As the COVID pandemic rages on, tens of thousands of nurses are still on the front lines. To keep themselves safe, they are required to wear personal protective equipment (PPE)—an N-95 mask, a gown and gloves. Some facilities have gone to great lengths in order to protect their nurses. One assisted living home even requires nurses to change their PPE after every time they see a patient, whether or not the patient is infected and even if the patients are right next to each other.
Leslie Moses, a hospice nurse who works for the assisted living home, acknowledged that her employer’s practices may be problematic.
“I think some of the stuff is a waste,” she said in an interview, referring to the flimsy gowns nurses are expected to wear along with the other measures. And these measures are not necessarily protecting her coworkers, as some of them have tested positive for the virus.
This overuse of PPE can cause shortages. The recommendations of the Centers for Disease Control and Prevention and the World Health Organization for all people to wear face masks, combined with the hospital system’s increased need for face shields and more advanced N-95 masks, have caused an uptick in medical waste globally.
The province of Wuhan, China, where the disease originated, saw an increase from 40 to 50 tons of medical waste per day before the outbreak to 247 tons on March 1, according to the American Association for the Advancement of Science. According to The Verge, regions in the US have seen increases on a similar scale. Some healthcare providers, out of an excess of caution, encourage their workers to overuse PPE, which is likely contributing to the phenomenon.
The pandemic is specifically leading to an increase in what the WHO classifies as infectious medical waste—defined as waste that could spread diseases to humans—and the recommended disposal method for infectious waste is incineration. However, according to the Food and Drug Administration, stockpiles of important PPE are running low in some hospitals, and, as a result, some facilities have decided to reuse their single-use PPE after using high-pressure heated steam to decontaminate it instead of incinerating it.
The shortages of PPE in some facilities make the excesses of others seem even more outrageous. Lisa Lonaberger works as a post-operative nurse at Frederick Memorial’s hospital’s Post-Anesthesia Care Unit (PACU). Even though most people who have been diagnosed with COVID-19 avoid having elective surgeries and put off other nonessential surgeries, Lonabeger does have to be cautious in case she interacts with a coronavirus-positive individual who either had an essential surgery or was asymptomatic or both. Her hospital, however, is facing slightly more strain on its PPE supply than Moses’.
As a result, Lonaberger said, “They dole them [masks] out like they’re gold, and they expect you to re-wear them.” No nurses in her unit have contracted the disease, but she is still concerned about the safety of her coworkers because they have to re-wear PPE in order to have protective equipment to wear. “Some of the nurses have them for up to a week at a time,” Lonaberger said.
The unequal distribution of PPE might be the result of a variety of causes. First, it is possible that the larger size of the hospital which employs Lonaberger might cause its resource strain. It’s also possible that the two facilities have similar amounts of PPE but Lonaberger’s hospital, anticipating a second wave, is conserving its resources more. Regardless, the stark differences in use demonstrate two different approaches, one of which is much more conscious of the excess of medical waste produced amid this pandemic.
Moses, for her part, said she is trying to do small things to reduce her own waste production. To quietly combat the excess of her company, she reduces her personal waste production in small ways. “It’s stupid to waste these masks by taking it off and putting on a new one” in between every patient, she said. “Especially when there’s all these other places where they don’t even have access to PPE.”
Adam Leff ’22