The COVID-19 pandemic has laid bare the cracks in the health care supply chain. In early March, as cases began to skyrocket in the United States, front-line health care providers reported shortages of needed personal protective equipment (PPE), such as N95 respirators, face masks, isolation gowns, and face shields.

“Despite the very best efforts of my hospital system to get adequate supplies, there simply were none to be had,” says Megan Ranney, MD, an emergency medicine physician at essential hospital Rhode Island Hospital, in Providence, R.I.; director of the Brown Lifespan Center for Digital Health; and cofounder of Get Us PPE. “The supply system was completely frozen. We were scrambling to keep our workers protected.”

Esther Choo, MD, an emergency physician at association member Oregon Health & Science University, in Portland, Ore., took to Twitter, urging health care providers to share their PPE needs and tag their members of Congress. She hoped government officials would take notice and urge President Donald Trump to invoke the Defense Production Act, which would enable rapid mass production of needed hospital resources.

Emergency physicians around the country followed suit, using the hashtag to post photos of their makeshift PPE and raise awareness of the PPE shortage. Choo joined a coalition of emergency medicine physicians, including Ranney, to draft an online petition urging the federal government to boost PPE and ventilator supplies and develop infection control guidelines. But when the government failed to act, the team pivoted to direct action, and Get Us PPE was born.

“We were kind of a classified ad or a matchmaking service,” says executive director Shikha Gupta, MD.

Through GetUsPPE.org, health care providers and other essential workers in need began to register their PPE needs, and the organization coordinated and facilitated small-scale donations.

What began as a short-term distribution effort has blossomed into a full-scale operation. Since March, Get Us PPE has received more than 19,700 PPE requests and delivered more than 3 million units to hospitals, long-term care facilities, clinics, homeless shelters, and indigenous communities.

“As the country started to reopen toward the summer and the fall, we saw that the definition of a front-line worker and essential worker was really changing,” Gupta says. “It started to include teachers, homeless shelters, crisis response teams, anything where we expected people to show up to work and deal with their neighbors and their community, and they needed to protect themselves.”

In response, Get Us PPE has shifted toward larger-scale donations of PPE from individual donors, retail partners, and vetted suppliers and manufacturers that have begun producing medical-grade PPE. The organization also established a grant program, through which regional affiliate teams can apply for PPE funding. Most recent, the organization established a grant programs for makers interested in customizing PPE for use in schools. The support of the maker community has been a pleasant surprise for both Gupta and Ranney.

“I was totally unaware of the maker community in the United States — so people that sew, manufacture with 3-D printing, they have artisan workspaces. Hundreds of thousands of them retrofitted their work to help provide PPE over the last nine months,” Ranney says. “They provided things that are medical grade, like isolation gowns and face shields, in addition to sewing cloth masks for lower-acuity settings … that is why I so strongly urged activation of the Defense Production Act. People are here and willing to do the work.”

The nonprofit organization uses a “fairness framework” to allocate resources in a way that considers equity, logistics, and efficiency.

“At this point in the pandemic, many of the larger systems may have been able to pay the elevated prices for N95s and isolation gowns and may have been able to find homegrown solutions,” Ranney says. “I know of many hospitals that have basically contracted to create their own isolation gowns or have compounded their own hand sanitizer, but that’s something that not everyone can do. The supply levels of PPE are still insufficient for many health care systems, particularly critical access and rural and safety-net hospitals across the country.”

“They’re already serving populations that are particularly at-risk for COVID or who are more likely to die after they contract COVID,” Gupta says. “Handicapping those facilities and rendering them unable to care for their patients just widens the gap in disparity … in who’s able to get adequate care for any medical issue, but specifically for COVID-19.”

Although Get Us PPE can’t meet every request, the shortage data the organization collects is valuable in advocacy to government officials and donors, especially as media interest in the PPE crisis wanes. Gupta and Ranney hope to share the Get Us PPE dataset, tracking architecture, and equity framework with the incoming Biden administration. More than 24 million pieces of PPE are needed to fill one week’s worth of need, so increasing the PPE supply in the Strategic National Stockpile and invoking more fully the Defense Production Act are two major priorities.

“At the end of the day, we believe that every American has the right to health and safety, especially if they’ve been getting asked to show up to work every day,” Gupta says. “The more transparency that exists, the more likely we are able to come up with a solution nationally that actually addresses need.”

To request PPE, visit getusppe.org/request. All information is kept private.