Our nation’s most vulnerable population has been amongst the hardest hit by the historic COVID-19 pandemic. Since day one, caregivers in nursing homes and assisted living communities have worked tirelessly to ensure the health and safety of their residents and staff, but facilities were forced to fight the virus with limited resources.

Critical resources, essential in fighting the virus, were hard to come by in almost every facility. Specifically, access to personal protective equipment (PPE) was a challenge for many facilities. Worldwide supply chain issues and soaring demand across every industry left long term care providers scrambling to acquire and afford the masks, gowns, and gloves they needed to help keep staff members safe and prevent further spread of the virus.

Many suppliers delayed or limited the size of providers’ orders, and many providers got taken by scammers pretending to have legitimate PPE.

The long term care industry made repeated calls to federal and state officials to prioritize these settings for PPE, but shortages remained. Many facilities were forced to reuse items like N-95 masks or use handmade cloth facemasks, all in accordance with guidance from the Centers for Disease Control and Prevention (CDC) on how to optimize PPE supplies.

Moreover, early on in the pandemic, public health officials focused on a symptoms-based approach even though we knew the virus was spreading through asymptomatic and pre-symptomatic carriers. The CDC did not revise its guidance to nursing home personnel to wear facemasks at all times throughout the facility until June 2020—five months into the pandemic.

While access to PPE has improved since last year, long term care providers still struggle to afford the high cost of quality equipment, and suppliers anticipate continued strain on items such as gloves. Some believe facilities should be fined or issued citations by the Occupational Safety and Health Administration (OSHA) or other regulators in an effort to enforce use of PPE. But that approach would only make the situation worse.

The health and safety of long term care staff and the residents they care for is and always should be the top priority. Facilities have taken historic steps to keep the virus out of facilities and limit its spread if it does make its way in. Their efforts have saved lives. Fining a facility for lack of PPE due to global supply shortages would help no one. We need a public and private partnership so that health care settings, including long term care facilities, have the necessary supplies to protect our health care heroes on the frontlines.

We should all be working together to ensure facilities have the resources they need, not making matters worse with fines that only draw resources away from where they should be focused: on our residents and staff.

David Gifford, MD, MPH, is chief medical officer and senior vice president, quality and regulatory affairs, of the American Health Care Association/National Center for Assisted Living.
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