Helping to Solve the PPE Crisis

It’s become a part of everyone’s day-to-day conversation this year. And if you’re a parent or a caregiver of a medically fragile child, infection control and personal protective equipment (PPE) is absolutely nothing new.

But since the advent of the COVID-19 pandemic in mid-March 2020, it seems almost everyone knows about PPE and considers themselves an expert on it. Personal protective equipment has always been used in the health care setting, but Lisa Foster, Chief Clinical Officer at MGA admits that even at this level and to this degree of intensity, we are all living in uncharted waters.

Facing a Crisis

At MGA, the organization performs a risk analysis of how much and what kind of PPE will be required for the coming year. And perhaps to some folks’ surprise, it’s actually rather low when you are speaking of surgical masks and N95 respirators, says Foster. “The highest level of protection is the N95 respirator and we use them for patients who have airborne illnesses like tuberculosis.”

TB is an airborne illness, and while Coronavirus is primarily spread through close contact and respiratory droplets, it can sometimes spread by airborne transmission depending upon the size of the droplet, according to the CDC.

“This pandemic caused a huge need for both surgical face masks and N95 respirators for health care/home care personnel,” says Foster. So, when the pandemic hit, places like MGA had to figure out a plan in order to keep patients, clinicians, and everyone safe.

“When it comes to home care and the medically fragile population that we serve,” explains Foster, “it takes meticulous infection control practices, which we are all very used to.” She goes on to say that fortunately prior to Coronavirus, MGA’s clinicians didn’t typically need to use an N95 respirator unless there was an exposure to TB, which rarely occurs.

As COVID-19 reached pandemic levels, there were only a few N95 masks at each of the MGA locations and they were also running low on surgical face masks. The healthcare industry was hit with a crisis level supply chain of PPE, as defined by the CDC and MGA needed to have clinicians fit tested for N95 masks. The employees were sent off-site to a third-party occupational health provider–to make sure it was done as efficiently as possible.

The Fit-Test

A fit test is done in order to make sure there is a good seal on the mask.

The subject puts the N95 mask on and then places a hood on over it. Then either saccharine or peppermint is blown into the hood. If the subject being fitted can smell the sweetness or the minty smell they don’t pass. This means that there is
a section of the mask not completely sealed.

Needless to say, the subject must take off the mask and the hood and start all over again for a better fit. Sometimes it takes another size or brand of mask altogether to get a fit where you can no longer smell what is being sprayed.

Foster says that while field staff clinicians were undergoing fit tests, MGA’s clinical leadership team worked round the clock implementing emergency plans, assessing needs for PPE in all three states they operated in, and finding reliable and high-quality vendors.

“We first identified those who are in a high-risk role,” says Foster. That means, they either move from home to home as a visiting nurse/therapist, or they have other attributing factors that could put them at risk for getting COVID-19.

“We have spent countless hours and dollars locating more surgical face masks and N95 respirators for employees,” says Foster. MGA has strict monitoring in place to evaluate potential or direct exposures.

With each potential or actual exposure, there are detailed processes utilized to protect this vulnerable population. “Some of our medically fragile patients have chronic lung disease,” she says. “COVID-19 could be extremely detrimental to them.”

Precaution is Nothing New for the Medically Fragile

For those who live with chronic illness or are raising a medically fragile child, meticulous infection control and extreme vigilance is nothing new.

The COVID-19 pandemic has unveiled hidden issues that affect at-risk communities, as well as marginalized populations. Even though the PPE shortage is a real issue, it is nothing new for those who deal with an invisible enemy every day.

“Our patients have always been living with this hyper sense of infection control,” says Foster. “And now everyone’s eyes have been opened as to what is out there and what mask-wearing or going without really means.”

The entire world has suddenly been given the opportunity to experience the vigilance that those who live with chronic health conditions always need to have. It can very well mean the difference between life and death.

Because those at MGA are knowledgeable leaders when it comes to safe at-home care practices, they knew there was one thing they could rely on: education.

MGA is constantly improving their education and training and keeping on top of industry trends and best practices in order to best serve their medically complex population.

“We provide our patients and families information and education routinely,” says Foster. Knowledge is the biggest weapon against a pandemic, but this fact is known all too well by those that need to consistently fight to stay healthy each and every day.

If you need assistance with a medically fragile child, please reach out to us. We can help.

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