From this rural hospital in Newaygo County, Sall said he and staff have been preparing for COVID-19 for weeks. But he and other providers around the country are growing increasingly worried that, if COVID-19 spreads too quickly and widely, there simply won’t be enough masks, gloves, gowns, respirators and other life-saving supplies.

By Friday morning, Henry Ford Health System, where staff are creating their own moisture-wicking, bleachable face masks and eye protection, had offered a $300 Amazon gift card to staff with the best ideas for “improving quality, safety and efficiency during this unique time.”

The system even posted a video explaining to others the process for makeshift personal protection equipment.

“We are faced with the enormous challenge of caring for our patients and caring for ourselves during COVID-19's escalation and anticipated spike,” a message to employees read.

Hospitals elsewhere also have pleaded with the public to help.

RELATED:

Washington state-based Providence is recruiting “anyone with a willing heart and the ability to sew” to its Million Mask Challenge. Indiana-based Deaconess Health System offered a single-page of instruction with dimensions for making masks. A southeast Michigan Montessori teacher, Milena Thomas, took that model and set up a Facebook page to organize impromptu mask makers crafting supplies out of fabric scraps. Once they get up and running, members plan to drop off completed masks at nearby hospitals.

“If we are affected in the future, they need to be strong so they can help us. Reports are that eventually a lot of people are going to be exposed to this, even months from now,” Thomas told Bridge. “So we don’t want to deplete our health care workers. Anything we can do to help.”

It’s not clear just how protective the homemade masks are, according to Dr. Emily Toth Martin, the co-director of the Michigan Influenza Center at University of Michigan’s School of Public Health. Martin and her colleagues are part of the national surveillance of influenza strains and seasonal coronavirus strains that are related to COVID-19.

“The official answer is that we don't know whether or not they're protective,” she said. “You can't guarantee that a homemade face mask is going to be as safe as one that's made by a medical supply company.”

With health care workers feeling as though they may have to rely on homemade masks, “there's a lot of concern," she said.

In fact, the University of Michigan said it is not accepting hand-sewn masks “at this time,” in a Friday afternoon plea for donations. Still, it put out a call for other disposable face masks and N95 masks as well as face shields, safety goggles, disposable gowns, gloves, surgical caps, and foot covers. It also asked for bleach or antimicrobial wipes, hand sanitizer, and more more specialized items, such as powered air-purifying respirators, nasal testing swabs and viral testing kits.

Donations will be taken at the North Campus Research Complex, 2800 Plymouth Rd. in Ann Arbor, from noon to 5 p.m. Saturday and Sunday, and 7 a.m. to 6 p.m. Monday through Friday.

No clear picture on shortages

The scope of people who could be affected in Michigan is broad: 43 percent of people over the age of 18 — 3.4 million people — are at risk of serious illness or hospitalization if they catch the new coronavirus, according to the Kaiser Family Foundation, a nonpartisan nonprofit health research center. Nearly 73 percent of those who will have serious illness are older than 60.

For days now, health care workers have said they’re dangerously low on supplies to protect themselves and patients against coronavirus, and doctors, public health officials and leaders at every level — local to international — have urged social distancing to help “flatten the curve” and avoid overwhelming the health care system.

Gov. Gretchen Whitmer has taken to national television multiple times to press the federal government for help with needed resources.

But officials still “do not have a comprehensive understanding” of the resources and capacity of hospital systems across the state, chief medical executive Dr. Joneigh Khaldun said Wednesday afternoon. She was among the first in the state to acknowledge a possible shortage.

On Feb. 28, the same day Whitmer activated the state’s emergency center, Khaldun told Bridge that if coronavirus “really spreads significantly, we may not have the supplies that we would need, and it's something we're thinking about right now.”



Related: State 'may not have' needed supplies if coronavirus spreads in Michigan

As it turned out, she was correct to be concerned.

The Michigan Department of Health and Human Services does not yet have concrete statewide numbers on personal protection equipment including masks, gloves and hospital gowns; ventilators to help critically ill patients breathe; and coronavirus tests both available and needed, officials with the department said.

Hospitals across the state are required to regularly report the number of beds and personal protection equipment they have available, John Karasinski, spokesman for the Michigan Health and Hospital Association, said in an email to Bridge. The state also uses regional health care coalitions to meet with private hospitals’ emergency preparedness staff to discuss “issues, regulations, best practices, exercises, supplies” and more in preparation for public health emergencies.

MDHHS spokeswoman Lynn Sutfin said the department surveyed hospitals at the beginning of March and is now checking again to get updated data on supplies. The department did not respond to a request from Bridge on Friday for details on the March inventory.

Health care workers told Bridge this week they’re also running dangerously low on supplies that are necessary to protect them from getting infected as they treat those diagnosed with the virus. Some are already rationing the use of equipment such as N95 masks, which offer healthcare workers the best protection against the virus.

