Family physicians running low on personal protective equipment

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Shamini Kirupananthan’s hunt for surgical masks and other protective gear has gotten so desperate that the Scarborough obstetrician-gynecologist recently asked a friend if her mother, an expert quilter, could make the kind of washable cloth masks she’d seen online.

Dr. Kirupananthan said she has no idea if homemade masks would protect her or her patients from the new coronavirus, but she’s running out of options. All she has left is a box of 20 paper masks given to her by an orthodontist friend.

“This is just me, as a physician, going down the rabbit hole of, ‘What the hell are we going to do?’” she said. “Honestly, we’re all terrified.”

Like many other physicians in private practice, Dr. Kirupananthan is struggling to find personal protective equipment such as masks, gloves, gowns and face shields. Medical suppliers are sold out or jacking up prices, and requests to tap government stockpiles are going unfulfilled, some doctors say.

An online petition started by more than 60 doctors is urging the federal and provincial governments to mount a “war-like effort” to make more equipment available to Canadian health-care workers.

Hospital physicians are also worried about running low on protective gear as the new virus, which is known to have infected more than 1,000 Canadians, spreads like wildfire around the country.

But hospital doctors can rely – they hope – on procurement departments, while doctors who run their own offices are left to scour Amazon, make-it-yourself mask sites and even garages for protective equipment.

Samantha Lamont, a doctor who practises addiction medicine in Guelph, Ont., said she sent her husband to search the garage of his father, a painter. “He found some old surgical masks that they used for spraying ceilings,” Dr. Lamont said. “So that’s what I’ve got. God knows how long they’ve been there and they smell of motor oil but, hey, I’ll take it.”

Ottawa and the provinces say they are well aware of the supply crunch, but they are running up against worldwide shortfalls linked to COVID-19, the disease caused by the new coronavirus.

Prime Minister Justin Trudeau said Friday that his government would provide funding to help Canadian factories make crucial supplies such as masks and ventilators.

Health Canada announced earlier in the week that it would temporarily relax some regulations, such as those requiring bilingual labelling, to make it easier to import masks, gowns, swabs for coronavirus testing and other essentials.

The Ontario government, meanwhile, said it would invest $50-million to increase the supply of personal protective equipment for front-line workers.

"We’ve been strongly advocating for the purchase of more,” said Sohail Gandhi, president of the Ontario Medical Association. “We just need a better line of sight into how the [personal protective equipment] is going to be distributed.”

Melissa Yuan-Innes, an emergency physician in Eastern Ontario, would like to see the Ontario government immediately release the protective equipment it stockpiled after the SARS outbreak, most of which had expired by 2017, according to a report released that year by the province’s auditor-general.

“We’re so desperate that we would use it," said Dr. Yuan-Innes, one of the doctors who started the online petition. "If nothing else is available, we’ll use expired equipment. It’s better than no equipment.”

The auditor-general’s report said that, in 2017, Ontario’s Ministry of Health had, “a stockpile of over 26,000 pallets of supplies for medical emergencies, including respirators, face shields, needles, disinfectant wipes, disposable thermometers and other items."

The original cost of the supplies was approximately $45-million. About 80 per cent of the stockpile had expired by 2017, prompting the government to begin destroying it.

Travis Kann, a spokesman for Ontario Health Minister Christine Elliott, said by e-mail that, “once the situation in China was known, the ministry paused all destruction activities. They remain paused.”

The ministry is now working with manufacturers to figure out if the expired supplies, including N95 respirators, can be used safely, Mr. Kann added.

Whatever steps the federal and provincial governments take to make more gear available cannot come fast enough for David Gerber, a Toronto gynecologist who runs an out-of-hospital clinic that performs procedures such as removing polyps and tumours from the uterus.

With his regular supplier sold out of surgical masks that usually cost $5.99 per box, Dr. Gerber contacted another supplier who e-mailed him to say that masks flown in from Europe or India would cost $59.95 per box now, with future supplies selling for $100 per box.

“When I got that e-mail about the masks, it was almost too much for me. I was up all night thinking, ‘How are we going to get masks?'“ Dr. Gerber said. "We’re on a knife’s edge all the time.”

With a report from Karen Howlett

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