Pictured: Alexa Coughlin shows a mask she has sewn for local healthcare workers. Photo submitted.
by Kimberly Rivers
As more people are tested for the novel coronavirus, positive cases are ticking up in Ventura County. The number of patients hospitalized with COVID-19, the resulting illness, has also increased. The current number of patients hospitalized is relatively low at 30, but healthcare administrators and medical providers are planning and preparing for a potential surge in cases that would stress already strained supplies.
Personal Protection Equipment (PPE) is the term for everything from gowns to face shields to full hazmat suits that healthcare workers need to be fully protected from the virus when in proximity with those infected. Local healthcare facility employees – from the front desk receptionists and janitors to nurses to surgical specialists – are on the front lines of the battle to stop the spread, and at the highest risk of potentially contracting the virus.
Hospitals across the county, like many across the nation, are looking ahead and asking for donations. True to form, Ventura County is answering the call.
Hospitals seeking donations
“Based on current supply, projected usage, and market demand and supply availability, Community Memorial Hospital [CMH] anticipates it may face supply shortages of protective masks, protective gowns, face shields, and medical goggles.” The hospital’s March 25 statement included a request to the public for “masks and other critical supplies,” but also stated the hospital, “is not accepting cloth masks,” and continues that supplies in “original, unopened packaging” is “particularly useful and appreciated.”
The list of needed items included N95, N99, P95 and standard procedure masks, isolation gowns, respirator hoods or hazmat hoods and P100/N95 respirators and the replaceable cartridges/filters. CMH is a private not-for-profit system that includes CMH in Ventura, Ojai Valley Community Hospital, the Centers for Family Health and several outpatient clinics across the county.
On March 23, Ventura County put out a call for donations of PPE for their facilities.
“We are facing an unprecedented public health emergency, and the increasing demands of our healthcare system is contributing to shortages in personal protective supplies,” said Mike Powers, CEO of Ventura County. The following items are requested: surgical masks, N95 masks, procedure masks, isolation gowns, medical goggles, DacronTM culture swabs and Tyvek.® suits.
“Medical providers do have PPE at this time. They are preparing for a possible surge and asking for PPE gear to have on standby for that surge,” said Ashley Bautista, public information officer for Ventura County, responding via email on March 26 to the VCReporter about supplies at the hospitals and the cloth masks.
“We have accepted them [cloth masks]. Heard some other hospital systems are not. There is not a lot of data on cloth masks. That makes it challenging to know how protective they are. We are certainly very appreciative of all community efforts to help us,” said Dr. Todd Flosi MD, chief medical officer with Ventura County Medical Center. One way the masks are being used now “is when employees go home, they are concerned they will make their families and loved ones ill. Some are using [cloth masks] as a way to save our in-hospital, medical grade masks, to have some safety and protection and comfort of wearing a mask at home.”
Flosi said right now, “It is not recommended that cloth masks be used for direct patient care or contact. In a dire shortage of other types of masks, we will certainly consider them. We do have enough [N95] masks currently, and have a fairly large order from what we think is a reliable source, arriving later in the week.”
Community mobilizes a sewing brigade
When hospitals are ready for cloth masks, the community will be ready for them. An army of hands has already amassed – donating, driving, cutting and sewing 3,000 cotton masks to be delivered to county hospitals.
“We’ve been going around the clock since March 12,” said Amy Towner, chief executive officer with the Health Care Foundation of Ventura County (HCFVC). HCFVC is a nonprofit organization with a mission to support the Ventura County Healthcare Agency, which governs two county hospitals, Ventura County Medical Center and Santa Paula Hospital, as well as other clinics and facilities. “The main thing is getting hospitals ready for the surge.”
Towner was involved in founding a sewing brigade of over 300 individuals, plus 15 groups with their members, who have sewn over 1,769 masks so far.
The group came together before the novel coronavirus reached Ventura County. Towner had reached out to her network through HCFVC about forming a “baby brigade that would create special gifts for low-income moms having babies.” Towner was surprised when the group wanted to give handmade gifts. “I had no idea this would happen,” she said. Most in the group “began saying they could sew bibs, burp cloths,” for the new moms. “I was just shocked . . . I thought sewing was really a lost art.”
