It had been months since the state sent any personal protective equipment.
The residents of Dorothy Schlimme’s long-term care homes, many of whom are frail, as well as staff, have been wearing blue disposable face masks she bought from Costco.
She would’ve liked some of Washington’s huge stockpile of N95 masks, which filter 95% of airborne particles, but hardly any of them made it to providers. By mid-November the stockpile had grown to more than 30 million N95s.
This week, however, 150 of the state’s N95 masks arrived for her three Auburn homes, free of charge.
“All the help we can get from the state government is welcome,” Schlimme said. “We’re basically opening our hands.”
Washington officials have been distributing millions of N95 masks over the past month to prisons, long-term care providers, county emergency managers and others. The change comes after pleas from advocates and a November Seattle Times report that spotlighted the state’s extensive surplus.
Some providers, the Times report found, were unable to obtain masks because the ordering process was a bureaucratic maze. Others were reluctant to accept the state’s main N95 model because of concerns over its fit.
Gov. Jay Inslee’s office and Department of Health officials in November approved a plan to distribute masks, for free, to all counties and tribes, based on their population sizes. The first shipments went out last week. The state also sent more than 1 million masks to the Department of Corrections, which has had a wave of coronavirus infections, and the Department of Social and Health Services (DSHS), which then distributed them to homes like Schlimme’s.
Over the past month the state has shipped more than 6 million N95 masks — as many N95 masks as have been pushed out in the first eight months of the pandemic.
The disbursement comes as coronavirus cases and deaths shatter records in Washington and across the U.S., and emergency managers are eyeing a post-holiday surge in January.
“If we have the opportunity to get our hands on particular supplies, I’m going to take it,” said Chandra Fox, the Spokane County deputy director of emergency management. She ordered nearly 784,000 masks, the maximum allotment under the state’s new order, in anticipation of “things really going off the rails.”
Her agency plans to begin handing out the free masks next week to child care centers, home health organizations, long-term care facilities and social service nonprofits like Meals on Wheels, among others.
One group notably absent from the list: hospitals. This fall, the state sent samples of its main N95 mask, a model made by BYD, a Chinese automotive conglomerate. Some hospitals found samples didn’t fit well for smaller faces— an issue in a health care workforce made up primarily of women. Medical providers have told Fox they can’t use the state’s masks because of their fit.
Nonetheless, the masks help fill a gap in personal protective equipment at smaller organizations, which have had trouble placing N95 orders because suppliers are focused on large buyers like states and hospitals. It will help avoid staffing shortages at essential care providers, Fox said.
“You’re giving people a level of comfort about their own safety, so they’re more confident coming into work,” she said.
$100 million on masks
Washington’s stockpile of N95s is almost entirely made up of masks made by BYD, which converted some of its production lines from car interiors to medical supplies during the pandemic. The state agreed to pay BYD nearly $100 million.
Washington, like other states, has struggled to compete in a chaotic international medical-supply marketplace. Normal supply chains ran dry, especially for the N95 respirator, and the Strategic National Stockpile failed to fill the gaps.
In early March, DES, the state’s main buying agency, suspended competitive bidding requirements for acquiring goods and services. Procurement officers scoured the globe, and committed to buy tens of millions of masks with no-bid contracts. They were hoping to supply more than half of the state’s health care facilities with up to a 60-day supply of masks at any given time.
So far, the state has ordered nearly $475 million of PPE and ventilators.
The BYD masks, in particular, piled up due to hospitals’ hesitations and the state’s strict rules for distribution. Long-term care homes, for instance, would only qualify for N95s if they had active coronavirus cases and their PPE supplies were nearly depleted.
Not all hospitals, though, have shunned the BYD masks. The state sent Virginia Mason Memorial in Yakima 500,000 masks in November. They will be used by doctors, nurses, housekeepers and others who interact with patients, a hospital spokesperson said.
Do they fit?
As most long-term care facilities went months without N95s from the state, the Washington Adult Family Home Council, which represents facilities like Schlimme’s, pushed for masks to be distributed to its members. The homes are in residential neighborhoods and house between two and six residents each.
In late November an order of 400,000 masks was shipped to DSHS, and the agency has disbursed them across the state. Masks were sent to all of the roughly 3,300 adult family homes. The state’s 46,000 in-home caregivers who serve Medicaid recipients also received masks. The remainder went to DSHS staff who visit long-term care facilities while conducting inspections, for instance, or investigating allegations of abuse.
Now, Schlimme and other operators are facing the next challenge with N95s: making sure the masks fit properly.
Already, John Ficker, the executive director of the Adult Family Home Council, has said some homes are returning the masks made by BYD and another manufacturer, Outdoor Research, because they don’t fit anybody properly.
Schlimme is hoping the public health department or local fire stations will be able to send workers into her three homes to conduct fit tests.
“It’s protection of myself, protection of my patients,” she said. “We take care of vulnerable adults. The more I can take care of both my residents and staff, the more people can still come to work and make their livelihood. It’s really important to all their families.”