Personal protective equipment needs in the USA during the COVID-19 pandemic

Personal protective equipment (PPE) shortages (eg, masks, gloves, gowns) endanger patients and health-care workers alike during the coronavirus disease 2019 (COVID-19) pandemic.¹ Policymakers and experts have called for donations of existing PPE, increased production by manufacturers, and novel fabrication strategies, such as 3D printing of masks.2, 3 However, even as PPE sources are identified, a critical information challenge remains: tracking evolving PPE needs and matching them with existing or emerging PPE stockpiles. Although anecdotes of PPE shortages dominate the media, and epicentres of the pandemic, like New York City, NY, USA, have articulated clear needs, the national distribution of PPE shortages has not been examined. A quantitative, real-time snapshot of the PPE needs across the USA is needed.

The GetUsPPE web-based platform was developed by a collaborative of software engineers and physicians from across the USA collaborating in real-time on Slack, GitHub, and Asana. After merging multiple datasets from other grassroots efforts around the country, the platform was launched on March 20, 2020. Organisations requesting PPE reported descriptive characteristics (name, organisation type, address, recipient role in supply chain) and PPE needs (types, condition of acceptance, acuity of need) through an intake form. Public datasets were then used to determine each organisation's region, rural-urban status, and county-level data (including median income and number of deaths from COVID-19 for the county the requesting organisation was in).

The GetUsPPE platform also collects information about people or organisations interested in donating PPE, including type, quantity, and standard of supply (eg, CE certified, FDA certified). Matching of donations and need is done through manual human matching aided by computer algorithms. Real-time data for PPE needs nationwide can be viewed at GetUsPPE.org.

As of May 2, 2020, 6169 unique health-care organisations or individuals in all 50 US states had submitted PPE requests (appendix). Hospitals accounted for most requesting organisations (27%), followed by outpatient clinics (15%) and skilled nursing facilities (9%). Requesting organisations varied geographically, with 23% in the northeast, 16% in the midwest, 31% in the south, and 26% in the west. More than 87% of requesting organisations were in metropolitan areas, and 65% were in counties with median incomes in the highest quartile. N95 respirators were requested by 74% of organisations, making them the overall most commonly requested type of PPE. As depicted in the figure , need for PPE, which is measured by the volume of unique requests per county, appeared concentrated in major urban areas.

Figure.

Requests for personal protective equipment by county (N=6169)

Each circle represents a county in which a health-care organisation submitted a request for PPE, sized by the number of organisations in the county submitting a request. If one organisation submitted multiple requests, only the most recent is included. The greatest density of requesting organisations per county is clustered in major metropolitan areas, although many counties outside of major cities do have requesting organizations.

These findings provide a snapshot of the tremendous need for PPE among health-care organisations throughout the USA during the COVID-19 pandemic. These estimates are likely conservative, since the data are limited to organisations with awareness of the platform. Nonetheless, these results highlight that there are probably major disparities in access to and need for PPE. Targeted outreach to areas with few requests to date could fill gaps in knowledge about PPE needs in those areas (eg, rural and lower-income counties).

Nationally, the need was highest for N95 respirators, although all types of PPE were in demand. Organisations' needs for PPE, and for other resources like ventilators, must be characterised with maximum granularity in order to direct resources appropriately. Transparent information about the scope, location, and characteristics of need will allow more equitable distribution of PPE, supplying not only prominent health-care institutions but also those organisations in more isolated and less resourced settings. Understanding how collective needs change over time is another key function. Importantly, this information resource would ideally have been developed or maintained by a governmental entity instead of by a physician-run non-profit organisation.