ventilated headboards," say the guidelines.
States should get masks, federal government not a shipping clerk
At a White House briefing on March 19, President Donald Trump said that millions of masks are currently been made. At the same time, he also emphasized that it was up to the states to obtain masks and that the federal government was not a shipping clerk.
"The federal government is not supposed to be out there buying vast amounts of items and then shipping. We're not a shipping clerk. The governors are supposed to be, as with testing, the governors are supposed to be doing it," said Trump.
He said, "We'll help out and we'll help out wherever we can. And we can buy in volume and in some cases, great volume with the masks as an example, which were a problem. We have helped out and they're right now millions of masks being made. But, this is really for the local governments, the governors and people within the state depending on the way they divided it up. And they'll do that, and they're doing a very good job of it."
Vice President Mike Pence also spoke about the supplies during the briefing and said that industrial masks that are manufactured as N95s are now available to hospitals.
"Following the signing of last night's bill, all of those masks now have liability protection and the companies can sell industrial masks to hospitals. We continue to work with healthcare providers, businesses, and state leadership to identify available supplies not merely in the federal stockpile, but much more importantly available across the private sector. We're encouraged to see companies like Honeywell and 3M, that I visited a few short weeks ago, take advantage of the changes in the law last night that allow the sale of industrial masks directly to hospitals," said Pence on March 19.
He said these companies have now greatly increased — by the tens of millions — their production of N95 masks "that will give our healthcare workers the protection that they need to minister to those that are dealing with the symptoms or the disease of coronavirus."
"3M is increasing their output to 420 million a year. At the production in January, they make 35 million per month at that facility. We are prioritizing the distribution of those," said Pence.
When a journalist questioned when these masks will be ready, Pence said: "They're available now."
He elaborated, "The 3M facility that I was at told me that in January they went to full production on 35 million masks. The legislative change means that all 35 million of those that started to be produced at full capacity in January can now be sold to hospitals," said Pence.