Masks, Masks, Masks… But No One is Talking About Gown Safety

We have all heard about masks. Masks are mandatory nearly everywhere indoors except for your own home. Masks must be worn at restaurants at all times unless seated at your table. For healthcare providers, masks are worn throughout their entire shift, and the patients must wear a mask as well (unless unable or medically exempt). There was controversy at the beginning of the pandemic when healthcare providers did not have proper masks (N95s, face shields, etc.). There was such a severe shortage, they were being asked to reuse them throughout their shifts over multiple days, and they could only be replaced if visibly soiled.

At the start of the pandemic, Dan Cohen, CEO of 3D Bio Therapeutics, stated that the federal government’s Strategic National Stockpile included 12 million N95s and 30 million surgical masks, which was only 1% of the 3.5 billion that was needed during the first year of a pandemic (Cohen, 2020). Gowns were not even mentioned as being in the stockpile. Not only do we continue to have a shortage of PPE while Covid-19 numbers are once again rising, but we are now learning the gowns we do have may not be as safe as we thought.

The Emergency Care Research Institute (ECRI) is an independent, nonprofit organization created to improve the safety, quality, and cost-effectiveness of care across all healthcare settings worldwide (ECRI, 2020). This week, a report was released revealing that more than half of the gowns submitted by hospitals for testing failed safety standards (Clark, 2020). ECRI tested more than 170 samples of 34 different models of isolation gowns (Clark, 2020) using two methods. The splatter test determines if fluid penetrates the gown when exposed to spray, and the hydrostatic pressure test determines whether the gown can resist absorption of a particular weight of fluid (Clark, 2020). 

The failure of these two tests were most commonly seen in the area of the seams where pieces of the gown were attached using glue or heat. Due to the critical shortage of PPE, hospitals desperate for supplies scrambled and purchased items from manufacturers with no quality control (Clark, 2020), and most of these gowns were made outside of the United States.  ECRI was notified when a large hospital system received a cargo container of gowns and discovered they were labeled “not for medical use.” (Clark, 2020). 

ECRI President and CEO, Marcus Schabacker, stated, “We probably wouldn’t be in the situation we’re in if we had a better coordinated distribution system, which would shift supplies, even personnel and equipment, to areas where they need it most instead of everybody trying to hoard what they can get their hands on and creating a shortage.” (Clark, 2020) It remains to be seen if the stockpile will be replenished with PPE that passes quality control standards, or if hospitals and medical facilities will continue to purchase inadequate supplies out of desperation.

References

Clark, C. (2020, November 11). Report: Half of Gowns Fail to Meet Safety Standards. Retrieved from https://www.medpagetoday.com/infectiousdisease/covid19/89610?xid=nl_covidupdate_2020-11-12

Cohen, D. (2020, August 22). Why a PPE shortage still plagues America and what we need to do about it. Retrieved from https://www.cnbc.com/2020/08/22/coronavirus-why-a-ppe-shortage-still-plagues-the-us.html

ECRI. (2020). About ECRI. Retrieved from https://www.ecri.org/about/