Ebola Readiness: Direct Relief Survey of the U.S. Safety Net



One-third of America’s safety-net facilities reported a limited supply of waterproof shoe covers, gowns, face shields, single-use respirators and other personal protective equipment (PPE) the Centers for Disease Control and Prevention recommends for treating Ebola patients, a nationwide survey of nonprofit health centers and clinics reveals.

With current CDC guidance urging health facilities to make all required PPE and supplies available to health care staff, Direct Relief conducted the survey to assess current PPE availability and clarify the quantities needed to sustain health centers and clinics for one month.

Health center staff have expressed concern regarding equitable access to PPE and have sought clarification on the PPE standards for ambulatory care for suspected Ebola cases, according to Ron Yee, MD, Chief Medical Officer at the National Association of Community Health Centers.

“Health centers are critical partners in the containment of communicable disease outbreaks,” said Yee. “There is a lot of fear in the communities regarding the Ebola virus and we need to assure our patients that we will provide safe care while also protecting our health center staff.”

Safety Net Survey Results

Direct Relief issued the survey to its national partner network of more than 3,000 nonprofit health facilities in all 50 states. Both the National Association of Community Health Centers (NACHC) and the National Association of Free and Charitable Clinics made the survey available to their respective memberships.

Respondents, who represent facilities in 49 states and Puerto Rico with roughly 40,000 staff, reported current supplies of PPE at the following levels:

Number of clinical staff that require PPE:
  • More than 40,000 staff members reported
    • 23,000 – clinical staff
    • 17,000 – non-clinical staff
  • 10% (43 respondents) are from states with inbound travel watches (GA, IL, NY, NJ)
No surplus supply
  • Waterproof shoe covers (75.7%)
  • Waterproof gowns (62.8%)
  • Face shields (59.5%)
  • N-95 face respirators (53.8%)
Surplus supply (more than one month)
  • Nitrile gloves (65.9%)
  • Hand sanitizer (78.8%)
Usefulness of the information received regarding Ebola virus disease
  • 84.1% – useful/very useful
Usefulness of the guidance received regarding Ebola virus disease
  • 78.7% – useful/very useful
Feedback in the comments related to the usefulness of information and/or guidance facility received regarding the Ebola virus disease could be roughly categorized in a couple of groupings:
  • About one third reported they had enough good information
  • About one third wanted more information overall, and many requested more information specifically related to outpatient care guidance, not just hospital
  • About one third indicated a need for both additional PPE and more information for clinical staff

“Safety-net health facilities care for an estimated 23 million people in the U.S. — many of whom are among the Nation’s most vulnerable,” said Damon Taugher, Director of U.S. Programs for Direct Relief.  “Whether it’s a hurricane, an outbreak of influenza, or fear of Ebola, local health centers and clinics are turned to by their communities in times of emergency. Their role in managing Ebola in the U.S. cannot be overlooked.”

West Africa Ebola Response Continues

Since the Ebola virus erupted in West Africa six months ago, Direct Relief has provided frontline health professionals fighting to contain the outbreak with more than 140 tons of medical resources valued at $6.98 million (wholesale).

In addition, Direct Relief is working with local medical staff and Ministries of Health to support the broader health system by strengthening the in-bound supply-chain and in-country distribution of medical resources.

Direct Relief’s near-term priorities include the following:

  • Restock and resupply hospitals, health centers, and clinics to enable them to reopen by providing kits containing a stock of 35 essential items. These kits will be sent to hundreds of clinical sites around the country so they can reopen and begin seeing patients who have been unable to access care.
  • Modularize shipments specific to the 23 Ebola treatment facilities in both Liberia and Sierra Leone to ensure efficient in-country receiving and immediate delivery to the appropriate facility. This will help remove bottlenecks and enable more rapid and direct transportation of materials to the centers caring for patients with Ebola.
  • Provide 267 Midwife Kits to Liberia and Sierra Leone which will provide safe births for 13,350 moms and babies. In Sierra Leone alone, pre- and post-natal care visits are down 28%, and delivery with a skilled birth attendant is down 16%. Estimates show that maternal mortality may rise to 15% as a result of the Ebola crisis.

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