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Hospitals still ration medical N95 masks as stockpiles swell

Nurses picket Friday, Feb. 12, 2021 in Faribault, Minn., during a healthcare worker protest of a shortage on protective masks. One year into the COVID-19 pandemic, the U.S. finds itself with many millions of N95 masks pouring out of American factories and heading into storage. Yet there still aren’t nearly enough in ICU rooms and hospitals. (AP Photo/Jim Mone)

Nurses picket Friday, Feb. 12, 2021 in Faribault, Minn., during a healthcare worker protest of a shortage on protective masks. One year into the COVID-19 pandemic, the U.S. finds itself with many millions of N95 masks pouring out of American factories and heading into storage. Yet there still aren’t nearly enough in ICU rooms and hospitals. (AP Photo/Jim Mone)

Mike Bowen’s warehouse outside Fort Worth, Texas, was piled high with cases of medical-grade N95 face masks. His company, Prestige Ameritech, can churn out 1 million masks every four days, but he doesn’t have orders for nearly that many. So he recently got approval from the government to export them.

“I’m drowning in these respirators,” Bowen said.

On the same day 1,000 miles north, Mary Turner, a COVID-19 intensive care nurse at a hospital outside Minneapolis, strapped on the one disposable N-95 respirator allotted for her entire shift.

Before the pandemic, Turner would have thrown out her mask and grabbed a new one after each patient to prevent the spread of disease. But on this day, she’ll wear that mask from one infected person to the next because N95s — they filter out 95 percent of infectious particles — have supposedly been in short supply since last March.

Turner’s employer, North Memorial Health, said in a statement that supplies have stabilized, but the company is still limiting use because “we must remain mindful of that supply” to ensure everyone’s safety.

One year into the COVID-19 pandemic, many millions of N95 masks are pouring out of American factories and heading into storage. Yet doctors and nurses like Turner say there still aren’t nearly enough in the “ICU rooms with high-flow oxygen and COVID germs all over.”

While supply and demand issues surrounding N95 respirators are well-documented, until now the reasons for this discrepancy have been unclear.

The logistical breakdown is rooted in federal failures over the past year to coordinate supply chains and provide hospitals with clear rules about how to manage their medical equipment.

Internal government emails obtained by The Associated Press show there were deliberate decisions to withhold vital information about new mask manufacturers and availability. Exclusive trade data and interviews with manufacturers, hospital procurement officials and frontline medical workers reveal a communication breakdown — not an actual shortage — that is depriving doctors, nurses, paramedics and other people risking exposure to COVID-19 of first-rate protection.

Before the pandemic, medical providers followed manufacturer and government guidelines that called for N95s to be discarded after each use, largely to protect doctors and nurses from catching infectious diseases themselves. As N95s ran short, the Centers for Disease Control and Prevention modified those guidelines to allow for extended use and reuse only if supplies are “depleted,” a term left undefined.

Hospitals have responded in a variety of ways, the AP has found. Some are back to pre-COVID-19, one-use-per-patient N95 protocols, but most are doling out one mask a day or fewer to each employee. Many hospital procurement officers say they are relying on CDC guidelines for depleted supplies, even if their own stockpiles are robust.

Chester “Trey” Moeller, a political appointee who served as the CDC’s deputy chief of staff until President Joe Biden’s inauguration last month, said efforts to increase U.S. mask production were successful, but there has since been a federal breakdown in connecting those who need them with this new supply.

“We are forcing our health care industry to reuse sanitized N95s or even worse, wear one N95 all day long,” he said.

Before the pandemic tore through the U.S., the demand for N95 masks was 1.7 billion per year, with 80% going to industrial uses and 20% into medical, trade groups say. In 2021, demand for N95 masks for medical use is estimated by industry sources to be 5.7 billion.

With the increased demand and prodding from the federal government, U.S. manufacturers stepped in. Bowen’s company, Prestige Ameritech, boosted production from 75,000 N95 respirators a month to almost 10 million during the COVID-19 pandemic.

Still, many hospitals are building their stockpiles over fears of a future surge, and restricting the number given directly to health care workers.

The AP spoke with a dozen procurement officers who buy supplies for more than 300 hospitals across the U.S. All said they have enough N95s now, between two and 12 months worth, sitting in storage.

Even so, all but two of those hospital systems are limiting their doctors, nurses and other workers to one mask per day, or even one per week. Some say they are waiting for the supply to grow even more, while others say they never plan to go back to pre-COVID-19 usage.

Dean Weber, vice president of corporate supply chain management for Sioux Falls, South Dakota, Sanford Health, said the one-N95-per-patient guidelines were established with the help of manufacturers.

“You know, the mask manufacturers are in the business of selling masks,” Weber said. He said he prioritizes safety over cost, but he doesn’t believe these respirators need to be tossed after each use. “We were all, in fact, you know, just infatuated with an N95.”

But John Wright, vice president of supply chains for Salt Lake City-based Intermountain Healthcare, says reusing masks or wearing them longer “would not be appropriate” once they have enough supplies. He hopes his 23 hospitals and hundreds of clinics will be back to single use within two weeks.

As the coronavirus spread through spring and summer, demand for N95 masks surged to unprecedented levels and the respirators disappeared from stockpiles and distributors’ shelves. Hospitals and distributors looked overseas to fill the need. Read from source….