# 1209
A reoccurring theme in this blog has been the quandary that health care workers will find themselves in should a pandemic erupt and there not be sufficient PPE's (Personal Protective Equipment) to protect them.
A conversation is going on right now, on Allnurses.com, an online community of more than 240,000 health care professionals, about this issue in a thread called Will You Work In A Pandemic?
Officials who assume that nurses and other Health Care Workers (HCW's) will blindly risk themselves, and their families, by working without protective gear should read this thread.
It is an eye-opener.
Without masks (good ones, not surgical masks), gloves, and gowns, health care workers in direct contact with infected patients will likely contract the virus at an accelerated rate. Many would be sickened, and some might die, for lack of proper protective gear.
It would be hard to fault anyone for not being willing to work without the proper safety equipment.
We don't expect fire-fighters to run into a burning building without their bunker gear, how can we expect a nurse or other health care worker to treat infectious patients (with a potentially fatal disease) without masks and gloves?
While the United States has reportedly stockpiled 150 million masks in the Strategic National Stockpile, and hospitals, doctor's offices, and ambulance services undoubtedly have some reserves on hand, during a pandemic these disposable supplies will be consumed at an incredible rate.
Many hospitals have been reluctant to order in large quantities of PPE's due to the uncertainty of the pandemic threat, the costs involved, and the logistics of storage. Few facilities could operate without weekly deliveries of fresh supplies.
An N95 mask becomes difficult to breath through after a few hours of wear, a nurse or HCW's would be hard pressed to get more than 4 or 5 hours out of one, if that. Working a 12 hour shift, at best, they might get by with 2 masks a shift, but more likely they will need 3, perhaps 4.
Gloves?
Well, technically they should be changed between each patient, but that `standard of care' will likely be modified during a pandemic. Still, an hour, maybe 2, and most latex or vinyl gloves are going to be ready for the bio-hazards bin.
Gowns?
Well, as long as they don't get grossly contaminated, you can wear one for some time. Perhaps an entire shift, but you would quickly become a walking bio-hazard, and you'd risk not only infecting yourself when you changed your mask, drank or ate, but others as well as you worked.
With roughly 8 million HCW's, assuming they were all working (which they won't), you'd need 25 million masks per day, and probably 50 million pairs of gloves.
Suddenly that 150 million mask stockpile doesn't look so impressive. It might last a week, 10 days if we are lucky.
The private stockpiles held by hospitals would extend this timetable, but they too would quickly run out. In a matter of weeks, during a severe pandemic, our current supplies would be extinguished.
What then?
Your answer can be found in the All Nurses forum, where most of the respondents say they won't work without PPE's.
A pandemic wave is expected to last for 6 to 12 weeks, and multiple waves are anticipated during a pandemic. Even when the number of cases in a community have died down, hospitals will likely be treating some patients. There will be little rest for the weary HCW.
If 1918 was any indication, HCW's could be dealing with 200 `pandemic days' over an 18 month period. That's going to take a lot of PPE's. And the ability to restock in between waves, when everyone in the world will be clamoring for supplies, is doubtful.
You can add to these PPE's all of the other disposables that hospitals use routinely. IV's, Infusion kits, syringes, medicines of all sorts . . . even oxygen . . . these may all be in short supply during a pandemic.
We have 2 choices.
We either pay now to protect our healthcare workers by laying in the needed supplies, or we accept that somewhere down the line in a pandemic we will pay a much steeper price.
And no, this isn't just about influenza patients. While a pandemic rages, heart attacks, strokes, c-sections, car accidents, and every other medical need we see today will continue. More than 275,000 people rely on dialysis treatments. Who will care for them during a pandemic? What about those on chemotherapy? Or receiving radiation treatments?
There are nearly 1 million people in hospital beds in the United States on any given day, and 2 million more in long-term nursing facilities. Who will care for them?
Any way you slice it, health care workers are going to be one of our most precious assets during a pandemic. Having them on the job will mean the difference between life and death for millions of people. They deserve to be protected.
Yes it's expensive, and difficult, and we could prepare and a pandemic might not come for years. It's the cost of doing business in a dangerous world.
The idea that we might coerce (force is such an ugly word) HCW's into working without PPE's, by threatening them with revocation of their licenses or fines, isn't an answer. Even if it could be done, without protection, most would probably fall to the virus in short order, and all that would have been gained is a few days of coverage at a horrific cost.
It's been two years since the warning went out. Hospitals and other medical facilities have had two years in which to prepare. A pandemic should catch no one by surprise.
How many are prepared to weather a 90 day pandemic wave?
Not many, I fear.
One of the nurses on this forum, Indigo Girl, put it better than I possibly could. I'm sure she won't mind if I quote her.
I hope that that the CDC and HHS are noting the responses in this thread.
The public will assume that nurses are going to be working.
The govt assumes this also.
Homeland Security, are you reading this?
When will you sit down and talk with us? We are not just statistics.
We are real individual people with families that depend on us.
This is an avoidable tragedy. But only if we face it head on, and do something about it now, before a pandemic strikes.
Is anyone listening? Does anyone care?
