Pandemic ‘hero’ Filipino nurses struggle to leave home

By Karen Lema and Clare Baldwin

MANILA (Reuters) – From across the Philippines, they gathered to pray by Zoom.

They were praying to be allowed to leave: To be allowed to take up nursing jobs in countries where the coronavirus is killing thousands in hospitals and care homes. In recent months, these care workers have taken to calling themselves “priso-nurses.”

With infections also surging in the Philippines, the government in April banned healthcare workers from leaving the country. They were needed, it said, to fight the pandemic at home.

But many of the nurses on the two-hour Zoom call on Aug. 20, organised by a union and attended by nearly 200 health workers both in the Philippines and abroad, were unwilling to work at home. They said they felt underpaid, unappreciated and unprotected.

Nurses have been leaving the Philippines for decades, encouraged by the government to join other workers who send back billions of dollars each year.

With COVID-19 sweeping the globalized economy, the Philippine ban squeezed a supply line that has sent hundreds of thousands of staff to hospitals in the United States, the Gulf and Britain, where some commentators have called the nurses “unsung heroes” of the pandemic.

The Philippines’ healthcare system is already short-handed. In Germany there are 430 doctors and nurses per 10,000 people, in the United States 337 and in Britain 254, International Labor Organization data shows.

The Philippines – where the coronavirus death rate is one of the highest in Southeast Asia – has 65.

The April ban has stopped more than 1,000 nurses from leaving the country. Of those, only 25 have applied to work in local hospitals, Health Secretary Francisco Duque III told journalists late last month. The Department of Health did not reply to a request for an updated figure.

The government has since partially eased the restrictions, but sometimes also tightens them, so nurses are still clamoring to get out.

On the Zoom call in August, someone played a recording of the Philippine national anthem. A Catholic priest prayed and a man with a soft voice crooned a song about passing off your burdens to God.

One nurse, 34-year-old April Glory, had already spent years away from her young son and had been about to leave again when the ban kicked in. Even before the pandemic, she told Reuters separately, she was better off in a war zone in the Middle East than at home.

Soon after she arrived in Yemen in 2011, a bullet pierced the wall of her private hospital, she said. Staff moved patients to safety.

Still, she said, “we were insured, we had free lodging so my salary was intact and I could send more to my family.” Abroad, there was no need to do any work outside her job description: “You are not expected to sweep the floor.”

SIMPLE MATH

It’s mainly money that drives the Filipinos abroad.

A nurse in the United States can earn as much as $5,000 per month; in the Middle East it’s $2,000 per month, tax free. In Germany, nurses can earn up to $2,800 per month, and get language training, labor organizers, recruiters and the Philippine government’s overseas employment agency say.

Even with its emergency hiring efforts, the Philippine Department of Health is only offering nurses a starting salary of $650 per month. It says it will pay another $10 per day as COVID-19 hazard allowance.

Private nurses sometimes make just $100 per month.

“I felt that I was not earning enough,” said Glory, explaining why she left. Her son, now 11, was a year and a half old at the time. “My mother told me: Better to leave now because my child will not really remember.”

Abroad, Glory’s shifts were a standard eight hours and she only looked after one or two patients at a time in intensive care. Working in Yemen and then Saudi Arabia, she said she bought a house and a car.

Nurses have recently left faster than they are trained. Last year, 12,083 new nurses graduated in the Philippines. That same year, 16,711 signed contracts to go abroad, data from the Commission on Higher Education and the Philippine Overseas Employment Administration shows. Those renewing foreign contracts are counted separately. So far this year there have been 46,000 such renewals.

The Philippine government wasn’t able to provide figures for the total number of nurses overseas, or say which countries they are working in.

Filipinos are the biggest group of foreign nurses in the United States. In 2018, there were 348,000, an analysis of U.S. government data by Washington D.C.-based think tank Migration Policy Institute showed. Even with the pandemic, another 3,260 Filipinos have passed the U.S. nurse licensing exam this year.

A report to Britain’s House of Commons Library in May said more than 15,000 of the National Health Service nursing jobs held by foreigners went to Filipinos – nearly a third of the total and more than any other nationality. The NHS employs a further 6,600 Filipinos in other healthcare jobs.

Labor brokers say that, besides the UK and US, Filipino nurses are sought-after in Germany, Saudi Arabia, the United Arab Emirates and Singapore.

