U.S. nursing homes still don’t have enough PPE

Nearly nine months after the White House declared COVID-19 a public health emergency, nursing homes in the U.S. are still facing shortages of critical protective equipment such as masks and gowns. A new analysis of government data, looking at the trajectory over the summer, finds that shortages have gotten worse over time.

By late August, the report says, 226,495 nursing home residents were at risk because they lived in facilities with dangerously low supplies—less than one week’s stockpile—of one or more types of PPE. The report, from the Frontier Group and the U.S. Public Interest Research Group Education Fund, pulled three months of data that nursing homes began submitting to the Centers for Medicare and Medicaid Services in May.

Between May and August, nearly half of the country’s 15,000 nursing homes—which house around 1.3 million people—reported having low supplies at some point. Twenty percent of the homes reported completely running out of some kinds of PPE. Shortages worsened over the summer, even in some areas where cases were declining: In August, compared to mid-July, three times as many nursing homes said they’d run out of supplies such as masks and gowns. The shortages have likely exacerbated the challenges that nursing homes already faced, with tight quarters and vulnerable residents. More than a quarter of the Americans who have died in the pandemic so far have lived in nursing homes.

It’s not clear why the Strategic National Stockpile, a network of warehouses created to store PPE and other critical supplies such as vaccines, didn’t have an adequate supply when the outbreak began. The chaotic government response hasn’t helped, as some states have reported that the federal government outbid their own attempts to buy PPE or, in some cases, seized supplies when they arrived in ports. As the pandemic has continued, nursing homes have had to compete for a global supply that is still limited. Some staff have reported using garbage bags instead of gowns and wearing single-use masks repeatedly.

Though there’s a lag in the reporting of data, and it’s not clear what the situation is now, industry experts, including the American Medical Association, the American Health Care Association (which represents the nation’s nursing homes), and the AARP say it’s getting worse as COVID-19 cases surge again. “It’s not getting better. It stands to get worse without action, especially with the sudden COVID spikes in the last couple of weeks and the looming flu season,” says report author Teresa Murray.

To help, groups such as the American Nurses Association argue that the government should make full use of the Defense Production Act to increase the production of PPE. (While the Trump administration used the act to increase the production of ventilators, it didn’t do the same for masks and other PPE supplies.) Another act introduced in Congress in the spring, the Medical Supply Transparency and Delivery Act, would direct production and distribution through a center under FEMA, helping centralize the supply chain and make it transparent, using a public website to track the available supplies. The next COVID relief bill, the report says, should also include funding to help nursing homes fight the disease.

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