Do we have enough supplies? - Printable Version
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Do we have enough supplies? - magnus - 06-28-2020
2-3 months ago, our lack of supplies was daily headline news. Not enough ventilators, PPE, hand sanitizer, disinfecting wipes, elastic bands, toilet paper, pulseoxes, and many other things.
We've finally caught back up for most of these, though I'd argue that we're still short on PPE given how much limitation and reuse is still happening with N95s in healthcare settings.
But with cases surging again, are we about to run out of supplies again?
RE: Do we have enough supplies? - M T - 06-28-2020
I don't know who you mean as "we". California was monitoring counties on PPE but I no longer find that. LA County reports it here. San Diego Co. reports it here.
The state provides rather raw data here on PPE acquisitions (Click "Explore")
3 weeks ago the SCC Superintendent of Schools indicated they didn't have enough PPE to open.
Texas Medical Center (multiple hospitals in Houston) reports their supply here and here.
However, I talked yesterday to a physician that has a small (non-geriatric) LTCF in Texas. He's been applying to the state (or state medical association) for a supply of PPE but has not gotten any (for more than a month).
RE: Do we have enough supplies? - Genuine Realist - 06-28-2020
I would think the most indicate threatening shortage. Is ICU bed space.
RE: Do we have enough supplies? - chrisk - 06-28-2020
If cases continue to increase, more testing will be needed and testing supplies are currently a limiting factor.
They can ramp up the use of poooled testing to conserve capacity to run rests. But that becomes less effective if the percentage of positives increases too much.
RE: Do we have enough supplies? - dabigv13 - 06-28-2020
I don't have much special insight here, but I think the answer for the OP is probably not. Gloves and hair coverings have joined masks as being locked away and rationed, and our brands have switched to no name brands which are thinner and not as good. My wife still can't source n95 masks for her practice.
DPA should have been used aggressively to address these shortages. Should have been done months ago. Should still be done now particularly since our epidemic is only getting bigger.
RE: Do we have enough supplies? - fullmetal - 06-28-2020
On top of all that, it seems we shouldn't be trusting some mask suppliers in Texas:
https://www.propublica.org/article/he-removed-labels-that-said-medical-use-prohibited-then-tried-to-sell-thousands-of-masks-to-officials-who-distribute-to-hospitals
I don't think ICU bed space is a limiting factor as much as ICU staffing capacity. How many beds can you add before you start running short on doctors, nurses, RTs, and techs? How many of those staff can you afford to be exposed to covid daily and have quarantined for 14 days if they start feeling ill?
How much staff do you need to handle a 150% capacity ICU when five patients start coding at the same time?
RE: Do we have enough supplies? - magnus - 06-28-2020
(06-28-2020, 11:30 AM)fullmetal Wrote: On top of all that, it seems we shouldn't be trusting some mask suppliers in Texas:I think when NYC hit these shortages they pulled in from other disciplines. Disciplines with the most overlap in experience first. Doctors that had little ICU experience but were available would get assigned the more basic tasks while the specialists supervised/focused on the more ICU specific tasks.
https://www.propublica.org/article/he-removed-labels-that-said-medical-use-prohibited-then-tried-to-sell-thousands-of-masks-to-officials-who-distribute-to-hospitals
I don't think ICU bed space is a limiting factor as much as ICU staffing capacity. How many beds can you add before you start running short on doctors, nurses, RTs, and techs? How many of those staff can you afford to be exposed to covid daily and have quarantined for 14 days if they start feeling ill?
How much staff do you need to handle a 150% capacity ICU when five patients start coding at the same time?
RE: Do we have enough supplies? - BostonCard - 06-28-2020
(06-28-2020, 11:30 AM)fullmetal Wrote: On top of all that, it seems we shouldn't be trusting some mask suppliers in Texas:
https://www.propublica.org/article/he-removed-labels-that-said-medical-use-prohibited-then-tried-to-sell-thousands-of-masks-to-officials-who-distribute-to-hospitals
I don't think ICU bed space is a limiting factor as much as ICU staffing capacity. How many beds can you add before you start running short on doctors, nurses, RTs, and techs? How many of those staff can you afford to be exposed to covid daily and have quarantined for 14 days if they start feeling ill?