36-HOUR SHIFTS

Nine months into the pandemic in the Philippines, reported coronavirus infections in the Philippines have soared to around 270,000. Not all hospitals allow family members to visit, so nurses must feed and clean patients as well as giving health care, said Filipino Nurses United President Maristela Abenojar.

Some nurses are working up to 36-hour shifts because relief staff are calling in sick or not reporting for duty, she said, and sometimes nurses are issued just one set of protective gear per shift. Nurses can’t get tested regularly and if they get sick, there aren’t always hospital beds reserved for them, she said.

At least 56 healthcare workers have died in the Philippines, Department of Health data shows.

“It seems they don’t really value our contributions,” said Jordan Jugo, who works at a private hospital in the Philippines. “It hurts.” He had a contract to work in Britain, but the ban prevented him from leaving.

He said he could sometimes only eat two meals a day and could no longer support his siblings.

The Philippine Department of Health said its healthcare workers work long hours and “it is natural for them to feel tired and overwhelmed with their immense responsibilities.” It said it had arranged for “substitution teams” in some areas.

It said hospitals should provide sufficient protective gear and that healthcare workers should not go on duty without it. Healthcare workers should be prioritized for regular COVID-19 testing, it said, and the Department would ensure there are enough beds for everyone.

Health Secretary Duque has said previously that the government was appealing to the nurses’ “sense of nation, sense of people and sense of service.”

“I DON’T WANT TO BE A HERO”

Foreign countries have gone all-out to show Filipino nurses they are valued.

Saudi Arabia sent chartered planes to help them return to work, and only partly filled them so the nurses could maintain social distance.

British ambassador to the Philippines Daniel Pruce went on an 11-minute segment on Philippine television to praise the “incredible commitment and dedication” of Filipino healthcare workers in Britain.

When nurse Aileen Amoncio, 36, got trapped by a lockdown and then the travel ban during a vacation to the Philippines in March, Britain’s NHS granted her a special “COVID leave” and kept paying her, she said. The NHS said staff stuck abroad due to COVID-19 could qualify for such leave.

Amoncio got out of the Philippines in June, after the government eased the ban slightly.

Working at an NHS neurological rehabilitation hospital in the UK, she said she sympathized with the nurses back home, where she once handled as many as 80 patients on a surgical ward at a small hospital. Now she looks after no more than 10 at a time.

Not only are the pay and conditions better in Britain, she said, but she also hopes her daughter will one day be able to join her and get free treatment on the NHS. The hearing implant she needs would cost $20,000 in the Philippines.

“I’ve served my country already,” said Amoncio. “I don’t want to be a hero again. I am looking out for the future of my children.”

On the Zoom call, Labor Secretary Silvestre Bello III dialed in with an update: Some of those who had existing contracts could leave, he announced. Cheers went up.

Nurse Glory was one of them. She wept.

“I hope the government will not take it against us that we are leaving,” she said. “We are looking forward to helping the government with this fight in other ways. When we are able, when we’ve risen out of poverty, we will.”

Hours later, on the pavement outside the airport, she quickly hugged her son, then raced to board her flight in case the government changed its mind.

(Additional reporting by Eloisa Lopez; Edited by Matthew Tostevin and Sara Ledwith)

New York pushes ahead with more reopenings as COVID-19 cases rise in U.S. Midwest

By Maria Caspani and Barbara Goldberg

NEW YORK (Reuters) – Governor Andrew Cuomo on Thursday announced more reopenings in New York state as new coronavirus infections remained low in what was once the U.S. hot spot of the pandemic.

Next Wednesday, New York City malls will be allowed to reopen at 50% capacity and casinos statewide can reopen at 25% capacity, Cuomo said.

“Thanks to the hard work of New Yorkers, we are at a point in our fight against this virus where we can safely reopen malls in New York City as long as they adhere to strict health and safety protocols,” Cuomo said. “Masks, enhanced air ventilation systems, and social distancing will be mandatory.”

The governor also waded into the hotly debated issue of indoor dining in New York City, saying during a conference call with reporters that the final decision rested with the state.

New York City Council Speaker Corey Johnson came out on Wednesday in favor of allowing indoor dining in the city, which is home to a thriving restaurant industry that was battered by the pandemic.

“It’s time to allow indoor dining in New York City with reduced capacity and clear guidance to ensure social distancing and safety,” Johnson said in a statement.

Cuomo said he would like to see restaurants reopen for indoor dining in the city but that compliance and enforcement remained a major hurdle in doing so.