“I would say we are in very short supply,” Carrie DelBene, an anesthesiologist at Beaumont Hospital Dearborn, told Bridge.

“We are worried. I feel like looking at all the reports coming in, we are going to see more cases. If we all get exposed here, there wouldn’t be anybody to take care of the patients when they come in.”

Katie Oppenheim, president of the University of Michigan Professional Nurse Council, told reporters Friday that the university had decreased the personal protection equipment (PPE) requirement to the CDC’s minimal requirement a day earlier to conserve desperately-needed resources.

“Needless to say, it’s frightening for our staff,” Oppenheim said. “Nurses want to come to work and take care of patients regardless of their own health conditions, as long as it’s safe.”

Sutfin told Bridge the state recently received a shipment of a quarter of the state’s allocation of PPE from the Strategic National Stockpile, a federal reserve of medical supplies for public health emergencies. That shipment included:

N95 respirators (approximately 95,000)

surgical gowns (approximately 35,000)

non-sterile gloves (approximately 125,000 pair)

face shields (approximately 43,000)

surgical face masks (approximately 225,000)

Sutfin didn’t respond to a request for context as to how many health care workers those supplies cover and how much more is needed. But according to the Centers for Disease Control, most PPE is discarded after one use. Under extended use guidelines used in rare circumstances where preserving supplies is critical, N95 masks can be effectively used for up to eight hours depending on the patients health care workers are treating.

“There is a need for more of everything,” John Karasinski, spokesman for the Michigan Health and Hospital Association, wrote in an email to Bridge.

Bridge reached out to the state’s five largest health care systems — Spectrum Health, Henry Ford Health, McLaren Health, Beaumont Health and Michigan Medicine — for supply numbers. None could provide exact numbers of the supplies they currently have.

Michigan Medicine (the University of Michigan hospitals) said it currently has “adequate supplies,” but hospital officials are “proactively monitoring and ordering supplies to prepare for patient surge,” including asking other departments in the university to collect supplies for medical use.

Teri Grieb, senior director for research for the Michigan Medical School, sent an email to other departments earlier this week requesting help with “urgently needed supplies” such as face shields, gowns, testing swabs and more.

Bruce Rossman, spokesman for Spectrum Health, said there’s a national shortage but the network has “plans in place to shift equipment based on clinical need” and said it’s exploring the possibility of performing the test in-house.

Khaldun said there are more than 1,000 ventilators statewide and Suftin said MDHHS is “in the process of purchasing additional ventilators.” It’s not clear how many ventilators will be needed, but experts warn that the U.S. could be on a similar path as Italy, where doctors are being forced to choose who gets one of the life-saving machines and who does not.

Some countries are using to get medical companies to produce more ventilators and prevent them from being shipped out of the country, but the United States doesn’t yet have a federal strategy to meet that need. U.S. suppliers have said it will take time to ramp up production enough to meet needs. wartime tactics to get medical companies to produce more ventilators and prevent them from being shipped out of the country, but the United States doesn’t yet have a federal strategy to meet that need. U.S. suppliers have said it will take time to ramp up production enough to meet needs.

“We are not aware of any ventilator shortages at this time,” said Karasinski. “In preparation for a potential spike in cases, Michigan hospitals have been proactively working with their vendors to order additional ventilators and have been in contact for potential utilization of ventilators from the national strategic stockpile.”

There’s also a possibility that Michigan’s nearly 25,000 hospital beds won’t be enough to house the number of sick people, even as the state hospital association has called on members to prepare for “surge capacity” by canceling elective surgeries and moving patients who can be cared for in a less intense environment.

“This is unprecedented in size, scale and scope,” Dr. Vineet Chopra, chief of hospital medicine at the University of Michigan’s academic medical center, told Bridge earlier this week.

“Every resource we have is being constrained and pushed as we prepare to take care of a large number of COVID patients.”

Michigan currently has about 2.5 beds for every 1,000 people, though that doesn’t account for any possible changes that hospitals have made to prepare for coronavirus.

That’s less than in Italy (3.2 beds for every 1,000 people), China (4.3 beds) and South Korea (12.3 beds), all of which had health care systems that were swamped with an influx of cases. Cases in the United States are currently doubling every two to three days — on par with Italy.

Right now, Whitmer and top officials remain optimistic that by following social distancing and sanitation practices, we’ll be able to avoid overwhelming the hospital system.

“At this point so many things are changing at such a rapid pace. It is a fluid situation,” Whitmer said Wednesday. Right now the system will be able to handle the crisis, she said, but that assessment seems to change all the time.

“We’ve been working incredibly hard to marshal all the resources we can to support people in this tough time.”

“We’ll crank out what we can"

On Thursday morning, before falling into bed after the night shift at Spectrum Health’s Gerber Memorial Hospital in Fremont, nurse practitioner Jennifer Cambpell texted her crafting, seamstress mother: