Optimizing the Supply of Isolation Gowns; Procurement and Conservation Activities

April 18, 2020

GNYHA continues to work with our supply chain colleagues and local and State offices of emergency management to address shortages and ensure hospitals and other providers have adequate supplies of personal protective equipment (PPE) on hand. We are aware of the current shortage of isolation gowns and are working diligently with manufacturers and distributors to increase the supply to New York hospitals. We encourage hospitals to practice appropriate conservations strategies during this period. Below are recommendations from the Centers for Disease Control and Prevention (CDC) and information on our current isolation gown procurement efforts.

Efforts to Increase the Supply of Isolation Gowns

GNYHA is working with City and State emergency management agencies and Premier, Inc., to address the severe shortage of gowns. These efforts include identifying local textile businesses in New York and New Jersey and existing local manufacturing capabilities in the Brooklyn Navy Yard to manufacture isolation gowns to meet hospital demand. GNYHA and Premier are also working with Ford Motor Company, which has converted its automobile airbag materials and manufacturing capacity to make reusable isolation gowns for hospitals. We are hopeful that these efforts will result in increased supply in the weeks to come.

CDC Conservation Strategies

CDC offers a series of strategies to consider to optimize the use of isolation gowns in health care settings when there is limited supply. The New York State Department of Health aligns with CDC in its guidance for when health care provider efforts to obtain PPE through vendors and local Office of Emergency Management are exhausted or unsuccessful. The following is a summary of these strategies:

  • Shift gown use towards cloth isolation gowns. Reusable (i.e., washable) gowns made of polyester or polyester-cotton fabrics can be safely laundered and reused.
  • Consider the use of coveralls. While coveralls can provide full-body protection, the material, coverage provided, and the garment design and features will greatly affect the protective level. In the United States, the NFPA 1999 standard external icon specifies the minimum design, performance, testing, documentation, and certification requirements for new single-use and new multiple-use emergency medical operations protective clothing, including coveralls.
  • Use of expired gowns beyond the manufacturer-designated shelf life. Most isolation gowns do not have a manufacturer-designated shelf life. However, consideration can be made to using gowns that do and are past their manufacturer-designated shelf life. Facilities should contact the manufacturer.
  • Use gowns or coveralls conforming to international standards. Current guidelines do not require the use of gowns that conform to any standards. In times of shortages, health care facilities can consider using international gowns and coveralls.
  • Extended use of isolation gowns. Similarly, implement extended use of gowns or coveralls for patients without COVID-19 symptoms. Change gowns or coveralls only when soiled, wet, or after interacting with a patient or resident with other transmissible diagnoses (e.g., Clostridioides difficile, targeted multidrug-resistant organisms, Candida auris).
  • Re-use of cloth isolation gowns. While disposable gowns cannot typically be doffed and re-used, cloth isolation gowns could potentially be untied and retied and therefore considered for re-use without laundering in between. Additionally, consider reuse of gowns with no visible soiling for care of patients with COVID-19. Any gown that becomes visibly soiled during patient care should be disposed of and appropriately cleaned.
  • Prioritize gowns. Prioritize gowns for aerosol-generating procedures, activities possibly involving splashes or sprays, high-contact activities, and for the care of patients with non-COVID-19 transmissible diagnoses (e.g., Clostridioides difficile, multidrug-resistant organisms, Candida auris).
  • Conduct appropriate training and consider monitoring donning and doffing when health care workers layer gowns and gown alternatives.

GNYHA will continue to aggressively pursue all options to increase the supply of isolation gowns and other PPE, and will continue to provide updates on the status of these efforts.