We’ve heard a lot about masks — but Ontario also needs gowns

Companies across the province are pivoting to fill the need for a different kind of PPE: medical gowns. Here’s how
By Diane Peters - Published on May 19, 2020
Medical gowns are classified from levels 1 to 4: Level 4 is used by surgeons and by those intubating COVID-19 patients. (iStock,com/sergeyryzhov)

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On March 22, after hearing the Ontario government urge companies to pivot to help battle COVID-19, Mona Lam-Deslippe sent an email to Carmina Young.

Lam-Deslippe, the CEO of MLD Solutions, a software company in London, knew that her friend’s local fashion company, Carmina de Young, would likely be seeing slipping sales, so she asked whether she’d consider making medical gowns (also called isolation gowns).

“She said, ‘We’d love to do that.’ And away we went,” recalls Lam-Deslippe. Within two weeks, the garment company had its team of local sewers making gowns — and masks, too, using the scraps. Young and business partner Lina Bowden designed the gowns and made dozens of calls to procure fabric and elastic. Lam-Deslippe ran marketing and logistics and starting lining up customers.

“Demand has been high across the board,” says Lam-Deslippe, noting that family doctors, social-services agencies, hospitals, dentists, and grocery stores have already snapped up the more than 2,000 non-medical and Level 1 medical gowns the company has made to date — and they’re looking for more. “Places that did not need gowns previously need them now,” she says. Carmina de Young started with four production staff and will soon have more than 20.

“It’s an evolution of the shortage,” says Jasmin Tecson, president of the Association of Ontario Midwives. The group has an ongoing personal protective equipment drive; recently, it told prospective donors to worry less about masks, because its “need for cloth gowns is a higher priority.” It’s also looking to source gloves, hand sanitizer, and disinfectant wipes.

“We first focused on masks, as that’s the obvious first line of prevention when it comes to reducing droplet exposure,” says Tecson. “But when health-care providers have a high chance of being exposed to various bodily fluids, we want them to have the type of gown that reduces the risk.” 

Medical gowns are classified from levels 1 to 4 — Level 4 is used by surgeons and by those intubating COVID-19 patients. Medical gowns come as either reusable and fabric-made or disposable and plastic-based. Reusable gowns cost more, especially when they’re made domestically: Carmina de Young’s non-medical gown, for example, sells at cost for $25, and its more impermeable Level 1 gown goes for $35 (it was designed as a Level 2 but will be considered Level 1 until the team can figure out how to make the seams more liquid-resistant). But cloth gowns are increasingly the PPE of choice. The William Osler Health System, which includes the Brampton Civic and Etobicoke General hospitals, says it plans to use them exclusively. “When compared with disposable gowns, reusable isolation gowns provide the security of ongoing access, relinquishing the reliance on a competitive PPE supply chain, and are far more cost effective,” a spokesperson told TVO.org via email. 

The rules for which gown is used in which situation are not hard and fast, and various organizations have developed their own. Tecson says that midwives are currently adjusting to new PPE guidance from the Provincial Council on Maternal and Child Health, released on April 30, which indicates that everyone involved in a birth should wear full PPE — including masks and gowns — at all times. 

Generally, though, just about anyone who comes in contact with others and has to move from client to client, or in and out of potentially contaminated environments, needs to cover their clothes with something they can change often.

As health-care workers dealing with COVID-19 patients have to throw out or wash their gowns right away, one professional can go through many a day. “This is where the shortage is coming from,” says Namirah Quadir, a volunteer with the organization Project Northern Lights, which is helping PPE drives across the country link up and share resources. She’s says that her group has received requests for nearly 16,000 disposable medical gowns. 

Osler Health says it has seen a 700 per cent increase in gown usage since the pandemic began. It says it has enough PPE stock on hand but has been running a drive for disposable gear (including gowns) and disinfectant products.

Mass-produced gowns are in short supply: overseas supply chains have all but dried up; Health Canada is reporting a shortage of four different disposable gowns made in Quebec. Some Canadian PPE suppliers and manufacturers now work in co-operation with health agencies to make sure their limited stock of products go to organizations most in need first. 

Gowns intended for medical use must be approved by Health Canada. The agency has issued an interim order so that Canadian factories can be fast-tracked for medical use of their products — which is what happened with Carmina de Young. And it’s not the only company that’s pivoted to manufacturing a new kind of product in its existing local facilities.

Tilley Endurables in Toronto, for example, is making gowns in the GTA and supplying them to hospitals and other front-line workers. “I’m hearing from teams in places like long-term care and dentists, where they’d never worn gowns previously,” says president and CEO Andrew Prendergast. “Now, because of the virus, they require this barrier to protect their staff. But they’re starting from scratch in many cases.” Outerwear giant Canada Goose, too, has started manufacturing gowns. 

Tilleys worked closely with infectious-disease doctors from Michael Garron Hospital to help design its Level 2 gown, which is made with a tightly woven, liquid-repelling fabric it was able to source from a long-time supplier in the United States. The company says its gown will withstand 75 washes, at which point it can be downgraded to a Level 1 or to a non-medical gown. 

Home sewers are also trying to do their part. Quadir says that her group has linked up with sewers who are using both donated and purchased fabric to run up non-medical gowns of the kind hairdressers or health-care receptionists might use. Some of her volunteers are assessing whether they can make disposable gowns with plastic sheeting. “The sewers have never worked with plastics before,” she says.

Prendergast says that he’s been struck by examples of generosity and goodwill: some Tilley clients, for example, have agreed to wait for their orders so that organizations more desperately in need can get theirs first: “So many positives have come out of this for us.”

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