Manufacturers and distributors of impermeable gowns and full-body suits meant to protect medical workers from Ebola are scrambling to keep up with a surge of new orders from U.S. hospitals, with at least one doubling its staff and still facing a weekslong backlog. Many hospitals say they already have the proper equipment in place but are ordering more supplies to prepare for a possible new case of Ebola.
This gear is made of material that does not absorb fluids and is crucial to preventing the spread of the virus, which has infected thousands across West Africa, many of whom caught the disease while caring for those infected. Ebola is transmitted through direct contact, through cuts or mucous membranes, with bodily fluids such as blood, vomit and feces, and proper protective equipment helps prevent doctors and nurses from accidentally getting any fluids in their eyes, nose or mouth.
Hospitals are paying close attention to the type of protective gear they stock after two nurses contracted Ebola earlier this month while caring for a Liberian man dying of the disease at a Dallas hospital. The nurses were exposed to the disease during what the Centers for Disease Control and Prevention has called a "breach in protocol" at the hospital. But some medical professionals criticized the CDC for distributing guidelines that do not require medical staff caring for infected patients to don full-body suits or wear multiple layers of gloves.
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The CDC announced new guidelines Monday night calling in part for health workers caring for Ebola patients to wear face shields, hoods, boot covers and other garb that leave no part of the body exposed.
Last week the University Medical Center of Southern Nevada in Las Vegas ordered 30 cases of impermeable isolation gowns, with 50 gowns per case to add to their existing 10-case cache. The Lawrence and Memorial Hospital in New London, Connecticut recently placed a new order for one-piece full-coverage suits, even though the hospital already has plenty on hand.
"We had an ample supply to cover us in each of our hospitals with any immediate emergency situation," hospital spokesman Michael O'Farrell said Monday, "but in preparation mode we ordered more to have on hand, just in case."
The nation's largest hospital chain, HCA Holdings Inc., has stocked its hospitals with routine protective equipment like impervious gowns and leg and shoe coverings. It also bought respirators for its medical personnel when the H1N1 flu outbreak hit in 2009, and it has been updating that stockpile, said chief medical officer Dr. Jonathan Perlin.
The hospital chain also has stockpiles of hazardous materials suits and hoods that it can distribute to its hospitals as needed, but it needs to obtain more to have a "completely sufficient" number, spokesman Ed Fishbough said.
HCA runs more than 160 hospitals in 20 states and England. Its hospitals have yet to treat an Ebola patient, but its staff would be required to wear that protective clothing, plus a double layer of gloves and the respirator when dealing with any Ebola patients.
In an informal survey, Associated Press reporters spoke to 102 hospitals of varying sizes across the country, and all but two said they have protective gear in stock. The vast majority of the 102 hospitals said their protective gear provides full-body coverage, including either a one-piece suit or pieces that include a hood, goggles, face mask, leg and foot covers. Only 10 hospitals said their equipment left some skin exposed, and seven of those hospitals said they had either already placed orders for better gear or intended to do so.
Fletcher Allen Health Care in Vermont and the University of Virginia Medical Center in Charlottesville both said their equipment left part of the neck exposed but that they have already placed orders for hoods or full-coverage equipment. MultiCare Tacoma General Hospital in Washington also said it was working to procure gear that covers the neck, but that hoods and full-body suits are in short supply these days.
Tony Baumgartner, president of DQE Inc., an Indiana-based emergency services company that distributes gear recommended under federal guidelines, said he's doubled his production staff to keep up with the orders. Since Sept. 30, when the first case of Ebola was reported in the United States, Baumgartner said demand for his personal protective equipment kits, containing impermeable gowns, foot covers, face masks and other respiratory protection, has been "unprecedented."
"We're up ten-fold, if not 20-fold, from this time last year," Baumgartner said. Most popular now is a full-body suit, Baumgartner said. Those suits are currently on a 12-week backlog. "We get orders in that vary from a few suits to a few boxes of suits, supplementing existing stock to hospitals that are very concerned, and we have others who are ordering hundreds of suits. The order volume, the number of orders, has just been overwhelming."
Executives at Medline Industries, a personal protective equipment manufacturer that is one of three companies whose combined sales account for 72 percent of the surgical gown market, say they are receiving 150 calls a day from hospital customers asking about protective gear. As a result, Medline has increased production from multiple U.S. manufacturing locations to stay ahead of demand. But Stephanie Pasko Nelson, a vice president with 12,000-employee company, said there was no risk of running out of product.
Chemical industry giant DuPont says it has tripled production of hazmat equipment used to treat highly-infectious patients, including suits, aprons, foot coverings and sleeves. The company's leading Tychem suit is designed to protect against bacteria, viruses, microbes and fungi.
The nation's largest manufacturer of surgical face masks, Kimberly-Clark, is seeing a surge of orders and executives say they are staging materials, workers and production lines to stay ahead of demand. The company also sells fluid-resistant surgical gowns, examination gloves and other protective equipment.
When orders for masks outpace supply, the company uses a pandemic preparedness plan to fill orders, prioritizing shipments to first-line responders and hospital workers, followed by medical researchers and transportation authorities.
Judson Booth, manufacturing director with the company, says the most in-demand product right now is the Fluidshield surgical mask, which includes an eye shield to protect against blood and other bodily fluids.
"People are trying to get as prepared as they think they need to be," he said.