The Kindness of Strangers: Donations of Personal Protective Equipment
Mary C. Vrtis, Ph.D., MSN, RN, OCN, NEA-BC, FCN
November 24, 2023
Help Started to Arrive, the Impact of Ordinary People Who Came to Our Rescue
Although I have tried to stay objective and factual in this document, I am going to deviate from that voice for this section. It was the kindness of strangers, people who cared about our health and wellbeing and volunteered to help that got us through the worst times during the COVID-19 pandemic.
At one of the bleakest moments for this author, in my role as Vice President of Clinical Operations for a home health and hospice agency that cared for patients in Northern Virginia, the District of Columbia, and Maryland, I was called to the front desk. I was introduced to a woman carrying a very large box with hundreds of cloth face masks that she and a group of volunteers had sewn and were donating. She said to just call when we needed more.
Even now, almost four years later I am crying as I write this. Hospitals had cancelled elective procedures and stopped allowing visitors. Doctors’ offices converted appointments to virtual visits. Home health and hospice staff had to see patients in their homes, the setting with the least control over infection prevention measures. And we did not have enough equipment to assure their protection. Every night we saw the number of patients with confirmed COVID-19 infections increase by thousands, and the number of deaths were skyrocketing. It was a terrifying time.
We had very few medical masks and staff had to wear the same mask for multiple patients. N-95s and face shields were in very short supply and two offices did not have any. Our supplier, one of the biggest companies in the nation, did not have any more supplies of protective equipment to send. Even gloves were difficult to obtain. The agency bought a whole lot of “surgical masks” and “KN95s” from a popup supplier who shipped counterfeit products. The counterfeit KN95s would not pass a fit test and could not be used. Isolation gowns were being recalled by our primary supplier due to contamination during the manufacturing process.
The number of patients with active COVID-19 infections who were being sent home was increasing rapidly as the hospitals were running out of beds. Most of these patients were very ill, diagnosed in the Emergency Department and sent home – only to have to return to the hospital a few days later with pulmonary congestion, acute shortness of breath, and dropping oxygen saturation. Patient family members in the home providing direct care were under investigation for COVID-19 as well and had to be considered infected until proven that they were not.
We also had staff members who contracted COVID-19 out sick constantly, with a few in the hospital. There were several staff members with family members or close friends who had become infected and subsequently died. We were worried about one home health aide who was a no call, no show at the patient’s home the day before. We could not reach her or an emergency contact. She called later that morning to apologize for not being at work because she had been admitted to ICU the previous morning.
I was very concerned about one of our RNs who had developed a COVID-19 infection but was not recovering. Though she said she felt better, I could hear the severity of her dyspnea over the phone. She had to pause to breathe after every two words. She was showing signs of asymptomatic hypoxemia associated with SARS-CoV-2 infections that staff was seeing in our patients and was regularly checking her oxygen saturation. The criteria for long COVID fit. Another donor provided six huge cases of medical grade masks that could be distributed to our frontline staff. Yet another man arrived with fabric masks made by his family in Vietnam. We received a case of face shields from Apple. Supplies were also coming in from #GetUsPPE. We were most grateful!
I cannot begin to describe what it meant to me personally, and to our team, to receive these gifts of love. As our supply of personal protective equipment improved, we were able to provide fabric masks to our vulnerable patients and their direct caregivers to keep them safer as well. There is no possible way to estimate the amount of suffering and deaths prevented by the kindness of these people who made time in their busy days to care for our healthcare teams, our patients, and our patient’s families.
Craftivists versus COVID-19 the DC/Maryland/Virginia “Million Mask Challenge”
This group of 4,535 craftivists made and donated fabric masks to over 571 medical facilities and organizations in the metropolitan DC area (the DMV) from March 2020 until supplies were no longer needed. The website also provided instructions for how to make masks as well. Their website from March of 2020 describes who they were as follows:
“Who We Are — How We Described Ourselves in March 2020
We are a group of craftivists, stuck at home right now with a wide variety of skills, who want to help fight COVID-19. We refuse to allow the limits placed on us to prevent us from acting together to help our nation’s health care providers.