“We open restaurants, that’s going to complicate by the hundreds if not thousands the number of establishments that need to be monitored,” he said.

Indoor dining is allowed in New York state with the exception of New York City, where more than 300 restaurateurs recently filed a class-action lawsuit seeking $2 billion in damages, according to media reports.

On Wednesday, gyms in New York City opened for the first time in months. They must operate at 33% capacity, with floors rearranged so patrons can exercise more than 6 feet (1.8 m) apart.

SHIFTING TRENDS

New York has seen by far the most deaths from COVID-19 of any U.S. state, more than 32,000, but its rate of new infections has dropped to among the lowest in the country.

Nationally, new cases of coronavirus have fallen for six weeks in a row, but infections are surging in the Midwest. Iowa, North Dakota and South Dakota are reporting the highest percentage of positive test results in the country – over 20% in each state.

Iowa, with a population of more than 3.1 million people, saw over 8,300 new cases last week, up 116%. That compared with about 4,400 new cases in New York state, which has more than 19.4 million residents, according to a Reuters analysis.

Cases also rose 27% last week in Minnesota and 34% in Indiana.

The U.S. Centers for Disease Control and Prevention has told state officials to prepare to distribute a potential coronavirus vaccine as early as October, according to documents made public by the agency on Wednesday.

The vaccines would be given first to healthcare workers, national security personnel and nursing homes, the agency said in the documents.

(Reporting by Maria Caspani and Peter Szekely in New York and Barbara Goldberg in Maplewood, New Jersey; Additional reporting by Lisa Shumaker; Editing by Peter Cooney)

U.S. CDC tells states to prep for COVID-19 vaccine distribution as soon as late October

By Manojna Maddipatla

(Reuters) – The U.S. Centers for Disease Control and Prevention (CDC) has asked state public health officials to prepare to distribute a potential coronavirus vaccine to high-risk groups as soon as late October, documents published by the agency showed on Wednesday.

The timing of a vaccine has taken on political importance as U.S. President Donald Trump seeks re-election in November, after committing billions of federal dollars to develop a vaccine to prevent COVID-19, which has killed more than 180,000 Americans.

“For the purpose of initial planning, CDC provided states with certain planning assumptions as they work on state specific plans for vaccine distribution, including possibly having limited quantities of vaccines in October and November,” a CDC spokeswoman told Reuters.

The New York Times had earlier reported that the CDC had contacted officials in all 50 states and five large cities with the planning information.

The country’s top infectious disease expert Anthony Fauci earlier on Wednesday said on MSNBC that based on the patient enrollment rate in COVID-19 vaccine trials underway, there could be enough clinical data to know by November or December that one of the vaccines is safe and effective.

The documents put online by the New York Times showed the CDC is preparing for one or two vaccines for COVID-19 to be available in limited quantities as soon as late October.

The vaccines would be made available free of cost first to high-risk groups including healthcare workers, national security personnel, and nursing home residents and staff, the agency said in the documents.

Regulators around the world have repeatedly said development speed will not compromise vaccine safety, as quicker results would stem from conducting parallel trials that are usually done in sequence. But such reassurances have not convinced everyone.

Preliminary results of a survey conducted over the last three months in 19 countries showed that only about 70% of British and U.S. respondents would take a COVID-19 vaccine if available, Scott Ratzan, co-leader of a group called Business Partners to Convince, told Reuters in August.

Drug developers including Moderna Inc., AstraZeneca Plc and Pfizer Inc. are leading the race to develop a safe and effective vaccine for the respiratory illness.

The CDC documents describe two vaccine candidates that must be stored at temperatures of minus 70 and minus 20 degrees Celsius. Those storage requirements match profiles of candidates from Pfizer and Moderna.

Last month, the U.S. health department said the CDC was executing an existing contract option with McKesson Corp. to support potential vaccine distribution.

CDC Director Robert Redfield has asked state governors to expedite McKesson’s requests for building vaccine distribution centers and to consider waiving requirements that would stop them from becoming fully operational by Nov. 1, according to a recent letter obtained by Reuters.

(Reporting by Manojna Maddipatla in Bengaluru and Deena Beasley in Los Angeles; Editing by Maju Samuel, Tom Brown and Subhranshu Sahu)

Ravaged by COVID-19, California’s Central Valley gets 190 federal healthcare workers

SACRAMENTO, Calif. (Reuters) – Nearly 200 federal healthcare workers have been deployed to California’s Central Valley agricultural breadbasket, where hospitals are overwhelmed with COVID-19 cases and new infection rates are soaring, Governor Gavin Newsom said on Monday.

