Portland doctor's research helped spawn national movement
Nearly three weeks ago, Portland physician Val Griffeth began doing some personal research into the lack of personal protective equipment for health care workers as the COVID-19 pandemic spreads.
Since then, her work has merged with others' to spawn a national crowdsourcing movement, Get Us PPE, that's become the loud and persistent voice for doctors, nurses and other providers unnerved at the lack of needed supplies.
Members of the group, including not just Griffeth but her Oregon Health & Science University colleague, Esther Choo, have featured prominently in coverage of the issue in an array of major news publications including National Public Radio and the Wall Street Journal.
It's also helped connect workers with more than 100,000 masks.
In a lengthy interview, Griffeth talked about some of the things she and her colleagues are seeing, including false negatives on COVID-19 tests, inconsistent federal standards, a bewildering array of epidemiological models, and the appearance that Oregon so far been "lucky" in how the disease has hit the state. She also talked about the "calm before the storm" of when the expected surge eventually hits.
(This article has been edited for clarity and brevity.)
Portland Tribune: How did you get involved in this movement?
Val Griffeth: I started looking into PPE kind of at the behest of my partner who was concerned about the number of health care worker infections that were happening overseas. As I looked more into that, I realized that the number of health care workers that were being infected was much higher than you would expect just from the general population. And I looked at what China was doing along with Hong Kong and Singapore ... they're providing their health care providers and kind of first-line providers, whether that's EMS or people out on the streets that are running these screening stations, providing all of them with full body covering, respirator, mask, eye protection.
And unfortunately, our government took the stance early on that we don't have enough PPE to accomplish those things. And so we're gonna recommend inferior protection.
Tribune: What happened then?
Griffeth: So I drafted a letter that I sent to Esther Choo and to one of my other colleagues here at OHSU. And then Esther made some suggestions. We kind of split it into a more academic piece and then also into an editorial for media. And we sent that out, I think it was on the 16th of March. And unfortunately, nobody picked up the story at that time
Esther and Matt Cortland started the #getmePPE hashtag right around the same time ... Esther started reaching out to her contacts (who) said we're starting this website, but we need a letter. And Esther was like "I have a letter."
Tribune: How's it going so far? What have been the benefits of your advocacy?
Griffeth: I think the partnership has been beneficial for everybody involved. I know that there are hospitals receiving PPE through the website. Basically, people can go online, enter what they need. And then other folks are going online and entering what they have. And then here's back-end coordination that's basically hooking people up with what they need when it's available.
Tribune: At the heart of this, it seems like there's just a lot of fear. What is it like being on the front lines, where you're not just worrying about your patient but yourself?
Griffeth: It's been really frustrating. As a physician, it's kind of part of our code: we try to stay a little bit removed from patient care, trying to provide patients both with the emotional support that they need, but also an objective lens through which to see things. And that's become much more difficult, because we're not just coaches on the sideline providing advice to the people that come to see us for help. Now we're kind of involved on the field, putting ourselves at risk as well.
And now we very much have to make sure that we're staying safe, not just so we protect ourselves, but so that we protect the patients next door and our families at home. And that's a lot to think about when we're trained to really just focus on the patient in front of us. And it's a burden, it's a stress that I wish that we didn't have to deal with because our government (hadn't) heeded the warnings dating back as early as the 1990s, saying that we were very ill-equipped to deal with pandemic.
Tribune: How has that affected you personally?
Griffeth: I was meditating this morning, and I just had this wave of anger come over me. My colleagues, we still don't really know how to protect ourselves. Everybody is doing something a little bit different.
In the emergency department, in a best case scenario, what we do on a daily basis is universal precautions. We assume the worst until we've ruled out the worst. And that would be full body covering, respirator, eye protections.
And a lot of places are still not doing that because the national government is continuing not to make that a recommendation. And that's specifically because — and the CDC says this on their website — specifically it's because of the PPE shortage.
But instead of saying on their website that we need to solve the PPE shortage so that we can protect our health care workers now, their approach is to say, well, we just have to make do with what we have now.
Which is a very pragmatic approach. But it's also exceptionally problematic because it's putting health care workers at risk now, potentially taking them off the front lines, making them patients and, worst case scenario, dying. And we're seeing this — nurses and doctors are dying.
Tribune: Where are most of them dying?
