April 14, 2020 - With ongoing, serious concern about the availability of personal protective equipment (PPE) for physicians, frontline health care workers and laboratory workers handling specimens and test kits related to COVID-19, the American Medical Association (AMA) today called on the Federal Emergency Management Agency (FEMA) to act as the single national source for procurement of the supplies. After calling on the Administration last month to take a stronger role in PPE acquisition and distribution, the AMA is still seeing states and facilities in direct competition with the federal government and each other for limited amounts of PPE.

"In order to help ease these burdens, it is critical that FEMA move towards a national system of PPE acquisition, acting as the single source of procurement for these critical supplies and alleviating pressure on states and health care facilities to source this equipment themselves," the letter says. "This would not only provide critical clarity and reduction in administrative burden, but would also allow states and hospitals to benefit from the tremendous bargaining power of the federal government. We further urge FEMA to serve as the single national coordinator of distribution of these supplies, ensuring that states, hospitals, and other facilities have one centralized agency to work through to acquire essential PPE."

To download a PDF copy of the letter, click here.

The full text of the letter is below:

Dear Rear Admiral John Polowczyk:

On behalf of the physician and medical student members of the American Medical Association, I am writing to express our serious ongoing concern with the availability of personal protective equipment (PPE) for our nation's health care workforce battling on the frontlines of the COVID-19 pandemic. In a recent letter to President Trump, we strongly urged him to move towards a national system for acquisition of PPE, as well as a system of distribution managed by the federal government. However, we have not seen any movement towards centralizing the current flawed, state-based system and we continue to let our dedicated physicians, nurses, and other health care workers treat highly infectious patients at significant risk to their own health and wellbeing due to lack of appropriate PPE. This is an urgent matter to protect these brave men and women fighting on the frontlines to save American lives.

As you are well aware, PPE shortages have been rampant across the United States. Physicians and other health care workers in every state have expressed serious concerns regarding the availability of appropriate safety equipment. We are hearing that in many facilities treating COVID-19 patients are days away from running out of PPE. In others, there are reports of health care workers being forced to reuse single-use N95 respirators and surgical masks for days, if not weeks, due to extreme shortages. We see photos of physicians, nurses, and others treating patients in rain ponchos or plastic garbage bags in lieu of appropriate protective gowns. As we highlighted in or letter to President Trump, we are asking everything of our nation's exceptional health care workforce, and they have answered that call without hesitation despite the extremely high risks they are facing every day. We must ensure that they are protected and safe as we ask them to take on the tremendous challenge of fighting this deadly disease.

We are also growing more concerned about PPE shortages and the potential impacts of these shortages on the laboratory community. Laboratory workers handling SARS-CoV-2 specimens and test kits are at significantly heightened risks for contracting COVID-19. As the United States continues to struggle with providing widespread testing services, it is critical that we have a robust, healthy laboratory workforce to process these tests. A lack of appropriate PPE poses similar risks in a laboratory environment as it does in other health care facilities, and PPE will be especially important once point-of-care testing is widely available. Should we not have enough PPE to provide at facilities where point-of-care testing is available, it will severely hinder our ability to offer those services to patients.

In addition to concerns about lack of access to appropriate PPE, we continue to see significant issues with acquisition and distribution of PPE. States and facilities across the country continue to report tremendous challenges in identifying suppliers with available PPE. When those suppliers are identified, states and facilities are frequently put in direct competition with other states as well as the federal government for the limited amounts of available PPE, adding more difficulty and burden on to systems already overwhelmed and at their absolute limits. In order to help ease these burdens, it is critical that the Federal Emergency Management Agency (FEMA) move towards a national system of PPE acquisition, acting as the single source of procurement for these critical supplies and alleviating pressure on states and health care facilities to source this equipment themselves. This would not only provide critical clarity and reduction in administrative burden, but would also allow states and hospitals to benefit from the tremendous bargaining power of the federal government. We further urge FEMA to serve as the single national coordinator of distribution of these supplies, ensuring that states, hospitals, and other facilities have one centralized agency to work through to acquire essential PPE.

As we continue to face the tremendous challenge of overcoming this deadly global pandemic, we must do everything we can to protect our health care workers fighting on the frontlines. Allowing these exceptional men and women to treat highly infectious patients in makeshift gowns and homemade masks cannot be the standard by which we continue to operate. At a time when we face one of the most daunting health care challenges in this national's recent history, strong leadership and significant collaboration is needed to ensure we prevail. As such we urge FEMA to take on a larger role in this fight, creating a national system of acquisition and distribution of all PPE.

Sincerely,

James L. Madara, MD