(Reporting by Sharon Bernstein; Editing by Sandra Maler)

Miami medical teams feel helpless as COVID-19 devastates South Florida

By Zachary Fagenson

MIAMI (Reuters) – As the coronavirus ravages Florida, healthcare workers in Miami hospitals are struggling to cope with the emotional and physical impact of treating a crushing wave of COVID-19 patients.

After seeing 10,000 new cases a day become the norm across the state in July, many of those on the front lines are frustrated with the apparent inability of local, state, and federal governments to coordinate an adequate response. They are equally aghast with what appears to be the reluctance or refusal of many Floridians to honor safety precautions to stop the spread of coronavirus.

“I know, and my colleagues know, that we’re putting a Band-Aid on a problem, we’re supporting people as best we can to get them through, but the real fight happens outside,” said Dr. Eric Knott, a pulmonary and critical care fellow working in three of Miami’s largest hospitals. “If you can’t stop the spread, all of my work is for nothing.”

For Miami doctors, concerns about the virus far surpass those stirred up by even the largest hurricanes.

“A hurricane tends to be a sort of finite amount, and this is infinite,” said Dr. Mark Supino, an attending physician in Jackson Memorial Hospital’s emergency department.

Many healthcare workers and union leaders were critical of Miami’s reopening several weeks after the number of cases of the novel coronavirus first began rising in early March.

On Friday, state health officials reported a total of 402,312 cases across Florida, with 135 new deaths bringing the total to more than 5,600.

While the death toll in South Florida has not approached that of New York City, an early epicenter of the U.S. outbreak, hospital beds and intensive care units across the region have filled to capacity, and in some cases surpassed it.

At Jackson Memorial Hospital, the largest facility in the region, officials have called in hundreds of additional medical workers as employees have fallen sick and had to stay home or be hospitalized. An auditorium was sealed and prepared for COVID-positive patients with a negative pressure system to limit the air flow to prevent new infections.

“In 10 years of medicine I never had to put another nurse on life support, I never had to worry about my co-workers dying,” said Kevin Cho Tipton, a critical care nurse practitioner who works at one of Miami’s largest public hospitals. “It’s been emotionally very challenging, physically very challenging.”

Among the most difficult and stressful parts of the job are the sheer number of ICU patients.

Healthcare workers must constantly keep tabs on the vital organs of patients on ventilators, and many of the sick have to be flipped over and over again to stave off any complications from lying in one position for a prolonged period. To do so without risking detaching any of the life support systems can take up to six people.

The intensity has overwhelmed some.

Jude Derisme, vice president of Service Employees International Union 1199, which represents 25,000 medical workers across Florida, said the union had to help get one nurse, a 25-year veteran, off a hospital floor after a “break down.”

“My fear is that if we don’t find a way to bring these numbers down over the next two weeks, if they’re worse than these last two weeks, we’re going to be stretched too thin,” said Martha Baker, a registered nurse and president of Service Employees International Union 1991, which represents about 5,600 medical professionals within Miami’s Jackson Health System. “The sad news is that that’s when patients die.”

While her chapter of the union along with others across Florida have advocated for more personal protective equipment, better overtime pay, hazard pay, and worker’s compensation for those waylaid by the virus, they also acknowledged that medical workers can only do so much against the pandemic.

“This is war, and instead of bullets we’ve got viruses,” Baker said. “If we don’t find a way to dampen our curve we just keep chasing our tails.”

(Reporting by Zachary Fagenson in Miami; Editing by Frank McGurty and Tom Brown)

Global COVID-19 trial of hydroxychloroquine, which Trump takes, begins

By Kylie MacLellan and Kay Johnson

LONDON/BANGKOK (Reuters) – Healthcare workers in Britain and Thailand have started taking part in a trial to determine whether two anti-malarial drugs can prevent COVID-19, including one that U.S. President Donald Trump says he has been taking.

The study, involving more than 40,000 healthcare workers across Europe, Africa, Asia and South America, seeks to determine whether chloroquine and hydroxychloroquine could play a role in the fight against the novel coronavirus.

Demand for hydroxychloroquine surged after Trump touted it in early April. He said this week he was now taking it as a preventive medicine against the virus despite medical warnings about its use.

The lead investigators in Thailand and Britain said their ‘COPCOV’ trial, in the works for several months, would cut through the heated and unhelpful debate.

