Apr 7, 2020
City Responses to PPE Shortages
Five actions cities can take to help organize their responses to well-intentioned offers to supply PPE
Disclaimer: This post lists suggested actions and resources for cities looking for ideas on how to best manage offers of personal protective equipment (PPE) from individuals and companies. For technical guidance on Healthcare Supply of PPE, including strategies for optimizing the supply of PPE and equipment quality standards, please utilize the CDC’s guidelines here.
Here at What Works Cities, we have heard from numerous cities looking for ideas and viable good practices to manage and/or coordinate the influx of offers from individuals and companies who have been reaching out to them to supply or donate personal protective equipment, or PPE.
As cities work around the clock to respond to the pressing health emergency posed by coronavirus, one area that has been elevated as a critical need is the reported shortage of PPE such as masks, gowns, and gloves that provide essential protection for doctors, nurses, hospital staff, first responders, and other city workers like those employed in public transit.
In a March 20, 2020 survey conducted by the U.S. Conference of Mayors of over 200 U.S. cities of varying sizes and geographies, cities conservatively estimated a need for over 28 million face masks and over 24 million items of PPE such as gowns and gloves. Yet, 92% of cities also reported not having an adequate supply of masks for their medical personnel and first responders, 88% reported not having an adequate supply of other PPE, and of those receiving help from their State with regard to PPE supply, 85% reported that the assistance was not adequate to meet their needs.
Many cities have been proactive in taking steps to purchase protective gear on the private market, but in addition to cities’ efforts, individuals, community groups, and the private sector have been mobilizing to collect and/or supply protective gear. As a result of this well-intentioned effort, some cities are now faced with the additional responsibility of managing offers from individuals and companies to supply PPE, controlling inventory for quality and making sure it meets CDC-recommended guidelines, and ensuring donations of PPE are distributed efficiently and equitably.
There are undoubtedly multiple right ways to move forward given the specific circumstances and context of your city, your city or county’s hospital system, and the non-profit and community organizations that exist in your locality — but to aid in local government leaders’ efforts to respond to the influx of offers for PPE, we have compiled a few suggested actions as well as examples of collection and distribution mechanisms that are being utilized in other cities and regions.
1. Ask the important questions
As your city makes decisions about how to manage the influx of PPE offers and what your PPE procurement and collection strategy will be, below is a sampling of questions related to gathering PPE-related data and information that cities might want to consider asking and tracking.
What do the data say about PPE needs in your city? For example:
- What is the current and projected PPE shortage in your city?
- What is the current stock (including at public, private, and community hospitals)?
- What are the projected case counts and hospitalizations in your city?
- What is the local landscape of donation hubs? Are hospitals collecting? Through whom and how?
- Who are the people in your city that need PPE? (Cities should follow CDC guidelines about who needs PPE, found here.)
Asking the right 3–5 data questions upfront — and checking in on them at frequent intervals — can be enormously valuable in setting the right course of action for your city based on what the data are showing.
What is the most equitable way to distribute donations and supply? If your city is acting as a distribution hub, determine what inputs you will use to define “equitable distribution” to inform the design of your distribution process. Some examples of relevant inputs might include:
- Availability of stock by individual location and aggregated by location type (e.g., public, private, or community hospital)
- Availability of stock by who needs PPE (e.g., hospital staff and medical professionals, city workers who regularly interact with the public, etc)
- Historical and projected intake of patients seen and tested on a daily basis (i.e., the projected need)
If applicable, how can cities direct people’s giving behavior so that equitable distribution of PPE can be achieved? In places where there are various ways to donate PPE, including direct donations to hospitals, there may be large, well-known hospitals getting the equipment they need while health care professionals at smaller, local community hospitals are working with less. Regardless of whether your city is responsible for distribution, one thing cities can do is use their communication channels to provide lists of locations in particular need of PPE and/or create simple dashboards or maps so that donors can see where there is need across the city.
2. Determine what role your city is best suited to play
Examine your city’s context and landscape, and determine your preference for receiving and culling through supplier/donor information. Some guiding questions to help cities make decisions could include:
- Do you have the capacity to centralize this effort and do it yourselves?
- Do you have the ability to provide purchasing power and/or serve as a distribution hub?
- Does your city’s size or context necessitate directing inquiries to local hospitals, as they are doing in Philadelphia with PPE donations?
