Should our State Become the Procurer of SNF and ALF PPE?

One of the frustrating aspects of mitigating the impact of the COVID-19 pandemic on our post-acute and long-term care (PALTC) facilities has been the difficulty that each entity has had procuring adequate PPE to protect their health care workers (HCWs) and residents.  As I look at my community, the acute care hospitals have had sufficient PPE to meet their needs for about the last 7 weeks, but not enough PPE to share with our PALTC providers.  Our local health department (LHD) has created a real-time inventory of each facility’s PPE and has been working hard to procure sufficient PPE to direct to a facility when there is an outbreak.  

We now know that residents living in PALTC settings have the least resistance to acquiring COVID-19 and have a high rate of hospitalization, ICU use, and ICU mortality in the 50-80% range. In fact, almost half of the deaths in California from COVID have been in PALTC residents 

(https://www.latimes.com/california/story/2020-05-08/california-coronavirus-deaths-nearly-half-linked-to-elder-care-facilities). When they are managed in our facilities, the mortality is generally about 20-25%.  But either situation can quickly overwhelm a facility and nearby hospital critical care capacity.  

Because our facilities are generally operated as stand-alone business entities, most facilities struggle procuring essential PPE and testing capacity, while settings with less need for these vital supplies are fully stocked.  

This pandemic doesn’t wait for facilities to have adequate PPE on-site prior to an outbreak.  

Having a consistent supply of PPE and nasopharyngeal swabs during this pandemic would be a real morale booster for our staff and go a long way towards relieving the justifiable mega-fears of our elders.  

Viewing the COVID-19 pandemic from this perspective, is it time for our State to become the procurer of medically approved PPE and testing supplies?

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