“We still do not know whether anything is beneficial in COVID-19,” the University of Oxford’s Professor Nicholas White, the study’s co-principal investigator, told Reuters.

“The only way we can find out if things are beneficial overall is to do large, well-conducted clinical trials,” said White, who is based at the Mahidol Oxford Tropical Medicine Research Unit (MORU) in Bangkok. “These are extremely well-established drugs.”

The COPCOV team said laboratory evidence showed the anti-malarial drugs might be effective in preventing or treating COVID-19 but there was no conclusive proof. Accord Healthcare has donated the hydroxychloroquine and matched placebo.

Medics who have tested positive will not be able to take part. More details can be found here.

Trump said on May 18 that he had been taking hydroxychloroquine and many frontline medical workers were too, although the U.S. Food and Drug Administration has issued a warning about its use.

“I’m taking it — hydroxychloroquine,” Trump said. “I’ve been taking it for the last week and a half. A pill every day.”

Professor Martin Llewelyn, the lead UK investigator, said many health workers were relying on social distancing and personal protective equipment but the measures were not perfect.

“Anything that can be done to reduce that risk further would be an enormous breakthrough,” he told Reuters.

(Writing by Kate Holton; Editing by Guy Faulconbridge and Catherine Evans)

U.S. graduates turn regalia into PPE: Wear the cap, donate the gown

By Barbara Goldberg

(Reuters) – In this year’s mostly virtual commencement ceremonies, thousands of American graduates are adorning their mortarboards with the slogan “Gowns 4 Good” after donating their gowns to healthcare workers fighting the coronavirus pandemic to use as personal protective equipment.

Gowns 4 Good is the name of a charity started three weeks ago by Nathaniel Moore, a front-line physician assistant in Burlington, Vermont, who is asking graduates to donate their gowns to more than 75,000 front-line responders and others who have registered for the regalia on Gowns4Good.net.

Across the country, school graduations have been canceled to abide by social distancing rules, including Moore’s own ceremony at the University of Vermont, where he was earning an MBA with a focus on sustainability.

“The image of my colleagues on the front line and at other medical facilities that lack the appropriate PPE and wearing trash bags with no sleeves and no protection under the waist, that just struck me,” Moore, 30, told Reuters.

After researching Centers For Disease Control and Prevention guidelines for PPE in times of shortage, he launched the non-profit with the slogan, “Wear the Cap, Donate the Gown.”

Gowns worn backwards, with the zippered opening in the rear and the high collar in the front, fit the CDC requirements for covering “critical zones,” including forearms, chests, stomach and waistline, Moore said.

“We are getting cries for help – from New York City emergency departments that have hundreds of patients coming in a day and they have no adequate gown protection to assisted living facilities that are sending us pictures of their staff without gowns,” he said.

In keeping with the tradition of graduates decorating their caps to express their individuality, those who donate their gowns are using the Gowns 4 Good logo to draw attention to the cause.

On Wednesday, Gowns4Good.net listed more than 75,000 gowns requested by medical facilities, more than 4,100 gowns donated by individuals and more than 1,500 gowns donated by institutional partners, including a regalia manufacturer.

Nearly 4 million people are expected to graduate from U.S. colleges in the 2019-2020 academic year, according to educationdata.org.

With much of the nation locked down, hundreds of schools have announced they will either cancel, postpone or stage virtual ceremonies.

Before the crisis hit the United States, Graduation Source in Greenwich, Connecticut, one of several cap and gown suppliers nationwide, received about 2 million orders for regalia for this spring’s graduation season, a spokesman said.

But the cancellations of graduation ceremonies have been changing that number daily, he said, although he declined to release an updated number.

Even gowns that students wear for a virtual graduation in the living room or back yard can be donated as PPE. But recipients are advised not to use the regalia before the three days that researchers say the virus can remain active on clothing, Moore said.

Among the most poignant donations were gowns sent by parents who included notes saying their sons and daughters died years ago, before they had a chance to graduate, and their regalia was just too precious to give away – until now.

“It’s the gown that has been sitting in their closet collecting dust but is too sentimental to do anything with,” Moore said.

“Now this is an honorable donation. So they can feel good about where it’s going.”

(Reporting by Barbara Goldberg; Editing by Dan Grebler)

Trump says he might lock down New York as health workers call for more supplies

By Alexandra Alper and Jonathan Stempel

WASHINGTON/NEW YORK (Reuters) – President Donald Trump said on Saturday he might prohibit travel in and out of the New York area to limit the spread of the coronavirus from its U.S. epicenter, as healthcare workers in the hard-hit region said they did not have enough masks and medical equipment.

