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Supplies of personal protective equipment still short for Sonoma County physicians

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Although two months into the local coronavirus outbreak, some Sonoma County health care professionals continue to raise concerns about having adequate personal protective equipment to keep them safe, as the county moves toward relaxing more public health emergency restrictions.

On the one hand, small and midsize physician practices struggle to maintain a supply of face masks and surgical gowns while they are trying to ramp up outpatient visits and non-urgent medical procedures people postponed when the virus threat was greater.

“As we’re trying to get physicians to reopen their practices, this is all going to bubble up — the lack of PPE is going to be a challenge,” said Wendy Young, executive director of Sonoma County Medical Association.

Separately, a health care advocacy group is calling on the county health officer and the Board of Supervisors to establish a uniform standard for use of protective gear among area nurses, physicians and other health care providers.

The group, Health Professionals for Equality and Community Empowerment, or HPEACE, held a virtual press conference Tuesday and said the lack of such a local standard was jeopardizing health care worker safety. The rules around protective gear vary from one medical provider to another, several medical professionals said.

Dr. Sundari Mase, the county’s health officer, said Tuesday during her daily press briefing such local guidance already exists. She pointed to an April 30 county public health order she issued related to COVID-19 patient management, which states that for “aerosol-generating procedures, N-95 respirator, gloves, gown and eye protection are recommended for (medical staff) present in the room.”

The health professionals group criticized Kaiser Permanente, which operates a Santa Rosa medical center, in particular claiming Kaiser discourages the use of N-95 masks for some health care workers who buy the masks themselves and for those who work in areas where there are COVID-19 patients.

“There’s a difference between who gets it, between the surgeon and the anesthesiologist compared to the techs,” said Dr. Toni Ramirez, a co-founder of the health professional empowerment group.

Kaiser spokesman David Ebright said such claims are unfounded and that Kaiser’s policies abide by guidelines from the Centers for Disease Control and Prevention and World Health Organization.

Kaiser staff treating possible COVID-19 patients where there’s a risk of aerosolization of the coronavirus are required to wear N-95 masks, Ebright said, as well as face shield/goggles, gowns and gloves. Staff members participating or assisting in these procedures are required to wear N-95 respirators.

Last week, meanwhile, Young visited Redwood Family Dermatology in Santa Rosa to drop off a box of face shields made through a partnership between the county medical association and TLCD Architecture in downtown Santa Rosa.

The county medical association is donating face shields to local doctors having trouble acquiring them. Since the onset of the pandemic in March, Young said private practice physicians have had trouble securing face masks and N-95 masks. In some cases, their orders were diverted to larger health care providers and hospitals stockpiling supplies in anticipation of a surge of COVID-19 patients.

Dr. Jeffrey Sugarman, a pediatric dermatologist and the medical director of Redwood Family Dermatology, said his practice is running “very short” on N-95 masks. The dermatology practice, with six physicians, is a division of Northern California Medical Associates.

Sugarman said the donated face shields will allow him and other medical staff to use regular surgical masks and still be pretty well protected. Until recently, only the practice’s patients needing urgent care were being seen in person while most other appointments were done through televisits.

But this week, Redwood medical staff resumed in-person dermatology appointments for regular skin cancer screenings and other treatments.

“We want to protect our physicians and staff as much as possible now that we’re really opening,” Sugarman said. “With a lot of exams, we’re looking at face, head and neck areas, because that’s where a lot of skin cancers occur.”

Dr. Yong Liu, who has a private internal medicine practice in Sonoma, said her protective equipment supplier limited her to one box of surgical masks per month, with each box containing 50 masks. Liu, who sometimes performs minor surgical procedures, said she’s been unable to order face shields.

“This is not going to be easy,” she said. “Hopefully, the supply will get better.”

Dr. Rajesh Ranadive, president of the county medical association, said a steady supply of protective gear and sanitation products are critical as private physicians continue jump-starting their practices.

“In order for them to reopen, they need to have adequate resources,” he said.

At the start of the pandemic, the medical association rallied seamstresses in Sonoma County to produce thousands of fabric face coverings for local medical staff. The association has delivered about 12,000 masks and still has orders for 27,000 of them.

“All the normal sources that they go through, even if they take your order, later they’ll tell you they can’t fill it,” Young said.

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