RICHMOND TIMES-DISPATCH, MICHAEL MARTZ
Private ambulance companies handled almost half of all emergency medical services transports in Virginia last year, but now they’re scrounging for gowns and other protective gear from local retailers because they say they’re not getting emergency supplies purchased by the state to fill a deep shortfall during the coronavirus crisis.
“We have agencies buying ponchos with sleeves from Walmart and dollar stores to try to protect their staff,” Virginia Ambulance Association President Randy Breton wrote state EMS officials last week.
The Virginia Department of Health’s Office of Emergency Medical Services says it has distributed all of the personal protective equipment, or PPE, it has received from the depleted Strategic National Stockpile.
But the emergency supplies haven’t reached private EMS agencies such as Priority Patient Transport in the Shenandoah Valley, where its crews frequently transport people infected with COVID-19 between nursing homes and hospitals.
“Somewhere, there’s a large stockpile of PPE, but they’re telling me, ‘We’re not giving it to you yet,’” said Steve Higgins, owner of the company based in Harrisonburg and serving a territory that extends from New Market to Lexington and east to Albemarle County. “The question is when. We need it now.”
Three Democratic members of Virginia’s congressional delegation have intensified their push for investigation of alleged mismanagement of the Strategic National Stockpile. But the state also faces questions about how it has distributed PPE among hospitals, long-term care facilities and EMS providers that have soaring demand for it.
Private EMS companies are required to carry their own supplies of protective equipment, but the demand has far outpaced their ability to obtain what they need. The ambulance association says hospitals no longer share PPE with crews who transport infectious patients. Nursing homes and dialysis centers increasingly require EMS crews to wear protective gear when they pick up and return patients.
“We all have the same suppliers,” Higgins said. “If I’m having trouble getting it, so are they.”
A shortage of protective gear — gowns, masks, gloves and face shields — has plagued the response to the COVID-19 crisis from its beginning. The Virginia Department of Health has confirmed more than 1,500 cases of infected health care workers but it doesn’t specify how many EMS providers have tested positive for COVID-19.
“What we’ve been asked to do as governors is to fight this war without supplies,” Gov. Ralph Northam said on Monday. “We started from ground zero competing for PPE.”
Northam credited the federal government, particularly the Federal Emergency Management Administration, for delivering supplies and financial help in recent weeks.
“So, we’re in a much better place today regarding what is coming from Washington,” he said, “but we started two months behind.”
Three Virginia congressional representatives want Congress to make investigation of the stockpile management a priority for $6 million included in the last emergency relief package for the inspector general at the U.S. Department of Health and Human Services, whom President Donald Trump has proposed to replace.
“The consequences of HHS’s mismanagement of the Stockpile have been disastrous for our states and our constituents,” Reps. Abigail Spanberger, D-7th; Don Beyer, D-8th; Gerry Connolly, D-11th; and two other congressional Democrats said in a letter last week to House and Senate budget leaders.
Virginia has received three shipments from the stockpile, which is managed by the Office of the Assistant Secretary for Preparedness and Response at HHS. The stockpile delivered 111,440 of the 3.5 million N95 face masks first requested by the state on March 6 and none of the goggles.
However, the state also received 95,520 protective gowns, although it asked for only 7,500; 476,000 pairs of gloves; and supplies of face shields, procedure masks, and coveralls it had not sought.
“We got about 10% of what we asked for,” Secretary of Public Safety and Homeland Security Brian Moran said Tuesday.
Moran said the situation has improved because of help from FEMA and the first deliveries of supplies that Virginia has purchased from a private vendor, including 8 million protective gowns that have been hard for EMS providers to procure.
“Protective gowns are one of the things we’re struggling to get our hands on,” said Capt. Matt Lawler, director of EMS operations at the Augusta County Fire and Rescue Department and representative of the Central Shenandoah Valley Regional EMS Council on a statewide advisory panel.
Virginia health officials say they’ve delivered everything they’ve received from the stockpile, but only 7% of those supplies went to the 584 active licensed EMS agencies in the state. Those include private, community nonprofit, fire department, government, non-fire, and hospital-based agencies, the state said.
Karen Owens, emergency operations manager at the Virginia EMS Office, said private providers should ask their regional councils for any leftover supplies from the national stockpile and then contact their local emergency managers “so that they can request resources from the state-purchased cache of equipment.”
However, local emergency managers say they, too, are trying to figure out how to get those supplies.
“I would definitely say it’s a challenge,” said Anthony Ramsey, deputy emergency coordinator for Augusta County. “We’re in the same boat as the other neighboring localities.”
Augusta has received some PPE supplies the state purchased, but is still awaiting the status of additional requests.
“We’re taking care of our front-line emergency responders,” said Ramsey, who said he hasn’t seen requests for supplies from private EMS companies and isn’t sure how he would process them.
For private companies, finding supplies at an affordable price also is straining their budgets, said Breton, president of the Virginia Ambulance Association, which includes about 90 commercial EMS vendors.
“Every time they take a nursing home patient, every time they take a dialysis patient, they’re losing money,” he said. “What you’re going to see is the death of commercial ambulances.”