With the number of known cases soaring past 115,000, the highest tally in the world, Trump said he might impose a quarantine on New York, and parts of New Jersey and Connecticut to protect other states that have yet to bear the brunt.

“They’re having problems down in Florida. A lot of New Yorkers are going down. We don’t want that,” Trump told reporters.

Since the virus first appeared in the United States in late January, Trump has vacillated between playing down the risks of infection and urging Americans to take steps to slow its spread.

Trump has also been reluctant to invoke emergency powers to order U.S. companies to produce much-needed medical supplies, despite the pleas of governors and hospital workers.

He also appeared to soften his previous comments calling for the U.S. economy to be reopened by mid-April. “We’ll see what happens,” he said.

It was not clear whether Trump would be able to block road, air and sea travel out of a region that serves as the economic engine of the eastern United States, accounting for 10 percent of the population and 12 percent of GDP.

New York Governor Andrew Cuomo said he had no details on a possible quarantine order.

“I don’t even know what that means. I don’t know how that would be legally enforceable, and from a medical point of view I don’t know what you would be accomplishing,” Cuomo told reporters. “I don’t even like the sound of it.”

Some states have already imposed limits on interstate travel. New Yorkers arriving in Florida and Rhode Island face orders to self-isolate if they intend to stay, and West Virginia Governor Jim Justice asked New Yorkers to avoid citizens in his state.

New coronavirus cases in China leveled off after the government imposed a strict lockdown of Wuhan, the epicenter of the disease.

The body count continues to climb in Italy, where authorities have blocked travel across the country and prevented people from leaving their houses for all but essential reasons.

In the United States, the number of cases stood at 119,327 on Saturday afternoon with at least 1,992 deaths, according to a Reuters tally. The number of cases in the United States eclipsed those of China and Italy on Thursday.

TOO LATE FOR A LOCKDOWN?

Trump said any New York-area lockdown would only apply to people leaving the region. It would not cover truckers making deliveries or driving through the area, he said.

U.S. courts would likely uphold a presidentially imposed quarantine, but Trump would not be able to enlist local police to enforce it, said Louisiana State University law professor Edward Richards.

“The logistics of deciding who is an essential person or essential cargo could shut down the ability to transport essential personnel and supplies,” he said.

Even if it were possible, a New York-area lockdown might come too late for the rest of the country.

Los Angeles Mayor Eric Garcetti said Southern California was on track to match New York City’s infection figures in the next week.

In New Orleans, where Mardi Gras celebrations late last month fueled an outbreak, the number of coronavirus patients “have been staggering,” said Sophia Thomas, a nurse practitioner at DePaul Community Health Center.

American healthcare workers are appealing for more protective gear and equipment as a surge in patients pushes hospitals to their limits.

Doctors are also especially concerned about a shortage of ventilators, machines that help patients breathe and are widely needed for those suffering from COVID-19, the pneumonia-like respiratory ailment caused by the highly contagious novel coronavirus.

Hospitals have also sounded the alarm about scarcities of drugs, oxygen tanks and trained staff.

On Saturday, nurses protested outside the Jacobi Medical Center in New York, saying supervisors asked them to reuse their masks, putting their own health at risk.

“The masks are supposed to be one-time use,” one nurse said, according to videos posted online.

One medical trainee at New York Presbyterian Hospital said they were given just one mask.

“It’s not the people who are making these decisions that go into the patients’ rooms,” said the trainee, who spoke on condition of anonymity.

 

(Additional reporting by Jonathan Stempel, Gabriella Borter and Brendan Pierson in New York, and Joel Schectman, Andy Sullivan and Michelle Price in Washington; and Lisa Shumaker in Chicago; Writing by Andy Sullivan; Editing by Daniel Wallis)

3M taps regional suppliers to meet soaring demand for masks

By Karl Plume

MAPLEWOOD, Minn. (Reuters) – Diversified manufacturer 3M Co has avoided major supply chain disruptions from the coronavirus outbreak by sourcing materials for its protective face masks from regional suppliers instead of far-flung locations, a company official told Reuters.

More than 3,200 people have died from the fast-spreading coronavirus, which has reached more than 80 nations. It has spurred buying sprees on medical supplies like face masks, even as world health officials have warned that citizens generally do not need to buy such supplies, and that stockpiling by the public can put healthcare workers, who do need them, at risk.

