Abstract
The COVID-19 pandemic has laid bare the inadequacy of the U.S. healthcare system to deliver timely and resilient care. According to the American Hospital Association, the pandemic has created a $202 billion loss across the healthcare industry, forcing health care systems to lay off workers and making hospitals scramble to minimize supply chain costs. However, as the demand for personal protective equipment (PPE) grows, hospitals have sacrificed sustainable solutions for disposable options that, although convenient, will exacerbate supply strains, financial burden, and waste. We advocate for reusable gowns as a means to lower health care costs, address climate change, and improve resilience while preserving the safety of health care workers. Reusable gowns' polyester material provides comparable capacity to reduce microbial cross-transmission and liquid penetration. In addition, previous hospitals have reported a 50% cost reduction in gown expenditures after adopting reusable gowns; given the current 2000% price increase in isolation gowns during COVID-19, reusable gown use will build both healthcare resilience and security from price fluctuations. Finally, with the United States' medical waste stream worsening, reusable isolation gowns show promising reductions in energy and water use, solid waste, and carbon footprint. The gowns are shown to withstand laundering 75–100 times in contrast to the single-use disposable gown. The circumstances of the pandemic forewarn the need to shift our single-use PPE practices to standardized reusable applications. Ultimately, sustainable forms of protective equipment can help us prepare for future crises that challenge the resilience of the healthcare system.
Highlights
In the spring of 2020, the COVID-19 pandemic swept across the United States and overwhelmed the supply of personal protective equipment
The U.S healthcare sector alone is responsible for 10% of U.S greenhouse gas emissions, 64% of which comes from supply chain [4]; averting the worst effects of climate change requires substantial supply chain emissions reductions [6]
We find that reusable isolation gowns are poised as an excellent first step for hospitals to save money, stay safe, and transition to climate-smart healthcare practices
Summary
In the spring of 2020, the COVID-19 pandemic swept across the United States and overwhelmed the supply of personal protective equipment. Johns Hopkins estimated that a single 100-day COVID-19 wave would require an additional 321,000,000 isolation gowns on top of baseline isolation gown use in hospital inpatients, emergency departments, emergency medical services, outpatient visits, and nursing homes in the U.S [8]. As this model assumed strict social distancing, even more PPE may be needed if and when compliance decreases [9]. Assuming proportional cost savings to those for Carilion Clinic, reusable gown use would save healthcare systems an estimated $128,400,000 in surge gowns over that 100-day period alone These savings may be greater during large-scale crises when competition over limited singleuse supplies drive up costs. Reusable gowns provide a baseline cost savings and price and supply stability during times of high PPE demand
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