Mon Mar 23rd, 2020 at 07:04:17 PM EST
The editors of JAMA recognize the challenges, concerns, and frustration about the shortage of personal protective equipment (PPE) that is affecting the care of patients and safety of health care workers in the US and around the world. We seek creative immediate solutions for how to maximize the use of PPE, to conserve the supply of PPE, and to identify new sources of PPE. We are interested in suggestions, recommendations, and potential actions from individuals who have relevant experience, especially from physicians, other health care professionals, and administrators in hospitals and other clinical settings. JAMA is inviting immediate suggestions, which can be added as online comments to this article.
Corresponding Author: Howard Bauchner, MD (email@example.com).
I read through the more than 50 submissions at the JAMA site on March 20, 2020 and will attempt to summarize them along with some other resources I've come across:
A Belgium nonprofit worked with their government to design a DIY face mask:
Korean DIY mask
An emergency mask from a T shirt:
Home-Made Face Masks
https:/www.dailykos.com/stories/2020/3/17/1928552-Home-Made-Face-Masks [three different versions of improvised face masks, including directions for 1918 Spanish flu design]
Use mask covers (surgical mask sleeves)
How to Make n95 Mask Covers
Mask Sewing Crowd Source on FB: https:/www.facebook.com/groups/1596375590537476
The Million Mask Challenge
Swedish/St. Joseph's Providence is making homemade PPE [face shields]
3-d printed face shield
DIY substitute for N95 respirators, "create your own reusable respirator using only a face mask, an in-line ventilator filter, and two elastic straps. All for less than 3 dollars! Find instructions, details, and video at
We need quantities of Personal Protection Equipment [PPE] within the next week or two until the factories ramp up, Could a significant proportion of that need be supplied by a crowd-sourced production method? Can people in quarantine do whatever they can do from home in order to help the effort to "bend the curve" (make sure fewer people die) now and in the near future? Can they be paid in $$$, kind, or services to tide things over? (It would also be helpful to have utility and rent payment moratoriums as in France and, I've read, El Salvador. That would alleviate some worry, I suspect.)
It seems some form of short-term "universal basic income" [UBI] is going into legislation but what if it were combined with a possibility of universal service as well in this particular? What if we were thinking of this the way Churchill thought about Dunkirk and called out everyone who can help to help? What if we mobilized our own "little ship navy" to get all hands on deck to deal with this crisis?
Here are some more ideas from JAMA:
There is a 1975 study indicating that the material used in masks matters less than the fit. See Br J Surg. 1975 Dec;62(12):936-40. The efficiency of surgical masks of varying design and composition. Quesnel LB.
(And other studies suggest that any mask is better than none, down to a bandana across the nose and mouth.)
"On any surface, the virus dies off over time anyhow, so merely storing used masks for a week might adequately decontaminate them." I suspect exposing them to sunlight's UV radiation would be good too.
Sanitization for re-use:
Data from WHO suggests heat at 56°C kills the SARS coronavirus at around 10000 units per 15 min (quick reduction)
disinfect with alcohol and then dry at 60ºC of higher
gamma or e-beam radiation decontamination
SARS-coronavirus can be effectively eliminated at 56-65 deg C for 30-90 minutes. Heat PPE at 65 deg C in an oven for 90 minutes before reusing
(According to the CDC, flu viruses are killed by heat above 167º F
ultraviolet decontamination for reuse although this needs testing as UV may degrade mask quality
ethylene oxide (EtO) sterilization for n95 and all PPE
Reusable gowns for patients in contact isolation have already been deployed at large medical centers (https:practicegreenhealth.org/tools-and-resources/ronald-reagan-ucla-medical-center-reusable-isola
tion-gowns), with the primary motivation being an overall reduction in waste and greenhouse gas emissions associated with the manufacture, transportation, and disposal of one time use gowns. [Margin note: there's going to be a lot of waste with all these one use items. Already there are reports of littering with used face masks in areas where many are used.]
categorize patients and have batch examinations so caregiver can use one set of PPE
schedule batch medication administration times so nurses can use just one set of PPE instead of multiples for patient care
wash gloves while still wearing them with alcohol hand sanitizer
use of telemedicine services such as https:doxy.me
World's smallest cheapest ventilator
Mass-bio list of materials & supplies currently needed in MA
Novel Coronavirus Fighting Productswww.americanchemistry.com/Novel-Coronavirus-Fighting-Products-List.pdf
So that is JAMA's crowd sourcing ideas (and crowd sourcing home production) for dealing with this health emergency with some addition I found along the way. It looks like a good start.
Oh, and washing your face as well as your hands is a good idea.
Here is another example of crowd sourcing:docs.google.com/forms/d/e/1FAIpQLScXC56q2tPgz0WbPrhP7WareiclfxfaKQFI0ZbXg4FkKan5iQ/viewform"
"There is a call for scientist volunteers by Dr. Michael Wells at the Broad [Institute]. pls see this Google form below and sign up if you are interested and are able to.
Broad Institute is part of the testing effort in MA as well as a leading biomedical research institution based in Kendall Square, near MIT.
I'm sure there is an overwhelming amount of research work that needs to be done in order to find possible treatments and possibly a vaccine for Covid19. Again, if people who can help with this work can apply their enforced leisure to these efforts, would we be able to use that help?
For instance, could students be brought up to useful speed through such events as this study group?
Learning Circle: COVID-19, Tackling the Novel Coronavirus (Week 1)meet.jit.si/covid19-learning-circle
Tuesday, March 31
6:00 PM to 8:00 PM Every week on Tuesday until April 14, 2020
THIS MEETING WILL HAPPEN ONLINE AT https:meet.jit.si/covid19-learning-circle
Learning circles are free, facilitated study groups for learners who want to take online courses. More information about learning circles can be found on the P2PU website: https:www.p2pu.org/en.
Starting on March 31st and for 3 weeks, BosLab will host a learning circle to help participants study the FutureLearn course "COVID-19: Tackling the Novel Coronavirus" from the London School of Hygiene and Tropical Medicine (https:/www.futurelearn.com/courses/covid19-novel-coronavirus).
More of this will and should be happening. A lot of people stuck at home have plenty of time to study this virus and crowd-source solutions to our current health crisis.
If as many of us as possible spend the next two weeks or so of quarantine or shelter in place or social distancing devoting as much time as we normally devote to our favorite sports team(s) or the Presidential campaign, could we maybe crowd source the sh!t out of this m*therf^cker? Already?