3M has ramped up testing and production of single-use N95 respirator masks, designed to filter 95% of airborne particles, along with more robust respiratory protective gear amid the coronavirus outbreak.

So far, the company has not seen disruptions in production, Nikki McCullough, global lead for occupational health and safety at 3M, told Reuters at its global testing lab outside of Minneapolis,

“If we start to see disruptions, we’ll certainly work to alert our customers. At this point in time, we are able to manufacture and we are continuing at capacity for respirators,” she said.

U.S. Vice President Mike Pence, who is heading the coronavirus response team in the United States, said on Sunday that the U.S. government is seeking 35 million additional masks per month from 3M. Pence will visit the 3M facility on Thursday.

3M produces all of the components of the filters in its N95 respirator masks in house but sources other materials from regional suppliers, including the straps and metal nose clips that hold the masks in pace, McCullough said.

“Since we have this regional manufacturing model, many of our items are coming regionally. And we’re working with our supply partners very closely to monitor the situation,” McCullough told Reuters.

The company is not currently under contract to produce the masks and is preparing to respond to the government’s request, 3M spokeswoman Jennifer Ehrlich said.

Demand for masks like the ones produced by 3M has outpaced supply as the coronavirus outbreak, which originated in China, has spread. The outbreak has riled markets and disrupted global supply chains, largely in export-dependent China.

“The demand is outstripping capacity right now, and we’re working 24/7 to ramp up and be able to meet as much of that demand as we can,” CEO Michael Roman told investors at an industry conference last month.

The U.S. Department of Health and Human Services intends to buy 500 million N95 respirators over the next 18 months for the Strategic National Stockpile (SNS), the nation’s supply of pharmaceuticals and medical supplies.

(Reporting by Karl Plume; Editing by Chizu Nomiyama)

Mixed messages, test delays hamper U.S. coronavirus response

By Julie Steenhuysen, Andrew Hay and Brad Brooks

(Reuters) – Even as U.S. officials warn of an inevitable outbreak of coronavirus in the United States, and are alerting Americans to take precautions, some health agencies charged with protecting the public appear unprepared to deal with the threat.

Barely more than a handful of public health departments across the country are able to test for the novel virus, which began in China and has spread to at least 44 countries. The federal government has less than 10% of the protective masks required to protect healthcare workers and the public. And Washington still does not have adequate funding in place to support health departments’ efforts, though more money is on the way.

Conflicting messaging from the White House and top U.S. officials regarding the severity of the threat has only added to the uncertainty.

The U.S. Centers for Disease Control and Prevention (CDC) this week for the first time advised American businesses, schools, hospitals and families to prepare for domestic acceleration of the virus, which has infected more than 80,000 people worldwide and killed nearly 3,000.

President Donald Trump on Wednesday assured Americans that the risk of coronavirus transmission in the United States was “very low.” Despite an explosion of cases in China over the past two months, the Trump administration only this week put in a request for $2.5 billion to aid in the response, an amount both Republicans and Democrats have said is too small.

Critics of the federal response say the United States squandered precious weeks by focusing too narrowly on keeping the coronavirus from crossing U.S. borders rather than marshalling resources to prepare American communities for a widespread domestic outbreak that officials now say was inevitable.

“This has been a realistic risk for a month, and the signal to trigger that kind of preparedness has only been going out in the last few days in an explicit way,” said Jeremy Konyndyk, a senior policy fellow at the Center for Global Development in Washington. “That’s a huge problem.”

An employee carries cans of freeze dried food to put into boxes as part of personal protection and survival equipment kits ordered by customers preparing against novel coronavirus, at Nitro-Pak in Midway, Utah, U.S. February 27, 2020. REUTERS/George Frey

FEW BEING TESTED

There are 60 confirmed U.S. cases of the novel coronavirus, which causes the disease known as Covid-19, U.S. health officials said on Wednesday. But experts admit they have no way of knowing the true figure because access to testing at present is severely limited.

So far, the U.S. strategy has focused almost exclusively on testing infected travelers, using a test that looks for genetic material from the virus in saliva or mucus. As of February 23, fewer than 500 people from 43 states had been or are being tested for the virus.

Currently, just seven state and local health departments have the ability to screen for the virus, the Association of Public Health Laboratories (APHL) said on Wednesday. CDC-developed tests issued three weeks ago were producing inaccurate results in some labs, so new tests had to be made and cleared by the U.S. Food and Drug Administration (FDA), leaving many labs with no local testing capability, the group said.

