“PPE, Yeah You Know Me” – with Dr. Sarp Aksel

Dr. Sarp Aksel discusses his recent work with Last Mile, a grassroots organization with a mission to distribute PPE to healthcare workers in need during the coronavirus crisis. He and Dr. Fox explain the PPE supply-chain, which health care systems are most effective, and how people can help.  

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In this episode, Dr. Sarp Aksel joins Dr. Fox to talk about how he has recently worked with Last Mile, a grassroots organization dedicated to distributing PPE to hospitals and healthcare workers during the coronavirus crisis. Dr. Aksel explains that early on, as the situation was unfolding, he was connected with PPE manufacturing and supply-chain contacts. From there, he was able to establish further connections to help secure donations for healthcare workers.  

Dr. Aksel explains that hospitals and healthcare workers have had to “dig deep into their stockpiles” for PPE, which includes various types of gloves, gowns, and masks. Most hospitals did not keep a very large stockpile of N95 masks, which are typically considered the most important piece of PPE for COVID-19. That’s because they’re only in use to protect against viruses or bacteria that are spread through the air; Dr. Aksel notes that “before this hit, I could count on one hand the number of times I needed an N95.” Usually, like all PPE, these masks are disposable and single-use, but due to the shortage, supply was running out and things had to be reused.  

The problem was further complicated because hospitals’ usual distributors did not have an adequate supply of PPE either. Dr. Aksel explains that these distributors are essential “middlemen” between manufacturers and hospitals, and are protected by laws that certify them to provide supplies. This meant that when their regular distributors did not have the PPE they needed, hospitals had few places to turn to for supplies. Another factor contributing to this problem is that many supplies are manufactured in China, where factories were closed for long periods of time as this is where the COVID-19 pandemic began.   

Dr. Aksel also notes that the hospitals hit the hardest tend to serve more at-risk patients with lower socioeconomic status, both because these communities had more cases of the virus and the hospitals had fewer connections to acquire PPE. In the early days, he explains, “everyone was in the same boat,” but later, some better-connected hospital executives or PR teams were better able to gather supplies from donations or other means.  

Last Mile, which has chapters in several major US cities, stepped in to help distribute masks where necessary. Dr. Aksel shares that he personally drove to pick up masks or stored them before they could be distributed to New York hospitals. The organization is a grassroots effort between physicians, manufacturers, distributors, and activists. They have created a “scorecard” to determine where the need is the greatest, and have determined ways to substitute various types of PPE – for example, sending masks that used for environmental work to hospitals that function in more or less the same way as an N95. Dr. Aksel says that more recently, requests are “dying down” from emergency rooms and urgent cares, but they are starting to see more support roles, such as pharmacists or transporters, who have a greater need for PPE.  

If listeners wish to donate to Last Mile, they can do so on GoFundMe. Physicians can also fill out a PPE request form and find the organization online.