- Would you prefer to partner with local, community, non-profit, and/or business partners to create a “donation connector center,” similar to the one created in King County, WA?
- Is your state already organizing a strong program to procure and distribute PPE across the state? If so, is what they are producing adequately meeting your city’s needs in a timely way?
- Are PPE collection efforts already underway by strong community or volunteer organizations?
Regardless of the path you choose, cities should add a button to their homepage and COVID-19 information page with information about how to donate or supply services and goods, record 311 call line messages, and provide instructions to call center staff with guidance on how to submit donations for PPE, as well as for companies who can supply PPE in bulk.
3. Use your city’s website and communication channels to facilitate collection of supplier and donor information and inventory (if applicable)
We encourage the creation of dedicated portals that relay pertinent information in a manner that is easy to use and engage with. Consider the following sampling of exemplar sites, which can be copied or adapted to meet your needs:
- The City of Boston’s dedicated Coronavirus homepage has a clearly marked “Donate supplies to first responders” button in its COVID-19 Information section. From here, individuals are taken to a COVID-19 donation intake form that can be filled out online, collects essential information about the donation, and provides clear guidance on who the form is for and what kinds of supplies will be accepted in accordance with the Boston Public Health Commission’s public health and safety protocols.
- The City of Los Angeles’ Mayor’s Office launched its L.A. Protects website to facilitate the city’s PPE procurement and purchasing efforts. The page clearly marks entry portals for those in need of PPE and those who can produce it, provides equipment specifications for manufacturers, and provides a space for online collection of relevant information from both suppliers and locations in need of PPE.
- Washington State and King County, WA provide great examples of dedicated portals designed for engaging with those who want to help. They clearly identify what forms of help are needed and provide clear steps on how to get involved.
- New York State’s dedicated basic landing page clearly directs anyone looking to volunteer services or donate or sell relevant products to the relevant information and forms. The site also links to a page that lays out clear guidance for manufacturers of medical supplies and equipment (including PPE), as well as an online procurement form that collects important, relevant information upfront about the quantity, pricing, and quality-control certifications of the medical equipment and supplies being produced. Each of these pages are readily accessible and easily shareable.
Even if your city decides not to centralize collection and distribution of PPE, your website, text alert programs, and social media channels are important avenues to disseminate information about where people should go to supply or donate PPE.
If your county or state has a strong program that is managing distribution of PPE to local hospitals and clinics, consider directing suppliers and donors to your state’s PPE collection site.
4. Utilize partnerships and tap into existing efforts to secure PPE
In cities where volunteer brigades and community or national organizations are mobilizing to collect and distribute PPE, or where resources to bolster PPE supply are needed, here are some organizations that may be worth connecting with.
- #GetUsPPE maintains a robust national database of PPE donors and PPE needs to connect and match supply to demand. Cities can submit (and/or direct partners like hospitals to submit) information about donation sites and needed equipment; the submitted information is shared with PPE relief efforts like Find The Masks, a member of the #GetUsPPE coalition that maps all hospital and clinic sites accepting donations of protective gear across the U.S. and allows donors to filter by state and items accepted.
- Project N95 is a national clearinghouse that coordinates with manufacturers and suppliers across the globe to connect healthcare providers with critical equipment, including PPE. The online intake form allows healthcare providers to request PPE and city governments that want to aggregate funding for large scale purchases and serve as a distribution hub to become local partners.
- National PPE Coalition provides a hotline for organizations in need of PPE to be connected to an organization that can help. The site also provides a list of coalitions (including Project N95 and Get Us PPE) that are matching need to supply; while most of the targeted organizations are hospitals and clinics, cities can utilize these networks to partner with these coalitions and play a central role in building an efficient supply chain for your city or region.
5. Join the conversation
One way to learn about any of these various channels in more concrete detail and to crowdsource tailored approaches that fit your city’s particular needs and context is to join the What Works Cities private community Slack channel for cities. For those of you who are a part of the WWC community, you can use this channel to communicate directly with each other, ask questions, and share information. If your city is a member of the WWC community but you do not have a login, please request access with your government email address here.
What Works Cities is a national initiative that empowers cities to tackle pressing community challenges and improve residents’ lives through data-driven decision making. Operating as a partnership between five national organizations, What Works Cities works directly with city leaders and staff by providing coaching and technical assistance, a range of online and in-person learning opportunities, and a growing nationwide professional network.