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Community Joins Together to Improve and Provide PPE for Healthcare Workers and First Responders

Carpenetti mask drop off Blacksburg Rescue Squad

The call to help others in need is one that many people hear, especially during a time of crisis, such as the COVID-19 pandemic that is currently sweeping through the world. One such person who is listening to this calling is Tiffany L. Carpenetti, PhD, an Assistant Professor for Anatomical Sciences at the Edward Via College of Osteopathic Medicine (VCOM)-Virginia. With a severe shortage of personal protective equipment (PPE), Dr. Carpenetti was looking for ways to help fellow healthcare workers since they are on the frontlines every day during the COVID-19 pandemic. She then came across an article from the University of Florida's College of Medicines Anesthesiology department on how to make two different prototypes of masks.

Little did she know that her friend, Matthew Hull, a Research Scientist for Virginia Tech, ICTAS, had already begun putting the wheel in motion for community outreach, he had contacted the Blue Ridge Fudge Lady, Robin Burdette. "Matthew called me and asked if I would be interested in helping coordinate a group of people to sew these masks for the community. I told him I would love to help! He felt like I had a good reach in the community, and I could get together a team of people to sew," said Burdette. Matthew Hull then introduced Dr. Carpenetti to Robin, and the two of them began the plans of mask making. Dr. Carpenetti sent Robin the prototypes to make from the University of Florida, and they met up to get the material that Matthew Hull had collected. Robin decided that it was time to call out to the community for help.

We created social media posts, and 107 Country PSK put us on the radio to advertise that we needed people to sew. Then Fox News National picked up my posts from Instagram and did a story on the Mask Initiative. We call it Operation Face Mask. So far, I think we've made about 200 masks

Robin Burdette , the Blue Ridge Fudge Lady

Shannon Ainsley, with the Pulaski Chamber of Commerce, helped Robin get the group organized and bought the wire for the masks. Members of Operation Face Mask still speak with Dr. Carpenetti about the prototypes she makes and which mask is preferred. Currently, it is the prototype 2 mask.

But with every story, there is more than one side. Dr. Carpenetti's neighbor, Dan Crowder, is another piece to this puzzle. He introduced her to Carol Davis, the leader of NRV Mask Makers, and who is also the Town of Blacksburg's Sustainability Manager. The NRV Mask Makers created a Facebook group where members can post questions, tips, and tricks, messages of encouragement, and updated numbers of masks that have been donated to local healthcare communities.

When asked how the large group of mask makers was created, Carol said, "I saw a post from a Facebook friend of mine, and she posted a video of a simple DIY mask. I thought to myself it doesn't seem too terribly hard. So I posted it to another Facebook group that I had just joined, called "Looking Out for Each Other- Montgomery County." Essentially my post on that page was to let others see and ask if they were up to it. I didn't even mean to start the group at that point. I just was like, "Hey, if you have this material on hand and a sewing machine, and you know how to sew. Probably can't hurt to make some of these."

At that point, it was becoming a known factor of the shortage of PPE for healthcare workers; this was mid-March. Little did Carol know that her post was going to create a wave of generosity. Her post ended up receiving hundreds of comments from people all over the New River Valley (NRV) volunteering to help.

"People came out of the woodwork, and it was tough to keep track of them. It was created in this much larger Facebook group, so I decided I needed to extricate it. So on March 23, 2020, that day, on my lunch break, I created a Facebook group called NRV Mask Makers," said Carol. The Facebook group is close to 600 members as of May 4, 2020.

The group is currently operating out of the Blacksburg Presbyterian Church, thanks to two ladies who volunteered to help, Anne Campbell and Jan McGilliard. The church is used as a central drop-off location for completed masks. Once the masks are dropped off at the church, Richard Hammer and his army of Mini Cooper enthusiasts, pick the masks up and deliver them where needed. They also pick up materials when required.

Carol and Dr. Carpenetti formed a specialized team of seamsters who could sew using the H600 material. "We hand-selected four mask makers who are really good and have high sewing skills, along with high output. We asked them, would you be willing to come over and be on a special team making these masks with this surgical material? And they said, yeah, I'd be totally happy to. Now they are a separate team that is kind of rock and roll on making those masks from surgical material and getting them largely out to EMS," said Carol.

Tracy Kwock is coordinating the special materials team with the help of Michelle Lucas, Paula Golden, Karin Tauber, and Karen Veilleux.

Dr. Carpenetti is not the only one from VCOM who is helping with the NRV Mask Makers, Debbie Geiger, and Mukarram Razvi, DO, are also helping. Dr. Razvi helped determine the best material and style mask to create that would meet the needs of healthcare workers in the New River Valley and help design a guidance document for "home-made" mask use. While Debbie Geiger, in her down-time, is "working diligently to fill requests from healthcare workers in the area for masks using materials that we either already had at home, were donated by others in the community or we personally purchased using Joann fabric curbside pick-up," said Geiger.

"Well, I think just overall, it's been amazing that people have come out of the woodwork willing to lend whatever skills or materials they have and that people have done a tremendous amount of work. I know everyone is fitting this in with their regular lives that have been upended, and then this has been another full-time job on top of it. Everyone is just very happily doing it, and we know that the community is really grateful," said Carol.

The mask makers average about 1,000 masks a week and 100 to 200 H600 masks. As of May 4, 2020, the group has donated close to 3,000 masks to local healthcare facilities personnel.

