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President Donald Trump wondered how the demand for masks could rise 30-fold.
The use of masks and the number of new COVID-19 cases go hand-in-hand and cases nationally shot up by a factor of 45 in the past two weeks.
The range of hospital jobs that require a mask has expanded to prevent the spread of the virus.
President Donald Trump voiced disbelief at the skyrocketing demand for protective masks at New York hospitals.
"Are they going out the back door? How do you go from 10,000 to 300,000?" Trump asked at a March 29 press conference. "And we have that in a lot of different places. So, somebody should probably look into that, because I just don’t see, from a practical standpoint, how that’s possible to go from that to that."
The head of the Greater New York Hospital Association Kenneth Raske shot back that hospital workers "deserve better than their president suggesting that (personal protection equipment) is ‘going out the back door’ of New York hospitals."
As has New York Gov. Andrew Cuomo. "In terms of a suggestion that the (personal protective equipment) equipment is not going to a correct place, I don't know what that means. I don't know what he's trying to say. If he wants to make an accusation then let him make an accusation."
We can’t fact-check an accusation. But there is an explanation as to why hospitals are burning through masks at a higher rate.
The number of COVID-19 cases and the number of masks go hand-in-hand, and the number of cases has surged.
According to the Centers for Disease Control and Prevention, the number of reported cases topped 186,000 as of March 31.
Even if just 12% required hospitalization — a national average reported by the CDC in mid March — the number of daily admissions nationwide would have gone from about 430 to over 19,600 in just 15 days. (We ran our method by Boston University epidemiologist Eleanor Murray, who said it was sound.)
The data on the number of COVID-19 patients in hospitals is limited. In New York City, the nation’s epicenter for the disease, the hospitalization rate is closer to 20%. According to the COVID Tracking Project, deaths in New York State rose over 200-fold in the second half of March. That’s not a perfect measure of hospitalizations, but since deaths largely take place in hospitals, it’s an indication of the increased care that hospitals provide.
Trump wondered how it was possible to jump from needing 10,000 to 300,000 masks. Assuming his starting point is valid, that’s a 30-fold increase in about two weeks. Our estimated nationwide rise in hospitalizations was 45-fold.
The swelling numbers of people needing care drives up the need for personal protective equipment "at an exponential rate," said New York State Health Department spokesman Jonah Bruno.
Beyond the explosion in the number of patients arriving at hospitals, an infectious disease touches many steps in hospital operations. Every person who might have the virus is a risk. And that has expanded the range of jobs where a mask should be used.
The changes start right at the point where people first show up at the hospital lobby or emergency room.
"We don’t know if someone who presents in the emergency department with a cough, if they have COVID-19 or the flu or a cold," said Anna Adams with the Georgia Hospital Association. "We have to treat those patients who have symptoms as if they are positive for COVID-19."
Before this new coronavirus, an intake clerk wouldn’t need any sort of mask. Now, they do, even if it is a simple surgical mask (in contrast to the N95 mask that direct caregivers use to block water droplets that carry the virus). And the same goes for technicians who take blood pressure, the dietary staff who deliver food, and the housekeepers who clean the common areas and rooms.
Dave Dillon with the Missouri Hospital Association echoed that point.
"This can lead to a lot of churn as identified cases or patients under investigation multiply," said Dillon, the group’s head of media relations.
The rules for anyone who comes in contact with a confirmed case are stringent.
"Anyone who goes in and out of the room of a COVID-19 positive patient or a patient under investigation would ideally need a complete change of personal protective equipment," Adams said. "We have to protect our staff, because if they get sick, or pass the virus to a coworker, we won’t have the people to take care of our patients."
Adams said hospitals in Georgia are re-using masks as long as possible, but they still are falling short of the masks they need. At many health centers, they aren’t getting the number they would have received in ordinary times.
"There’s a finite number of masks, and everybody’s going after the same supply," Adams said.
White House, Remarks by President Trump, Vice President Pence, and Members of the Coronavirus Task Force in Press Briefing, March 29, 2020
Centers for Disease Control and Prevention, Cases in U.S., accessed April 1, 2020
Centers for Disease Control and Prevention, Severe Outcomes Among Patients with Coronavirus Disease 2019 (COVID-19) — United States, February 12–March 16, 2020, March 26, 2020
New York City Department of Health and Mental Hygiene, Daily Data Summary, March 30, 3030
COVID Tracking Project, data, accessed April 1, 2020
New York Times, Coronavirus (Covid-19) Data in the United States, accessed March 31, 2020
Johns Hopkins University Center for Systems Science and Engineering, data download, accessed April 1, 2020
Wired, The ‘Surreal’ Frenzy Inside the US’ Biggest Mask Maker, March 16, 2020
Reuters, In trenches of New York's coronavirus crisis, nurses beg, borrow and steal precious masks, March 27, 2020
Interview, Anna Adams, vice president for government relations, Georgia Hospital Association, March 31, 2020
Email exchange, Dave Dillon, vice president of media and public relations, Missouri Hospital Association, March 31, 2020
Email exchange, Jonah Bruno, director of communications, New York State Department of Health, April 1, 2020
Email exchange, Eleanor Murray, assistant professor of epidemiology, Boston University, April 1, 2020