In response to the scarcity of protective equipment, students and faculty in the University of Hawaii at Manoa’s Department of Theatre and Dance and the John A. Burns School of Medicine are sewing fabric face masks and assembling face shields to be donated to health care workers and other first responders on the front lines against the new coronavirus.
About a dozen theater students and 60 medical students, along with several staff members, are making the critically needed items at home, with JABSOM serving as a central clearinghouse where the masks are dropped off for sanitizing and distribution.
While the N95 face mask, or filtering face piece respirator, which filters out at least 95% of very small particles, including bacteria and viruses, is the medical standard for professionals treating COVID-19 patients, “this (sewing) effort is in response to the U.S. Centers for Disease Control and Prevention’s guidance that fabric masks are a crisis response option when other supplies have been exhausted,” said Maile Speetjens, assistant professor of costume design and technology.
The CDC’s COVID-19 website warns, “homemade masks are not considered PPE (personal protective equipment), since their capability to protect HCP (health care professionals) is unknown.”
But unlike many DIY patterns circulating online, Speetjens said, the UH team’s version was designed in collaboration with Angel Yanagihara, a biochemist and associate research professor in the UH department of tropical medicine.
Both seamstresses, they developed two models, each made of densely woven, but breathable, 100% cotton fabric and made to be laundered and reused.
One is pleated, like paper surgical masks, held on by elastic around the ears, with a flexible metal insert at the bridge of the nose that can be pinched for a closer fit and a pocket that can be filled with a filter material, Yanagihara said.
The other version is for physicians’ use: It has twill ties and can be worn over an N-95 mask to help protect it so that it can be reused.
Both can also be worn over a pleated surgical mask.
Once they had a plan for the project, Yanagihara contacted Jerris Hedges, dean of JABSOM, who “kicked (the project) off with his own personal donation” and arranged for the UH Foundation to help pay for the project, she said.
“I feel glad JABSOM was willing to collaborate so we could ensure what we’re doing is what is wanted by the medical community,” Speetjens said.
Yanagihara arranged for three prototypes to be tested by doctors in a surgical practice group. “They have used and like them,” she said, adding that those with larger faces “asked to put little darts in the bottom for a better fit.”
Thanks to the UH Foundation, the project was able to purchase sewing machines so that students could work from home and to pay students what they were earning at scholarship jobs they lost due to the shutdown, said Rick Greaver, production and facilities manager for UH’s Kennedy Theatre and the department of theatre and dance.
“We need to keep people working, not in a situation where they can’t pay bills or buy food,” said Greaver, who on Friday picked up a new batch of material from Fabric Mart, which “has been greatly generous with discounts and donated fabric,” and dropped it off at students’ homes, where he also picked up the masks they’d sewed.
“It’s worthy work and also an opportunity for them to learn a useful skill for a theater person,” Greaver said, noting that several theater students in other specialties such as lighting and sound design had begun sewing in order to participate in the project.
“I’ve found the masks are really easy to make and go pretty fast,” said Jesse Hoyhtya, a UH sophomore in the women’s studies department who had been working as a stitcher in the costume shop. “I made around 23 from Monday to Thursday, and we’re only allowed to work 20 hours a week.”
The first batch of cloth masks will be distributed through the University Health Partners of Hawaii, the faculty practice plan of the medical school, with priority given to providers and staff in primary care and emergency care specialties.
ACCORDING to the CDC, homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.
In the other half of this interdisciplinary collaboration, medical students are assembling face shields and seeking donations of PPE under the guidance of Jill Omori, director of the JABSOM office of medical education, who is married to a firefighter.
“The purpose of a face shield is if a patient is coughing or you’re intubating someone to put them on a ventilating machine, any droplets will be stopped physically,” said Joseph Go, a fourth-year medical student and president of the class that will be graduating in May; he will do his residency in internal medicine in Hawaii, where he plans to practice.
“It’s also important for people like first responders and people doing testing, because you’re the first contact for this patient and sometimes you have no idea what they have, and you’re trying to triage them,” he added.
Omori, Go said, had found instructions for a homemade face shield on the Johns Hopkins University website and was helping the medical students get all the materials they needed.
These were foam boards that the students were cutting up to make the part of the shield that rests on the forehead of the user; elastic bands that serve as the headband that holds the shield in place; and sheets of plastic.
While waiting for the strong plastic they’d bulk ordered to arrive from the mainland, they were using plastic transparencies normally used with overhead projectors.
“It still serves as a pretty good barrier for droplets, and we assume they’ll be wearing face masks underneath it,” Go said.
He anticipated that their first batch of shields should be done this week, and “Dr. Omori will help us distribute them to first responders and medical staff.”
He added that Omori had ordered enough materials to make 3,000 face shields.
The third- and fourth-year medical student volunteers also are seeking donations of PPEs by calling up community businesses and organizations who might have the equipment but are not open for business during the stay-at-home order.
This could include dentists, construction and pest control companies, tattoo parlors “and many different types of businesses, and we also have volunteers to pick up donations for distribution to health care providers,” Go said.
The coronavirus crisis “makes our passion for this profession stronger,” Go said of himself and his classmates. “While we’re in the back lines right now, doing what we can to help support front lines, in July we’ll be on the front lines, treating these patients as full-fledged doctors.”
Hoyhtya, the seamstress, said she valued being part of the project, which she viewed as a microcosm of the Hawaii community.
During the coronavirus crisis, “you can see how much the community has come together to help one another,” she said. “We’re a little, small part of what’s happening, with so many people sewing masks, getting groceries for one another, making sure people who have to stay inside are taken care of and staying safe,” Hoyhtya said.