How much staff do you need to handle a 150% capacity ICU when five patients start coding at the same time?
I have heard anecdotally that COVID-19 patients were not being resuscitated if they coded.
BC
RE: Do we have enough supplies? - magnus - 11-18-2020
with stricter mandates, Costco is again running out of toilet paper. Crazy
I hope those of you in CA and WA among others have a comfortable supply.
RE: Do we have enough supplies? - Snorlax94 - 11-18-2020
(11-18-2020, 05:56 PM)magnus Wrote: with stricter mandates, Costco is again running out of toilet paper. Crazy
I hope those of you in CA and WA among others have a comfortable supply.
I read about the shortages, and when I looked on the Target App, my local Target wasn’t offering curbside pickup for TP (at least for name brands).
We were down to about 1/4 of a giant Costco Cube of TP so I bought the next Cube last week and on that trip there was plenty at Costco (on a weekday afternoon).
I haven’t seen bulk gloves in stores in ages, but I ordered some from Walmart.com and the quality was actually much better (and thicker) than the ones I used to get from Costco and Amazon.
Everyone seems to carry lots of no name hand sanitizer and no name disposable “dust masks.” I briefly saw ASTM Level 1 medical masks in some stores over the summer, but not since. I do see a lot of KN95 and KF94 masks available online. I probably should stock up on masks. If both the US and EU go “purple” it could make things tight.
RE: Do we have enough supplies? - teejers1 - 11-18-2020
(11-18-2020, 05:56 PM)magnus Wrote: with stricter mandates, Costco is again running out of toilet paper. Crazy
I hope those of you in CA and WA among others have a comfortable supply.
It is crazy. This post caused me to head over to Costco because we are very low on TP. Empty.
There is a special place in hell for hoarders, especially in pandemics or other crises.
And I know I shouldn't stereotype, but I do anyway. My gut tells me the hoarders are all those clamoring for more lockdown "for the good of everyone," and then they hoard . . . for the good of only themselves.
On the bright side, we all should be getting more humorous videos to keep our spirits up.
https://www.youtube.com/watch?v=q0PBg_3iVBw
RE: Do we have enough supplies? - magnus - 11-18-2020
(11-18-2020, 07:45 PM)teejers1 Wrote:Sorry to hear, teejers1.(11-18-2020, 05:56 PM)magnus Wrote: with stricter mandates, Costco is again running out of toilet paper. Crazy
I hope those of you in CA and WA among others have a comfortable supply.
It is crazy. This post caused me to head over to Costco because we are very low on TP. Empty.
There is a special place in hell for hoarders, especially in pandemics or other crises.
Hopefully your local grocery stores still have some. If you want to time it for Costco, I believe they get new shipments every couple of days and usually in the morning.
(11-18-2020, 07:23 PM)Snorlax94 Wrote: I briefly saw ASTM Level 1 medical masks in some stores over the summer, but not since. I do see a lot of KN95 and KF94 masks available online. I probably should stock up on masks. If both the US and EU go “purple” it could make things tight.
medical masks is the more concerning one. As dabigv13 mentioned, doctors that want to use N95s are still resorting to reusing old ones. Hospitals may not be as bad off as they were in the Spring, but they certainly aren't at a point where any doctor can have a new one each day.
RE: Do we have enough supplies? - teejers1 - 11-18-2020
(11-18-2020, 09:50 PM)magnus Wrote:(11-18-2020, 07:45 PM)teejers1 Wrote:Sorry to hear, teejers1.(11-18-2020, 05:56 PM)magnus Wrote: with stricter mandates, Costco is again running out of toilet paper. Crazy
I hope those of you in CA and WA among others have a comfortable supply.
It is crazy. This post caused me to head over to Costco because we are very low on TP. Empty.
There is a special place in hell for hoarders, especially in pandemics or other crises.
Hopefully your local grocery stores still have some. If you want to time it for Costco, I believe they get new shipments every couple of days and usually in the morning.
