In China, over 3,300 health care workers were infected with COVID-19 during the height of the crisis. As of March 19, in Italy, where COVID-19 infections and deaths continue to soar and health care professionals have been working around the clock, over 3,500 health care workers have become infected and some have died. What will our numbers of infected health care workers in the United States and Maryland be?
In Maryland, the first case of COVID-19 in a child has been diagnosed and, as of this writing Friday, there were 149 confirmed cases of COVID-19, with reported cases increasing daily as more testing kits become available and community spread is occurring. According to the Maryland Department of Health, people concerned they may have symptoms of COVID-19, including fever, cough, or difficulty breathing should call their doctor or emergency department before they seek care. Will their doctors be ready to see what is expected to be a steep rise in ill patients over upcoming weeks?
The media has covered both disruption of the global supply chain and inappropriate stockpiling of personal protective equipment by the public that jeopardizes the supply of protective equipment in American hospitals and emergency departments. Much less attention has been given to the lack of protective equipment available in primary care settings where most people access health care and where less ill patients may be directed to seek care, so that emergency departments and hospitals are not overwhelmed.
The Maryland Chapter of the American Academy of Pediatrics represents over 1,100 pediatric health care providers in our state. Pediatric practices in many counties in Maryland are sounding the alarm that they are dangerously short of protective equipment. Not only do they lack respirators and protective eye shields, but also basic surgical masks and protective gowns. Critically, this lack of protective equipment leaves providers and their staff at risk, potentially also increasing the spread of COVID-19 to other patients. Without surgical masks, they cannot control spread of COVID-19 in patients and family members who present to their practices with respiratory symptoms.
We commend the aggressive and timely campaign that Gov. Larry Hogan’s administration has launched against COVID-19 that protects children and our communities, including school closures and school meal accommodations, and the tireless work that the Maryland Department of Health and Maryland Emergency Management Agency is doing to protect our citizens. The expansion of childcare services for emergency health workers will also make it easier for pediatricians and their staff to operate at full capacity.
We now urge our state leaders to work with the federal government to release increased amounts of protective gear from the Strategic National Stockpile to Maryland to be distributed to local health departments, which can then distribute protective gear to ambulatory health care providers according to their disaster preparedness protocols. The federal government should be transparent with health care providers about realistic release of this gear from the stockpile so that practices and public health leaders can plan accordingly.
We appreciate the federal government’s recent invocation of the Defense Production Act to begin production of protective equipment and hope it quickly reaches those in need.
In the interim, we urge any citizens and businesses, such as construction or landscaping, which may have purchased protective gear for their personal or professional use, who are well and not in need, to check if their doctors or health department are accepting donations.
Together we will fight this crisis, but we cannot continue to leave our health care workers ill-equipped on the front lines, and their patients inadequately protected. Recent data from a study of COVID-19 infections in children in China, published online in the journal Pediatrics on March 17th, showed that while children are less likely to become severely ill from COVID-19 than adults, there are subpopulations of children who may be at risk for significant disease.
Children will also need to be seen in their medical homes for urgent visits unrelated to COVID-19 and for necessary immunizations. All pediatricians need to be prepared and protected to maintain a safe medical home. Immediate increased access to protective gear is critical to mitigate the spread of COVID-19 and protect those on whom we depend to take care of our children and families.
Dr. Maria Brown (firstname.lastname@example.org)is president of the Maryland Chapter of the American Academy of Pediatrics, Dr. Richard Lichenstein (email@example.com) is chair of the disaster preparedness committee, and Dr. Susan Lipton (firstname.lastname@example.org) is chair of the infectious disease committee.