The help does not stop there; VCOM faculty member Eric Stanley, DO, Discipline Chair for Emergency Medicine at VCOM is helping to determine where the masks should go and where they are needed most. Dr. Stanley is giving guidance to Carol Davis and Dr. Carpenetti about getting masks to First Responders in the local areas. Dr. Stanley is the Medical Director of six of Montgomery County's Emergency Medical Services (EMS). Some EMS groups are so short on masks such as the Shawsville EMS that at one point, they were going to run out of masks to give to patients within six days. The Radford Arsenal Plant Fire and Rescue were the first to receive masks because they were down to almost no masks in their inventory.

It was astounding to me that the idea that these First Responders, the front line healthcare workers, are going to be at a huge risk because they can't even put a mask on a patient to help decrease the risk. It really struck me that there really is no PPE around, and even though we're not in a hot spot, they're still at risk, and there are still cases around here, and they have to treat everyone as possibly infected. My thought was we're going to funnel these where they need to go

Tiffany L. Carpenetti, PhD , Assistant Professor for Anatomical Sciences at the Edward Via College of Osteopathic Medicine (VCOM)-Virginia

Dr. Stanley commended all of the student volunteers that are sewing masks as amazing. "I think it's a pretty good number of folks. You know, it's amazing. I certainly I want to shout out a big thanks to VCOM and Dr. Dixie Tooke-Rawlins for buying material for the students to use and ultimately for it to be donated to Fire and EMS," said Dr. Stanley

An unfortunate truth of the pandemic is the move to virtual learning and canceling Clinical Rotations for third and fourth-year students that medical schools have had to do across the country. The students began to feel helpless by not being able to help when their calling in life is helping people, but Dr. Carpenetti gave VCOM students hope.

"The students have been fantastic, I'll tell them I have a bunch of copper that needs to be cut for the masks, and the students will come and pick it up and drop it off when they're done. Students will contact me saying they don't know how to sew, but what can I do to help. They have been dropping off bags of t-shirts to use as the ties for the masks, which I have found to be better than using the H600 material," said Carpenetti.

 

The projects don't stop there, Dr. Carpenetti, Dr. Stanley and Matt Hull have all been working with Dr. Jeff Kessel, an anesthesiologist for Anesthesiology Consultants of Virginia (ACV), to create a prototype mask that could replace the N95 mask. Dr. Kessel is able to take a mask to employee health at Roanoke Memorial and have the staff there test how protective the mask is. They are still refining the mask style, layers, and inserts, but are making progress. "Maybe this could help define the N95 style moving forward because the current designs and materials are woefully poor when someone has to wear it for hours on end. Having appropriate protection is paramount to our group. We are still doing urgent and emergent cases and have to provide care to known or suspected COVID-19 patients," said Dr. Kessel.

From the EMS perspective, Dr. Stanley is giving his guidance on what EMS personnel need. "My interests for EMS is more of a simple surgical type mask that isn't meant to function like an N95, but just something that is a layer of protection. The current wisdom from the Center for Disease Control (CDC) is that you only need the N95 for procedures where you are you going to be around a lot of small particles," said Dr. Stanley.

In their endeavors to create more available gear, Matt Hull at NanoSafe Inc and ICTAS and Dr. Kessel were contacted by the NRV Mask Makers group about supplies. They are sourcing H400-600 material from the hospital, and it is being shown that four layers to be relatively protective against small particle penetration. When the University of Florida published its article, and the NRV Mask Makers were introduced, they felt trying to use the material for masks would be beneficial. The material is being recycled from the hospital and decreases the cost of material for the mask group. The H600 material is used to wrap instrument trays in the Operating Room (OR) and is thrown away during standard OR cases. It is sterile and clean when removed from the tray and has been collected for Dr. Kessel by the OR staff at Roanoke Memorial Hospital. "Doing a small number of cases, we generate two garbage bags of material in one to two days (not everyone remembers to save it)," said Dr. Kessel. Once there is enough material to donate, Dr. Kessel meets people at the Park & Ride at exit 118 or 140 to give garbage bags full of H600 to the mask group.

"The other day, I snagged a mask that Tiffany was working on and drove up I-81 to meet Dr. Kessel to hand off the masks and to get more material. Then I met up with the Blue Ridge Fudge Lady to give her the material and now she's taking it out and distributing it. I think Tiffany has a pretty good source of material through VCOM and through the local hospitals. It's all just one big collaboration of just trying to do whatever we can to help," said Matt Hull.

Another version of masks that are being built in the New River Valley is with the use of 3D printing. The Design, Research, and Education for Additive Manufacturing Systems Laboratory (DREAMS Lab) with Mechanical Engineering Professor Chris Williams spearheading it is the 3D printing of face masks or other alternatives for N95 face masks. To ensure the 3D printed masks are up to par, the DREAMS Lab sends them to another lab where they are tested to validate their efficacy. Masks are not the only item being printed, items such as valves for respirators with filtering capabilities, swabs for testing, and face shields are also being produced.

Matt Hull is also involved in trying to bridge a relationship with Carilion Clinic and Project N95. Project N95 is a national organization that helps healthcare and frontline organizations to connect with vetted, reputable suppliers of PPE. "Unfortunately, what's happening right now is organizations are buying PPE from suppliers, and they will buy ten thousand units of something that's not going to work and ends being a fake product," said Matt Hull.

Through the many different pieces when they are put together, it completes the puzzle. It is not a competition of who can sew the most masks or who can create the best prototype. It is a joining of minds to help those in need during the COVID-19 crisis. People such as these mentioned are why healthcare workers can continue to get up and go to work every day.
"The answer is not throwing money at the problem, its putting time into the problem," said Dr. Carpenetti.

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