(11-18-2020, 07:23 PM)Snorlax94 Wrote: I briefly saw ASTM Level 1 medical masks in some stores over the summer, but not since. I do see a lot of KN95 and KF94 masks available online. I probably should stock up on masks. If both the US and EU go “purple” it could make things tight.
medical masks is the more concerning one. As dabigv13 mentioned, doctors that want to use N95s are still resorting to reusing old ones. Hospitals may not be as bad off as they were in the Spring, but they certainly aren't at a point where any doctor can have a new one each day.
We'll be fine on the TP front - I have no doubt we'll make it through, as we did through R1 of hoarding.
As for masks, my wife's company doled out N95s to their employees. We've used 4 (out of 10) of them for 3 passenger flights over the last 8 months. Otherwise, we just use the more basic mask. That's all I've used in doing the household errands . . . so far, so good. Maybe we should see if doctors in southern part of SCC need a few more . . .
RE: Do we have enough supplies? - dabigv13 - 11-18-2020
(11-18-2020, 09:50 PM)magnus Wrote: medical masks is the more concerning one. As dabigv13 mentioned, doctors that want to use N95s are still resorting to reusing old ones. Hospitals may not be as bad off as they were in the Spring, but they certainly aren't at a point where any doctor can have a new one each day.
To clarify on this, I could get a new n95 each day, but they are Chinese made ones that don't fit my face well and seemed less well constructed, so I have been reusing my old 3M masks. Luckily I have about 10 now so the rotation is enough that the masks still seem in good shape. Our glove suppliers are all over the place as well, sometimes I have these bright orange ones that look absurd but at least are pretty durable. Other times I have some real shitty thin ones that tear easily.
In any case the medical supply chains are certainly still stretched, but better than they had been. We at least now seem to have ample culture swabs, which is something and a definite improvement from early days.
RE: Do we have enough supplies? - M T - 11-18-2020
Texas Medical Center publishes their status on PPE. Note that Houston is not yet having the crazy surges of the MidWest. (COVID patients are 16% of normal ICU; 10% of "full" ICU)
They have 9 months worth of N95 masks, nearly 5 months worth of surgical face masks, 21 months of eye protection, 4 months of gowns, 1.5 months of gowns (of which they go through more than a million a day!).
RE: Do we have enough supplies? - magnus - 11-19-2020
(11-18-2020, 11:32 PM)M T Wrote: Texas Medical Center publishes their status on PPE. Note that Houston is not yet having the crazy surges of the MidWest. (COVID patients are 16% of normal ICU; 10% of "full" ICU)
They have 9 months worth of N95 masks, nearly 5 months worth of surgical face masks, 21 months of eye protection, 4 months of gowns, 1.5 months of gowns (of which they go through more than a million a day!).
Does 9 months worth of N95 masks mean 1 per staff (doctor, nurse, OR techs, etc) per day? And does surgical face masks mean 1 per doctor/nurse/MA/etc per patient?
Or is it like it was in the late spring (I don't know what it is now), for N95, 8 hours of use and max 5 reuses.
RE: Do we have enough supplies? - M T - 11-19-2020
(11-19-2020, 01:58 AM)magnus Wrote:They don't specify further details on how they use them, so I presume per current CDC guidelines. They are using about 7,500 N95 and 133,000 surgical masks per day.(11-18-2020, 11:32 PM)M T Wrote: Texas Medical Center publishes their status on PPE. Note that Houston is not yet having the crazy surges of the MidWest. (COVID patients are 16% of normal ICU; 10% of "full" ICU)
They have 9 months worth of N95 masks, nearly 5 months worth of surgical face masks, 21 months of eye protection, 4 months of gowns, 1.5 months of gowns (of which they go through more than a million a day!).
Does 9 months worth of N95 masks mean 1 per staff (doctor, nurse, OR techs, etc) per day? And does surgical face masks mean 1 per doctor/nurse/MA/etc per patient?
Or is it like it was in the late spring (I don't know what it is now), for N95, 8 hours of use and max 5 reuses.