Marching (Virtually) for Masks 

Healthcare professionals led a nationwide "virtual march" today to demand adequate supplies of personal protective equipment (PPE). The organizers of the event, called Need Masks Today, called for President Donald Trump to expand the use of the Defense Production Act (DPA) to require immediate manufacturing of masks and other PPE, as well as their equitable distribution.

"For lack of a 75-cent piece of equipment, we're losing lives and putting more lives at risk," said Lisa Lattanza, MD, chair of the Department of Orthopaedics and Rehabilitation at the Yale School of Medicine in New Haven, Connecticut.

While the Trump administration has used the DPA to ramp up production of some supplies, such as ventilators, the law has not been fully extended to PPE. The DPA gives the federal government substantial authority over the supply chain, from compelling companies to manufacture certain items to distributing them. Some state officials have said they need the federal government to take action because the current system forces them to compete with each other for necessary supplies.

Rural Hospitals Brace for Multiple Scenarios

In normal times, many rural hospitals are stretched thin financially and chronically understaffed. Now comes COVID-19, and rural hospital administrators are facing another challenge: How do they prepare for a surge that isn't one-size-fits-all? While some hospitals are responding to micro-outbreaks, others are more likely to see slower, more sustained outbreaks that could linger for months.

"As one of our doctors put it, it feels like we're waiting for a tsunami of molasses," Kimber Wraalstad, CEO of North Shore Hospital in Grand Marais, Minnesota, told Medscape Medical News. "We don't know if it's going to be up to our ankles or our knees or over our head. Are we going to be a hot spot? We don't know, so the planning has to be for the worst-case scenario."

Medscape talked to rural-health experts about their preparation and their biggest challenges. First on most to-do lists is taking stock of available beds and PPE. All supplies must be counted and compared to estimates for a possible surge. Experts are also trying to predict which areas may be most vulnerable to micro-outbreaks, such as towns with meat-packing facilities where employees may work in close proximity to one another. Hospital administrators are also lining up staff to respond over a prolonged outbreak while simultaneously trying to figure out how to prevent staff burnout.

And finally, preparing for a surge will look different at critical access hospitals, which have fewer than 25 acute-care beds. For those facilities, surge preparation is more about setting up transportation to a larger facility than adding beds and ventilators.

COVID-19 Data Remains Elusive

Electronic health records (EHRs) seem like a fertile source for comprehensive data on the COVID-19 pandemic, particularly on which treatments are working and should become standard of care. But the reality is that this information is stuck in electronic "silos," largely because of software built by rival technology firms that can't be shared between health systems.