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Sourcing Personal Protective Equipment During the COVID-19 Pandemic

Educational Objective
To Understand the need for PPE and summary of commenter suggestions for sourcing.
1 Credit CME

As the coronavirus disease 2019 (COVID-19) pandemic accelerates, global health care systems have become overwhelmed with potentially infectious patients seeking testing and care. Preventing spread of infection to and from health care workers (HCWs) and patients relies on effective use of personal protective equipment (PPE)—gloves, face masks, air-purifying respirators, goggles, face shields, respirators, and gowns. A critical shortage of all of these is projected to develop or has already developed in areas of high demand. PPE, formerly ubiquitous and disposable in the hospital environment, is now a scarce and precious commodity in many locations when it is needed most to care for highly infectious patients. An increase in PPE supply in response to this new demand will require a large increase in PPE manufacturing, a process that will take time many health care systems do not have, given the rapid increase in ill COVID-19 patients.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Corresponding Author: Edward Livingston, MD, JAMA (edward.livingston@jamanetwork.org).

Published Online: March 28, 2020. doi:10.1001/jama.2020.5317

Conflict of Interest Disclosures: None reported.

References
1.
Strategies for optimizing the supply of facemasks. Centers for Disease Control and Prevention. Published March 17, 2020. Accessed March 27, 2020. https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
2.
Bowden  E , Campanile  C , Golding  B . Worker at NYC hospital where nurses wear trash bags as protection dies from coronavirus. New York Post. March 25, 2020. Accessed March 27, 2020. https://nypost.com/2020/03/25/worker-at-nyc-hospital-where-nurses-wear-trash-bags-as-protection-dies-from-coronavirus/
3.
Morris  C . Some Amazon Prime shipments won’t arrive for a month due to coronavirus. Fortune. March 23, 2020. Accessed March 27, 2020. https://fortune.com/2020/03/23/amazon-prime-delays-coronavirus/
4.
Trexler  P , Tarpley  T . Strategic National Stockpile fails to quench Ohio’s need for medical supplies. MSN. March 26, 2020. Accessed March 27, 2020. https://www.msn.com/en-us/news/us/strategic-nation-stockpile-fails-to-quench-ohios-need-for-medical-supplies/ar-BB11HVZw
5.
Bauchner  H , Fontanarosa  PB , Livingston  EH .  Conserving Supply of personal protective equipment—a call for ideas.   JAMA. Published online March 20, 2020. doi:10.1001/jama.2020.4770PubMedGoogle Scholar
6.
Project N95. the national COVID-19 medical equipment clearinghouse. Accessed March 27, 2020. https://www.projectn95.org/
7.
Reusability of facemasks during an influenza pandemic: facing the flu. National Academies of Sciences, Engineering, and Medicine; 2006. https://www.nap.edu/catalog/11637/reusability-of-facemasks-during-an-influenza-pandemic-facing-the-flu
8.
Vozzola  E , Overcash  M , Griffing  E .  Environmental considerations in the selection of isolation gowns: a life cycle assessment of reusable and disposable alternatives.   Am J Infect Control. 2018;46(8):881-886. doi:10.1016/j.ajic.2018.02.002PubMedGoogle ScholarCrossref
9.
Harris  AD , Pineles  L , Belton  B ,  et al; Benefits of Universal Glove and Gown (BUGG) Investigators.  Universal glove and gown use and acquisition of antibiotic-resistant bacteria in the ICU: a randomized trial.   JAMA. 2013;310(15):1571-1580. doi:10.1001/jama.2013.277815PubMedGoogle Scholar
10.
Rubin  MA , Samore  MH , Harris  AD .  The importance of contact precautions for endemic methicillin-resistant Staphylococcus aureus and vancomycin-resistant Enterococci.   JAMA. 2018;319(9):863-864. doi:10.1001/jama.2017.21122PubMedGoogle ScholarCrossref
AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 CME points in the American Board of Surgery’s (ABS) Continuing Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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