San Diego County officials say they’re providing healthcare facilities with all the medical supplies they need during the escalating COVID-19 pandemic, but community health centers that cater to low-income and uninsured patients are still having to look elsewhere to meet their needs.
Family Health Centers of San Diego, which has offered healthcare services to uninsured and low-income patients for 50 years, said it asked the county for help obtaining masks in early February when a vendor said it couldn’t fill the nonprofit’s order.
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That help didn’t immediately come through, said Fran Butler-Cohen, the nonprofit’s CEO. The healthcare system said county officials told them instead they were prioritizing masks for acute care hospitals.
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Butler-Cohen said that by mid-March Family Health Centers had only a couple days’ supply of face masks and practically no N95 respirators, a more protective covering. A donor provided 15 of the respirators, which block 95% of particles from the air.
She said on Tuesday the nonprofit looked to other partners for help but couldn’t get what it needed.
“We literally can’t get it. We can’t get the masks that we need, the surgical masks,” Butler-Cohen said. “We can’t get the gowns we need. We can’t get the respirators that we need, the N95.”
The surgical masks are used for patients showing signs of respiratory illness to reduce the risk of transmission, she said, and the N95 respirators, along with gowns, goggles and gloves, should be worn by healthcare workers testing patients for the novel coronavirus, per federal guidelines.
An alert Thursday from the county said highly protective respirator masks and gowns should be prioritized for aerosol-generating procedures, such as intubation, and standard surgical face masks should be worn by healthcare workers in other cases when they’re interacting with symptomatic patients. The document said eye protection and gloves are recommended in patient care, as well as gowns if not in short supply.
Butler-Cohen said clinics like Family Health Centers can help ease the burden on hospitals by keeping patients who don’t need that level of care from seeking emergency services, but said her staff needs protective equipment to do that.
The nonprofit serves more than 210,000 patients annually. It has more than 20 primary care clinics in the county, with locations in San Diego, El Cajon, Chula Vista, Spring Valley, Lemon Grove and National City.
“If the virus gets worse and when it gets worse, we need to be able to have that ability to see patients in the community and not send them to the emergency rooms,” Butler-Cohen said.
When county officials were asked Thursday about the situation at Family Health Centers, they said they had met with representatives from clinics and hospitals to assess their needs and were making requests to the state and federal governments to access their stockpiles.
Public Health Officer Dr. Wilma Wooten also said the region wasn’t experiencing a shortage of N95 masks but acknowledged a supply problem with gloves, gowns and goggles.
“They are low,” Wooten said, but didn’t provide specific numbers.
A Family Health Centers spokesman said the nonprofit participated in the county’s digital meeting with health care facilities but was unaware officials would document needs at the end of it. The nonprofit’s representative left the call after an hour for an internal meeting.
The nonprofit had already sent the county a list of items it was lacking, including face masks, N95 respirators, gloves, gowns and sanitizer, Anthony White said in an email.
The county on Friday provided 10,000 N95s, which were expired, White said. Federal guidelines have said the masks can be used beyond their manufacturer shelf life in times of a shortage.
A spokeswoman for the county’s Health and Human Services Agency said the initial February request from Family Health Centers was for 90,000 N95 respirators — more than other hospitals or health care systems had asked for. The spokeswoman told KPBS on Sunday that the county waited for a shipment from the state and provided the nonprofit with 10,000 masks on Friday.
Rob Sills, who is coordinating the county’s equipment requests, said on Friday facilities are getting their requests filled the same day the county receives them.
“I don’t think a day has gone by since the last week of November that I have not spoken to an emergency manager from one of our healthcare systems, and they are getting what they need,” Sills said.
He said the county was also beginning to receive resources from the state.
Sills said officials have not had to prioritize hospitals over other facilities when it comes to fulfilling personal protective equipment requests, but they may have to.
“At some point, we will focus on the acute care facilities that are treating the coronavirus patients. We’re not there yet,” he said Saturday.
Another community clinic in San Diego said it’s going through supplies quickly and is also having trouble getting orders it has placed with vendors.
Dana Varga, marketing manager for Neighborhood Healthcare, said the nonprofit worked to build up its stockpile from various sources, including donations from construction workers and community members. It now has a two-week supply of masks.
She said the county provided the nonprofit with 2,000 respirators last week, but the majority of the supply is based on their own efforts. The healthcare system helps 67,000 patients annually in San Diego and Riverside counties. It has locations in Escondido, Fallbrook, Pauma Valley, El Cajon and Lakeside.
Varga said the nonprofit’s healthcare workers need respirators when testing for COVID-19 because the process exposes them to possible transmission.
“It tends to become airborne because people sneeze or cough, so people have to be fully protected and we’re complying with that,” she said.
The nonprofit is still looking for other supplies, such as eye protection, and recently received a donation of safety glasses from Habitat for Humanity.
“It’s been super heartwarming to see how the community’s rallied,” Varga said.
For now, she said, Neighborhood Healthcare is stocked with most supplies but is seeking options for the future.
Philip Greiner, director of San Diego State University’s nursing program, said everybody can do their part to help prevent shortages by donating masks they have to medical facilities.
“As people self isolate, again, no, you shouldn't have 20 surgical masks in your home,” Greiner said. “Those would be better deployed in long-term care facilities and places where the highest-risk patients are located. Every one you have in your home means there’s one less for a healthcare worker.”
