Early in the pandemic, before we had figured out all our procedures and policies, I witnessed a small but very important interaction. We were getting ready to transport a patient with possible COVID from the emergency department to the intensive care unit. She was on BIPAP, a form of noninvasive positive pressure ventilation that can aerosolize viral particles. We try avoiding BIPAP for this reason, but in this particular situation, it was necessary. To transport the patient to the ICU, we had the ICU nurse, respiratory therapist, and a transporter. The small interaction I witnessed was the nurse grabbing an N95 mask for the transporter who had been wearing a simple surgical mask. We recommend N95s for workers around infected patients on BIPAP due to the higher degree of aerosolization. It was a small thing, but it signaled to me: We look out for each other. Even amid shortages, we value each member of the team, and no title should entitle (ha!) anyone to more PPE over another. We make our PPE decisions based on risk, and it does not matter whether someone is a physician, nurse, therapist, technician, unit clerk, janitor, engineer, food services worker, or anyone else. (To be clear, N95s are specifically for high-risk aerosolization; otherwise everyone else is protected with standard mask, gown, and gloves). Even in crisis situations, we must approach rationing with an ethical and responsible mindset.

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