Critical Shortages Strain COVID-19 Response

Mar 20, 2020

Governor Steve Sisolak announced the statewide closures of schools, casinos and non-essential businesses to slow the spread of the novel coronavirus. The move is to save lives and to prevent the health care system from being inundated. However, the lack of crucial resources, including protective masks, tests and even providers, is already straining the system.

Dr. Jenny Wilson has been an emergency room doctor for more than two decades. She practices at St. Mary’s Regional Medical Center and is the medical director of the Reno Emergency Physicians Association.

As the number of COVID-19 cases increase statewide, and in Washoe County, she’s worried about the lack of personal protective equipment that helps prevent infections for doctors and patients.

“With regards to St. Mary's, locally, statewide, nationally and internationally, there is a shortage of appropriate personal protective equipment,” Wilson said.

Protective equipment includes gloves, gowns and masks. Wilson said she’s especially concerned about the lack of N95 masks, which are used by health care workers to prevent the spread of infection.

“It is a dire situation,” Wilson explained. "We cannot wait until we run out of N95 masks to figure out where we're going to get more.”

Wilson said that due to limited resources, some masks have been overused.

“I've been in touch with my colleagues around the region and I know that there's one place where each of the emergency medicine providers [have] one N95 mask,” Wilson explained. “You're supposed to only take it on and off six times before it loses its efficacy. It loses its seal, its ability to protect you against the very thing you're wearing it to protect you against.”

And getting more supplies is like a race against time.

“If every single person used the most protection that they could for every interaction with a patient,” Wilson said, “we would definitely run out, and I'm imagining we would run out while the pandemic is still going on.”

The Nevada State Medical Association represents about 2,000 doctors statewide. Jaron Hildebrand is the executive director of the group and said he’s been working with doctors, like Wilson, and many others in the state to obtain N95 masks to distribute.

“I'm getting calls from anesthesiologists, ER, urgent care, family physicians,” Hildebrand said. “We're giving them to any provider that's in need of these masks.”

Hildebrand said he’s seeing industries that use N95 masks for their work, scraping together what they have.

“I know the Sheriff's office, construction companies, non-essential businesses are starting to donate these masks to our providers,” Hildebrand said, “to help support the hospitals and our first responders.”

During this week, he said he was able to secure about 500 masks to distribute to a variety of providers. Many more are needed and he’s anticipating a shipment from various states and China, with thousands more. It’s not certain when or exactly how many N95 masks will be available, but he said he anticipates the shipment could arrive as early as this weekend.

These masks and other personal protective equipment are essential to protecting health care workers, who are needed to ensure the health system remains functioning during the crisis.

Northern Nevada HOPES is a community health care center in Reno. Sharon Chamberlain is the CEO and she said the pandemic is highlighting not just a lack of resources, but another health care capacity issue: the doctor shortage in Nevada.

“What this does is open up everyone's eyes, finally to the conversation that has been going on for years,” Chamberlain said, “that we have a medical health provider shortage in this state that is unprecedented.”

Chamberlain said more long-term solutions will be needed to address the ongoing doctor shortage.

“If we don't start working with our schools — to get more people graduating from medical schools and from physician assistants and RNs — and finding a way to keep those people in our state,” Chamberlain said, “we're going to see that when something like this happens, it can be extremely crippling to our entire community.”

According to the American Association of Medical Colleges, Nevada is ranked among the lowest in the country for physicians per capita.

Another shortage in Nevada is the lack of testing kits for COVID-19, which is a problem across the country. Chamberlain said more are needed to help the medical community mitigate the spread of the virus.

“We need a lot more tests. We're not testing at HOPES,” Chamberlain said. “We're doing screenings and we're referring to the health department. That's not what we want to be doing. We want to be able to do the test and help take some of that burden off, right there at the point of service, which is important with the community spread.”

Governor Steve Sisolak has announced the statewide shutdown of schools and non-essential businesses to stem the spread of the coronavirus. He has also highlighted the testing kit shortage, which makes it challenging to determine how widespread COVID-19 is in the state.

Chamberlain said she’s been in touch with health care leaders across the region. And since supplies are scarce and there’s a shortage of providers, the consensus is that the response to this pandemic requires sharing resources.

“I think we'd be willing to look at anything and everything in order to continue being able to curb this pandemic here in our area. So I think that across the board, I've heard that others are willing to share HR resources with providers, or even administrative type staff,” Chamberalin explained. “Anything we can do to help curb this epidemic. We're all in it together.”

For now, to curb the spread of coronavirus and reduce the burden to the health system, public health officials are urging the community to social distance and stay home. They are also asking individuals exhibiting symptoms, to first call a medical provider for guidance.