The CDC and FDA have worked out a fix that will allow 40 more public health labs to do testing by the end of next week, the APHL’s Chief Executive Scott Becker told Reuters.

In the meantime, the burden has fallen largely on the CDC, which does testing for most of the country on its campus in Atlanta.

“Unfortunately, we are now in the bottom tier in countries capable of doing population-based testing,” said Dr. Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

U.S. patients typically wait 24 to 48 hours to find out whether they have tested positive and need to be quarantined, health officials said, during which time those who are infected can spread the virus to others

The CDC’s test is restricted solely for use by public health labs, but if the virus begins spreading widely in the United States, hospitals will need to be able to do the tests themselves, public health experts say. Such testing is typically done using kits produced by commercial companies. Several privately developed tests are in the works, but none have yet won approval from the FDA.

Some health experts also fault the narrow testing criteria that the United States is using to screen for potential infections. Currently, individuals with flu-like symptoms are only tested for the coronavirus if they have traveled to a country where the virus is spreading. This has raised concerns that there are far more cases in the United States than are currently recorded.

“If the majority of testing is all around airports or travelers, we won’t know whether it’s circulating in communities,” said Dr. Tom Inglesby, director of the Center for Health Security of the Johns Hopkins Bloomberg School of Public Health.

Those worries were reinforced on Wednesday when the CDC confirmed the first U.S. case of coronavirus in a California patient with no apparent travel history. The University of California Davis said in a statement the patient was transferred to the hospital with severe pneumonia and the hospital requested testing. But since the patient didn’t fit the CDC’s criteria, those tests were delayed by several days.

On Thursday, CDC said it is broadening those criteria to allow testing when the virus is suspected.

MASKS IN SHORT SUPPLY

Around 15 state health departments contacted by Reuters raised concerns about challenges they would face in the event of community spread, including worries about not having enough personal protective gear to safeguard frontline medical workers.

The U.S. Department of Health and Human Services on Tuesday estimated that the United States would need 300 million face masks to protect healthcare workers and the public from people infected with the virus. The country has fewer than 20 million of the kind of masks needed to protect healthcare workers in the Strategic National Stockpile, a government repository of medical supplies needed to address public health emergencies.

“There is a real concern the availability of this equipment may be limited, in part because of the public buying it in a panic when they don’t need it,” said Matt Zavadsky, head of the National Association of Emergency Medical Technicians.

President Donald Trump’s administration is considering invoking special powers through a law called the Defense Production Act to quickly expand domestic manufacturing of protective masks and clothing to combat the coronavirus in the United States, two U.S. officials told Reuters.

With no Covid-19 vaccine or proven anti-viral medicine available, states are planning to isolate sick people in their homes, both to slow community spread and reduce pressure on hospitals, according to the CDC.

Their ability to track a rapidly expanding web of patients who test positive, and all the people with whom they have had contact, is of major concern, according to chief epidemiologists in several states.

Health departments in some states have purchased disease surveillance software to help them with that task. The state of Washington’s system, for instance, tracks patients and people they have had contact with, and asks them about their condition. If someone reports symptoms that merit hospitalization, the patient and doctors are informed of that.

The CDC said in a news conference on Tuesday that transmission of the virus could be slowed by the closure of schools and businesses and the cancellations of concerts and other mass gatherings.

But exactly who would make those decisions or how they would be enforced isn’t clear and could vary widely throughout the nation.

In Texas, for example, such decisions may be made by local officials, said Chris Van Deus, a spokesman with the Texas health department.

“Texas is a home rule state so the buck really stops with county judges and mayors,” Van Deus said.

Another concern is a flood of patients into health systems that are already overburdened in many parts of the country, particularly during winter flu season.

Washington state is considering temporary drive-through care facilities to stop potential coronavirus carriers entering healthcare facilities, mindful that hospitals can amplify outbreaks, as was the case with the viruses that cause MERS and SARS.

New Mexico is working with healthcare systems to turn outpatient facilities into care units if needed, said State Epidemiologist Michael Landen.

“The biggest challenge is getting a consistent message to the public with respect to their options with dealing with this virus,” Landen said.

(Reporting by Julie Steenhuysen in Chicago, Andrew Hay in Taos, New Mexico and Brad Brooks in Austin, Texas; Editing by Marla Dickerson)