Yale vs Covid

Seeking cover

By Cathy Shufro

Lisa Lattanza has worn an N95 mask just a dozen times during her 25-year career as an orthopedic surgeon. She needs the specialized mask, which blocks airborne particles, primarily when doing surgery on patients with skeletal tuberculosis. But once SARS-CoV-2 arrived in New Haven, N95 masks became indispensable to her colleagues in the thick of caring for coronavirus patients.

Yale New Haven Hospital had collected N95 masks before the coronavirus arrived, but there weren’t enough. Hospital staff of all stripes caring for diagnosed or suspected COVID-19 patients wore their N95 masks day after day, instead of following the standard protocol: putting on a new mask every time they entered a patient’s room. Lattanza, chief of orthopedic surgery at the hospital, was deeply troubled. But because elective surgeries and most clinic appointments were postponed during the crisis, she had some free time. She volunteered to help, and she began to look for sources of personal protective equipment (PPE).

It was a stressful, frustrating search. Supposed “suppliers” would offer substandard PPE or none at all. Although everyone had heard there were US government stockpiles, Lattanza says, nothing was distributed in the New Haven area or, reportedly, in many other areas: “There did not appear to be any coordinated centralized distribution from the federal government.” Furthermore, she adds, “product was not coming in through our normal medical distributors.” Among the impediments: most PPE is made in China, and the US has trade barriers with China; sellers and intermediaries had begun demanding cash rather than conforming to standard business practices of delivery first, payment after; organizations hijacked supplies before they could get to hospitals that had ordered them; and hospitals that had few COVID-19 patients held on to their PPE in case of a spike later.

Two things did go well. First, several factories in Connecticut—including Unilever, the Gilman Brothers Company, and Modern Plastics—retooled their systems to make face shields, goggles, masks, and gowns. And second: donations of PPE poured in, from various types of face masks to hazmat suits, coveralls, isolation gowns, and hand sanitizers. They came thanks to efforts by Chinese-Americans and people in China, some of whom have ties to Yale: alumni, researchers at Yale, the Yale Chinese Parents Club, and people’s friends and business associates.
Early in March, Yale nephrology researcher Jiankan Guo got memos asking staff to use masks sparingly. Guo worried about what might lie ahead: physician-friends in his native China had described the COVID-19 epidemic in Wuhan as “hell.” If mask supplies were already meager, what would happen to his colleagues when the virus really hit New Haven? “If they are down”—too sick to work—“we have no lifeline left. This is what happened in Wuhan in the first few weeks.” He says suffering people would wait all day outside hospitals in Wuhan, only to be turned away.

And so, for five weeks, Guo set aside what he was supposed to be working on—a grant application and a journal article—to tap into all his networks. These included friends and classmates still in China; WeChat social media groups; and the Chinese Association for Science and Technology in Connecticut, of which he is president. Guo’s efforts yielded, in all, donations of 27,230 face masks, 242 hazmat suits, 2,730 coveralls, and 150 isolation gowns.

Guo says Penghua Wang, a former Yale postdoc who’s now on the faculty at UConn Health, organized former Yale associates who are now in China; they donated enough money to provide 1,200 KN95 masks. Ty Tiefeng Hu ’92MPH gave 1,000 masks that went to Yale police and security personnel. In mid-April, the Yale-China Association received a gift of more than 23,000 N95 masks from a consortium of nonprofits in China. And on May 8, anonymous donors gave the university’s healthcare system 99,600 face masks and 99,600 face shields.

Because Yale was receiving so many different and new types of masks, Lattanza collaborated with Yale’s Center for Engineering Innovative and Design to set up a testing facility. Every mask had to pass “filtration and breathability testing at a level on par with our usual N95 masks,” she says. Those that couldn’t pass couldn’t be used. And meanwhile, the hospital developed a system of sterilizing and recycling N95 masks with hydrogen-peroxide mist.

It took an outpouring of help, contributions, and expertise, but, says Lattanza: “We never ran out of the appropriate PPE to protect our frontline workers.”

Cathy Shufro teaches writing at Yale.