The group was planning to meet again, “when COVID had reached Ventura. We realized there was going to be a shortage in supply of PPE and there was a message that these masks could be a layer of protection for healthcare workers . . . in the worst case scenario . . . in the event that the hospital is out of other masks.”
“This wouldn’t have been our first choice, regular PPE would be, but this is a way for our community to let our healthcare workers know we care about you and value you.”
Towner was careful to emphasize that the masks alone don’t provide the needed protection, and if they get “moist or wet” they have to be replaced. “These would never be for frontline staff,” she explained. While the majority of the masks are not in use now, some are being worn by “administrative [staff], none with direct patient contact.”
Towner worked with another local volunteer, Jamie Mattock, to determine which mask pattern would be best. Towning and Mattock knew each other from their work over the past six years with the Ventura County Chapter of the National Charity League, a group that raises money for the Children’s Center for Cancer and Blood Diseases at VCMC.
Towner said the group is using a “standard style” design. “It doesn’t have elastic [which has] infection control issues and elastic can’t withstand the temperatures of sterilization or the autoclave,” a machine for sterilization. They went with a hand-tie style, which covers facial hair, fits over an N95 mask and “comes up very high on the nose and far down on the neck, excellent coverage, it’s comfortable,” explains Towner.
Towner was surprised at the tremendous “mobilization” of the community. People were coming forward saying “I can’t sew but I can drive. I can’t sew but I can cut. I can’t sew but I have fabric, I’m willing to donate it.”
The group is coordinating closely with hospital leadership to ensure the masks are clean and sterile in the event that they are used. Towner explained that the person sewing the mask irons them at a high temperature and puts them in a plastic bag, which is then delivered to Gina Ferrer, a trauma nurse at Ventura County Medical Center in Ventura, who uses an industrial iron to press the masks a second time before delivery to the hospital, where they go through a laundry system for sterilization.
“Leadership coordinated with the laundry to create a process, with designated mesh bags,” for the masks, Towner said, adding that the hospital has created a policy on how the masks will be handled and laundered “in the event we need to use them.”
The army of hands working on the masks includes people across the county, and even from other states. Churches, a local quilting group, people in New York and Colorado have all called Towner. “Folks are sewing and sending them to Gina’s address . . . it’s really been a shining example of our community in the face of disaster.”
Stitch in time
“A surprising thing is that it has been remarkable to see how excited the nurses, staff and doctors are with the masks, a morale booster at a very difficult time,” Towner said. “Like kids in a candy shop, so much fun getting these gifts. Really these masks could end up being a memento of surviving an historic event in our world.”
“In WWII women went to work creating bullets to protect our country. There are women and men who are home sewing to protect our country. Another shocking thing is how many men have been sewing with their wives at the sewing machines,” Towner said. She also received an email from a woman whose two teenage children have learned to sew in order to make these masks. “They are in a production line now, it looks like they have transformed part of their living room into a sewing factory.” A local business owner wanted to keep staff working and was “willing to pay to have staff come in and be at their sewing machines.”
“With this disease, we are building it as we fly, finding out information as we go,” Towner admitted. “Some reports are, it’s not safe to wear over; we will leave that to infection control experts, to hospital leadership to deem how they will use in the event we run out of PPE..”
When asked how hospitals are currently using existing supplies, Towner said, “If we thought we would not have enough food, we’d probably ration our food,” noting that rationing of supplies makes sense.
The mask sewing efforts, however, remain a source of pride. “This has been a beautiful way for our community to show our healthcare workers that we value them, and we are collectively doing it in a safe way, with readily available product like cotton fabric in our homes and sewing in our homes, helping with social distancing in preventing the spread of the disease, which also in turn helps healthcare workers, by us all staying home it helps them because it flattens the curve.”
High-tech in-home solutions
Centers for Disease control states that “homemade masks” of fabric “are not considered PPE” and that “caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends below the chin or below) and sides of the face.”