We met on social media and decided to organize. We have never met in person, only through online conference calls. We are smart, no-nonsense, evidence-based people, and count nurses and health care experts among our organizers. We stepped up because many creative people are searching to find out how to help, trying to sort through misinformation online. At first we were just nine people. Now, we are an effective team of more than 50 organizers, working hours a day, on top of homeschooling our kids and trying to do our normal jobs.
The week of March 20, 2020, we were inspired to act, after reading news stories about Providence health in Washington state, and Deaconess Health System in Indiana. After these two hospital groups published patterns and projects, efforts to manufacture fabric masks sprang up spontaneously in every state in America. Our effort was among these.” (Craftivists versus COVID-19. https://millionmaskchallenge.com/).
#GetUsPPE Distributes Millions of Units of Personal Protective Equipment to Healthcare Organizations and Schools
Get Us PPE (getusppe.org) was a not-for-profit organization founded by a group of front-line physicians (including, but not limited to, Dr. Jeremy Faust, Dr. Ali Raja, Dr. Megan Ranney, Dr. Valerie Griffeth, Dr. Shika Gupta, Dr. Esther Choo, and Dr. Shuhan He). This group also helped organize volunteers to find and distribute personal protective equipment to frontline workers who desperately needed it. It started with a Twitter hashtag #GetMePPE.
Large hospitals that were part of healthcare systems received critical supplies first, and nursing homes, physician offices, home health and hospice providers, health clinics, homeless shelters, and schools faced extreme difficulty in sourcing equipment. As of June 2020, 65.5% of healthcare facilities who contacted Get Us PPE (getusppe.org) for help reported that they had NO personal protective equipment available for front line staff. The problem got progressively worse:
- June 2020: 65.5% of organizations had NO personal protective equipment available, 22% about one week of supplies, 12.5% less than a 7-day supply left.
- July 2020: 70.0% NO personal protective equipment available, 19% about one week of supplies, 11% less than a 7-day supply left.
- August 2020: 77% NO personal protective equipment available, 14% about one week of supplies, 9% less than a 7-day supply left.
- September 2020: 80% NO personal protective equipment available, 15% about one week of supplies, 4% less than a 7-day supply left.
- November 2020: 66% NO personal protective equipment available, 19% about one week of supplies, 15 less than a 7-day supply left.
- December 2020: 63% NO personal protective equipment available, 20% about one week of supplies, 17% less than a 7-day supply left.
From March to December of 2020, this volunteer organization received 19,981 requests for help from providers in 46 states. Respirators (N95 and equivalent), surgical/ medical masks, and disinfectant wipes were the most desperately needed items in the first several months. A global shortage of nitrile gloves then occurred in November and December 2020. To meet the needs of all requestors, over 87 million units of donated personal protective equipment were needed. The organization was able to provide 6.5 million units of personal protective equipment but was not able to meet 85% of the requests received (Get Us PPE, 2020 December).
As of July 2, 2021, when they were no longer able to accept requests, the organization had delivered 17,540,571 units of donated personal protective equipment to more than 23,001 organizations in need from all 50 states. The organization developed and used a fair distribution algorithm to equitably distribute needed equipment and also provided information on how to make cloth masks and gowns. This amazing organization was able to save countless lives through the efforts of an incredible team of visionaries and volunteers.
Apple Produced and Donated Millions of Masks and Face Shields
On April 5, 2020, Tim Cook announced that Apple had already sourced and was donating 20 million masks, and the company was in the process of manufacturing 20 million face shields (Cook, T. [@tim_cook]. (2020, April 5). Apple is dedicated to supporting the worldwide response to COVID-19. [Tweet, video]. Apple. https://twitter.com/tim_cook/status/1246916489589837824?lang=en). All of these were donated to healthcare facilities and organizations in need.
Cook, T. [@tim_cook]. (2020, April 5). Apple is dedicated to supporting the worldwide response to COVID-19. [Tweet, video]. Apple. https://twitter.com/tim_cook/status/1246916489589837824?lang=en)
Craftivists versus COVID-19. https://millionmaskchallenge.com/
Get Us PPE. https://www.getusppe.org