Griffeth: Most of this is obviously happening where the infection rates are highest in places like New York City. Spain, I read yesterday, has a 14% of their infections are among health care workers. The last one I read in Italy I think it was 8% of their infections were health care workers. So clearly health care workers are at exceptionally high risk. It's difficult to talk about at times.
I feel lucky for a couple reasons. One, Oregon has been spared thus far the worst of this pandemic. And I think it's because people have been successful at distancing. We had that case of a worker at a middle school in Southwest Portland over a month ago now. And as health care providers at the time, we all kind of thought, OK, here's our index case, we're gonna see a cluster now — and we didn't. And that is a stark comparison to what happened in New York, where they traced a giant cluster back to one person.
Tribune: So it's luck?
Griffeth: I think some of this has just been luck that we've been relatively spared. I think some of it has also been (Oregon Gov.) Kate Brown asking early on for closure of the government following the lead of Washington and California. And I think people in Oregon are doing a good job of physically distancing themselves, and using technology to stay connected. I continue to stay in touch with friends that way as well, friends that I otherwise would be having a game night with around our card table and instead of having to figure out, maybe let's do a Netflix group movie, and that sort of thing.
Tribune: What's that been like?
Griffeth: It's hard and it's disappointing. The other reason I feel like I'm really lucky is because I've been involved with (the effort ) to get us PPE…. You know, if not for the connections that Esther Choo has, I don't know that this letter would have gotten out to as wide an audience as it did. And now that it has we're seeing movement and we're seeing delivery of goods. I feel really grateful for that involvement.
I think we've all been amazed at how quickly things are happening, and also seeing opportunities for things to happen more quickly. And I think the biggest opportunity of those is if the federal government, just really the White House fully activated and invoked the Defense Production Act (to require manufacturing of protective equipment).
Tribune: Is this, as some of the media coverage has said, just the calm before the storm? Is it too soon to congratulate ourselves?
Griffeth: Having connections to emergency departments, we're definitely seeing a calm that is exceptionally uncharacteristic for United States emergency departments. And so right now we're really focused on being ready for a surge of patients with COVID.
I definitely think it is too early celebrate. I think we can congratulate ourselves in the sense that it's kind of like intermission. Maybe this is just a break between the first and second quarter. And we're doing a good job, we are winning, and that's great. And we need to keep doing the same things that we're doing.
Because if we let up, we're gonna catch up very quickly to places like Seattle and the (San Francisco) Bay Area. We are a large metropolitan area with a densely packed population, and that puts us at risk.
I think we can congratulate ourselves a little bit because we're definitely not seeing the surge into hospitals that other cities have seen. But we really don't understand what's happening outside the hospitals. And until we get to the point where we're not seeing a growth in the number of cases coming into the hospital should we relax and say that we're past the worst of this — because we're definitely not past the worst of this yet.
Tribune: The word is going around that some of the tests are coming back as negative in Oregon hospitals, yet the symptoms are so clear that doctors are saying, you know what, we're just going to treat this patient as positive.
Griffeth: Yeah, absolutely. And that's been a big problem. I think the first time I read about that was probably three weeks ago. And I think that continues to be an issue.
Tribune: There are these debates about whether the media is being overwrought. What is your take on that?
Griffeth: If we are successful in containing coronavirus in Oregon, people are gonna say that we were too aggressive. And that's the wrong conclusion to make.
If we successfully contain coronavirus in Oregon, we will have been just restrictive enough.
Because when it comes down to it, we're not being as restrictive as we could be. People are still allowed to go to stores to buy essential goods. For the most part, we can order food through delivery services and get a lot of the food that we enjoy on a daily basis
I have friends that are, you know, in the restaurant industry and the entertainment industry and this is an exceptionally painful time for their businesses. It concerns me for them and how are we going to help support them.
Tribune: Exactly how unprepared is the health care establishment in Oregon right now in terms of PPE for the storm, when the storm actually hits.
Griffeth: I'm not involved in kind of the frontline decision-making on looking at the PPE numbers. I think if it gets as bad as New York, we're not gonna be ready. I think our hope is that we continue doing the things that we're doing now, so that we do not get as bad as New York.
You count on us to stay informed and we depend on you to fund our efforts. Quality local journalism takes time and money. Please support us to protect the future of community journalism.