The Regional Response Team conducts primary research to inform coordinated approaches to addressing the needs of the most vulnerable in the current pandemic.  Information about this research can be found below.

June 2020 – Personal Protective Equipment Assessment

Personal Protective Equipment (PPE) is critical to navigating the COVID-19 pandemic as safely as possible. However, the region has been experiencing shortages of PPE. Anecdotally, the Regional Response Team (RRT) heard that some frontline social service providers had been particularly under-resourced. Simultaneously, we have seen resources emerge to help address these shortages. The RRT PPE strike team was tasked with determining an equitable way of allocating PPE to frontline organizations based on their unmet needs. The RRT developed and applied a prioritization schema to address any PPE needs of frontline organizations.

PURPOSE

The purpose of the survey was to understand current use, need, and access to Personal Protective Equipment (PPE) across the social service sector in the St. Louis region.

The data collected in the survey is being used to inform COVID-19 Regional Response Team (RRT) fundraising efforts, coordinated PPE purchasing, and equitable PPE allocation to those organizations with higher risk of viral transmission and low access to PPE. Higher risk organizations predominantly serve vulnerable populations in priority ZIP codes disproportionately affected by COVID-19.

Survey data has been used to connect PPE providers with organizations in need, and has been shared with county health departments.

SURVEY METHODOLOGY

The survey was designed by Dr. Karishma Furtado and Cristina Garmendia, with feedback from RRT PPE Strike Team members. It was hosted on the SurveyMonkey platform and was open from May8 to May 27 of 2020. Invitations to complete the survey were shared throughout the RRT network and by the United Way of Greater St. Louis and the St. Louis Community Foundation, with particular focus on reaching organizations in the areas of childcare and food insecurity. There was no direct benefit to anorganization for taking the survey (e.g. distribution of PPE).

SURVEY POPULATION

There were 343 unique survey responses used by the RRT for PPE prioritization. Duplicate responses by an organization and mostly incomplete surveys were removed from analysis.

The survey reached organizations that served populations in the City of St. Louis, St. Louis County, St. Charles County, St. Clair County, and Madison County. The racial and ethnic make-up of populations served by survey respondents is shown in the table below

About what percent of the people you serve are Black, Latinx, or Native American?
 Count of OrganizationsPercent of All Organizations
Less than 25%6720%
25-49%7321%
50-75%7522%
More than 75%12436%

Caveat: The survey was neither a complete census nor a random sample of organizations. It was voluntary. The results present the most complete pictures of PPE use and needs of social service organizations to date.

SUMMARY OF RESULTS

PPE Current Use by Organizations

  • Gloves and cloth masks are the most common forms of PPE in current use by organizations to protect front-line workers.
  • Just over 50% of organizations are currently using surgical masks, while 25% of organizations report using N95 masks.

PPE Needs of Organizations

  • Gloves are the most commonly needed form of PPE to protect front-line workers (61% of organizations).
  • More organizations would use eye protection, gowns, N95 masks, and face shields in the course of their operations to protect front-line workers than currently have access.
  • A commonly requested PPE need in the “other” category included hand sanitizer and disinfectant.

PPE Rationing

  • 198 organizations report rationing PPE, or 60% of respondents.
  • Of those organizations rationing PPE…
    • 60% are reusing PPE
    • 49% are having front-line staff bring in their own PPE
    • 48% are limiting PPE
    • 23% are limiting services to the community
    • 8% are not requiring front-line staff to wear PPE

PPE Supply Chain

  • 15% of organizations do not currently have a PPE supplier.
  • Of those organizations that currently have PPE…
    • 60% purchased PPE off the private market
    • 39% received PPE from a philanthropic donor or community group
    • 18% received PPE from federal, state, or local government
  • Organizations report having very low levels of confidence in receiving future PPE from all types of suppliers.

Prevalence of Risk to Front Line Workers

  • 40% of organizations report that their front-line workers are usually or always in physical contact with patients, clients, or customers.
  • 28% of organizations report that their front-line workers typically have interactions of longer than an hour with patients, clients, or customers.

PPE Research: Frequently Asked Questions

How were needs determined?

Nearly 400 agencies responded to a survey of frontline organizations. Questions were designed to reveal ways to establish prioritization. We had enough information to generate RISK, ACCESS, and NEEDRATIO scores for 343 organizations. If you’d like to know more, the pdf of that survey can be found here and the in-depth prioritization schema, complete with formulas, can be found here. A simplified chart of the prioritization is on page 2 of this document.

How did the RRT prioritize which organizations needed PPE?

The committee decided that an organization’s need for PPE was based on the following elements. After we computed RISK and ACCESS scores, we calculated a NEEDRATIO or an organization’s RISK score divided by its ACCESS score. Organizations with a NEEDRATIO greater than 1.0 have high risk and low access, and therefore “high need”.

Who was deemed “high need”?

Completed surveys came from all five counties: Just under 400 organizations from St. Louis City, St. Louis County, St. Charles County, St. Clair County, and Madison County completed the RRT’s PPE survey.  We had enough information to generate RISK, ACCESS, and NEEDRATIO scores for 343 of them. Of those 343 respondents with complete information, 58 were deemed highest need. Of those 58 highest need organizations, 48 served St. Louis City, 46 served St. Louis County, 28 served St. Charles County, 18 served St. Clair County, and 11 served Madison County.

What did “high need” organizations receive?

Thus far, the RRT has distributed about 70,000 surgical masks. Batches of face masks were given out in small (500 masks), medium (1000 masks), and large increments (2000 masks), based on how many frontline staff an organization had and how many individuals the organization served.

Will the RRT be distributing more PPE?

There are three things the RRT expects to happen going forward.

  1. Additional PPE surveys will be distributed by the RRT for agencies to complete.
  2. Additional PPE materials are expected to become available to the RRT.
  3. Our prioritization can be modified for those who complete multiple versions of our PPE survey, and can consider who has already received PPE from the RRT.

RRT PPE Decision Matrix

ElementPPE Prioritization ConsiderationsNEED RATIO
RISKSTAFF – What are the risks to staff of getting or transmitting the virus through their work?

  • Staff size?
  • Staff make up for high risk factors?
    • Race, age, immune status
  • Staff interaction exposure risk?

CLIENTS – What are the risks to clients of getting or transmitting the virus with this provider?

  • Client is a member of a high-risk population?
  • Client is a member of a target population?
  • Client interaction exposure risk?

LOCATION – What are the geographic risks?

  • Is service delivered in vulnerable ZIP Codes?
The equation for determining NEED RATIO is RISK score divided by ACCESS score. Then two filters were applied:

Filter #1: 

Is the agency a nonprofit or a for-profit home health care agency?

Filter #2:

Is another RRT channel currently providing PPE to the agency?

ACCESSWhat supply issues exist?

  • Is PPE available now?
  • Are there PPE reserves?
  • Are they rationing PPE?

What pipeline issues exist?

  • Is PPE procurement in place?
  • Is PPE funding available?
  • Is procurement source reliable?