Some local residents are using high-tech solutions to build face shields for healthcare workers. Ryan Beattie of Camarillo started by designing and creating a prototype of an N95 respirator mask that can be built on a 3D printer. The mask was tested last week by local medical professionals.
They “had concerns with their ability to sterilize them” during testing so “we’ve shifted gears,” said Beattie. “And are now printing the headbands for the face shields. The hospitals are accepting them and they are already in use.” As of March 29, his home machines have printed about a dozen headbands.
The N95 mask he designed used only about $2 in materials to print and he thinks that it could be used for a day and then disposed of. “Maybe they are not desperate enough yet,” Beattie acknowledged. He didn’t expect the masks to “be used in the long term, I expected them to be used for a day, treated as disposable.”
Beattie is the process expert in the engineering group at Takeda Pharmaceuticals in Thousand Oaks. Right now he is making eight headbands a day with the tabletop printer; it takes about two hours to print one. Takeda has allowed him to bring home another printer so he can double output.
He described a sort of crowdsourced approach to solving these issues happening on a global scale. A global 3D printing group he is a part of includes “a bunch” of local experts working with officials from Massachusetts General Hospital to create “a whole new knowledge, a rapid design” approach to “redesigning N95 masks” and other protective equipment.
Takeda itself is in the fight against the pandemic. The company makes several prescription drugs and Beattie says much of the staff is working remotely, with essential personnel going into the office as needed to ensure there are no shortages. According to the company’s website, Takeda is also working on an “investigational plasma-derived therapy for COVID-19” called TAK-888.
Students, teachers enter the fight
Beattie and his cohorts aren’t the only ones looking for high-tech solutions to the PPE shortage. The STEMbassadors of Ventura Unified School District (VUSD) are being directed by Alex Wulff, a teacher at De Anza Academy of Technology and the Arts (DATA), to print pieces of face shields which have been used by VCMC emergency staff since March 24.
“We are using them on every shift to prevent the spread of COVID-19. As healthcare providers, we are so touched by the community’s willingness to step up and find ways to help,” said Dr. Richard Rutherford, attending physician of emergency medicine at VCMC.
When it became clear that hospitals did not have enough PPE, Wulff saw an opportunity for students to help solve a real-world problem in their communities. An open-sourced design was used and Wulff got approval from VCMC officials.
STEMbassadors is a Ventura-based nonprofit organization formed of middle- and high-school students. It has provided 3D printers for classrooms, training 27 teachers to operate them. Every day, the group is producing 30-40 protective face shields for frontline medical staff. The group includes Torry Kightlinger and Allison Quiroz of Junipero Serra Elementary, Matt Haines of Cabrillo Middle School and former student Patrick Waechter.
The clear Plexiglass sheets are being provided by several different companies, including American Plastics and FASTSIGNS® in Ventura. The immediate goal is to make 500 face shields, but volunteers will keep printing until there is no longer a need. The group is running low on both the material to print the headbands and the clear plexiglass for the shield.
“This project highlights how important it is to have technology and innovation in the classroom,” said Wulff. Since members of STEMbassadors had already trained on how to use the technology, the group was more nimble than any large corporation and was able to start printing quickly. Currently there are 23 printers in operation. “We found a solution to solve a problem within our community,” said Wulff, “and within hours we were providing that solution to our frontline workers.”
Support for STEMbassadors: To donate PETG clear, 5mm sheets or materials for headbands, email Alex.Wulff@venturausd.org. More information on STEMbassadors at www.stembassadors.net/.
Centers for Disease Control: Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings: https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html.
CDC: Strategies for Optimizing the Supply of Facemasks: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html.
Protective equipment donation dropoff locations
Community Memorial Health System Monday – Friday, 10 a.m.-2 p.m.
147 N. Brent St., Ventura – white tent next to the grass area.
Ventura County Medical Center Monday – Friday, 9 a.m.-4:30 p.m.
Ventura County Community Foundation, 4001 Mission Oaks Blvd, Camarillo
Office of Assemblymember Jacqui Irwin, 2301 E. Daily Drive, Suite 200, Camarillo; and 230 West 7th Street, Suite B, Oxnard.