Following respirators and personal protective equipment, dialysis supplies are running short due to the coronavirus

Plus, summer camps are closing down, dry cleaners are "essential in most states, the ways the pandemic is changing advertising and more

April 20, 2020

Covering COVID-19 is a daily Poynter briefing about journalism and coronavirus, written by senior faculty Al Tompkins. Sign up here to have it delivered to your inbox every weekday morning.

This is starting to look a lot like the respirator shortage did a month ago. Over the weekend, a new emergency came into focus — the shortage of dialysis care for COVID-19 patients.

COVID-19 patients in intensive care units are suffering from a high rate of kidney failure. Doctors are trying to handle the unanticipated surge but the hospitals don’t have enough staff, equipment or machines to meet the need. The New York Times reported:

Kidney specialists now estimate that 20% to 40% of patients in intensive care suffered kidney failure and needed emergency dialysis. Outside of New York, the growing demand for kidney treatments is becoming a major burden on hospitals in emerging hot spots like Boston, Chicago, New Orleans and Detroit.

Baxter, a medical products company and one of the biggest suppliers of dialysis materials, said it is running plants at full capacity and has seen demand increase fivefold because of COVID-19 care.

Politico said its reporters got their hands on documents that show the Federal Emergency Management Agency is considering declaring the dialysis shortage an emergency so it could import more dialysis supplies. In the meantime, a group of hospitals in New York City has begun directly calling manufacturers to try to get the supplies they need — the same situation that unfolded with the shortage of protective gear and respirators.

Politico explained that the wide use of respirators is directly related to the eventual need for dialysis treatment:

Those who need dialysis are also often on ventilators but require the kidney treatment for days or even weeks after they are weaned off the breathing machines. Without dialysis, damaged kidneys cannot remove enough fluid and toxins from the body and patients essentially drown. The kidney problems caused by the coronavirus are exacerbated in those who require ventilator treatment, which itself can cause fluid to build up in the lungs.

Gothamist reported over the weekend:

“We only have nine or 10 machines, and now we have over 30 patients that need them,” said one physician who manages an intensive care unit in Queens but who wasn’t authorized to speak. “So, it becomes a question of who the resource goes to, and these are very difficult decisions.”

COVID-19 sickens people — and kills some — mainly by attacking the lungs. That’s why health officials around the country have focused on finding ventilators and staff members to operate them. But ICU doctors are discovering that up to one-third of their most severely ill patients are developing Acute Kidney Injury, as they call it. These largely are not people with advanced diabetes or chronic renal conditions.

MarketWatch explained why a shortage of dialysis equipment is not an easy fix:

“You have just two major companies that provide [dialysis] machines for ICU patients, each with specific tubing and cartridges that are unique for each machine,” said National Kidney Foundation president Holly Kramer. “If they run out of tubing, it has to be the right type to fit the machine. And in patients with COVID-19, their blood clots very easily, and can clot the tubing when you’re doing dialysis. Then you have to get all new tubing and cartridges.”

And even when hospitals find enough equipment, there is a potentially bigger issue: manpower. MarketWatch reported:

Staffing “is the biggest need, it’s probably a bigger issue than the equipment,” Kramer said. “You’re dialyzing more and more people with the same number of nursing staff. I think we really need more federal support and training of more dialysis nurses and professionals in nephrology.”

Tens of thousands of volunteer health care workers have signed up to aid New York in its battle against the virus, but no data is publicly available on how many of those nurses or specialists are trained to work with dialysis machines or to treat patients suffering from renal failure.

Journalists, you can get in front of this story, especially those of you in cities that have seen a jump in ventilator usage. We now know what will follow: a big need for kidney care.

Summer camps are closing

This is the time of year when parents and kiddos start making reservations for summer camps. Now they are learning summer camps may not open because of the COVID-19 pandemic.

The American Camp Association said there are 14,000 day and overnight camps in the U.S. More than 20 million kids and families use those camps every year, primarily in the summer. It is big business, too, employing 1.5 million people and generating more than $27 billion in revenue.

Think of the range of experiences that are in peril — from camps for kids with disabilities to nature camps, church camps, athletic and music camps and academic camps. My kids went to camps that taught rocketry, architecture, dance and biology. It was a significant part of many of our childhoods. And let’s face it, for parents it is summer childcare. If there is no camp, there will be a summertime scramble for childcare if parents go back to work.

In San Francisco, for example, one of the community’s most popular summer camps said it has laid off nearly all of its staff. University-based summer sports camps are announcing one by one they will close, too.

Summer camps are big business for universities. The Chronicle of Higher Education gave us a notion of how big:

Last year, 427 students and 116 faculty and staff members, musicians, and interns from 38 states and 28 countries participated in the American Dance Festival at Duke University. Twenty-four dance companies and choreographers presented 66 performances.

This year, the studios will be empty, the stages dark, as the storied summer festival, which dates to the 1930s, joins hundreds of other college summer programs canceled, or in some cases moved online, by the COVID-19 pandemic. Even with the online alternatives, the lost summer will cost colleges hundreds of millions of dollars in revenue, industry experts say, before what’s shaping up to be an even more financially devastating fall.

In fact, the story says, up to 10% of a university’s income can come from such “off-season” income. And it is not just the money at stake. Schools use summer camps as recruitment and scouting tools.

Some summer camps are not making a decision just yet, waiting to see what governors decide about lifting stay-at-home orders.

Summer camp cancellations may come in waves. Some schools have two summer camp semesters. The early one is probably already done for, but they will wait a while to see if they can salvage the second sessions.

And even if families try to camp together, state and national campgrounds are closed nearly everywhere. Here is a constantly updated website with campground information. In places like Maine, Wisconsin and Michigan, summer camping is more than a business or pastime, it is a lifestyle.

Join me for a webinar: “The Role of Jails in the Fight Against Coronavirus”

Give me a half-hour and you will hear from The Marshall Project’s Anna Flagg and Joseph Neff, who have been covering the unfolding national COVID-19 mess inside America’s jails and prisons. For my money, nobody has done as much covering this angle of the coronavirus story as Marshall, and these two journalists will help you zero in on how to tell the stories in your community. Sign up here. It is free and worth twice that much.

Dry cleaners are “essential” in most states

This one mystifies me a bit. As states try to figure out who is and is not “essential,” most states have determined that dry cleaning shops are essential. This map is compiled by American Drycleaner, a website that focuses on that industry.

(Courtesy: American Drycleaner)

Dry cleaners are telling customers that one way to fight viruses is to dry at high heats and that the chemicals they use are important sanitizers. But the Centers for Disease Control and Prevention and the World Health Organization have consistently said the virus is transmitted most commonly through human-to-human means and that virus-contaminated clothing is not a big concern. The exception, of course, is clothing that health care providers in known hot spots have worn.

How COVID-19 is changing advertising

In advertising, there are two main kinds of messages. One is the “topical” ad, which tells the customer that something is on sale now, act fast. The other is the “image” ad, which builds an image to keep your brand in the front of the customer’s mind.

In a heated economy, when people have money to spend, topicals make sense. But COVID-19 is changing the way that companies are sending messages to customers. When businesses don’t have something to sell or some way to deliver what they sell, they may still have a powerful message, a branding message, to deliver. And that is happening in so many sectors of business. (See how people’s spending habits are changing during COVID-19 from a New York Times analysis of market data from Ernest Research.)

The central message of 2020 seems to be “we get you,” “we are with you” and “we are one.” It is a starkly different message than “the best,” “the most affordable,” “the most stylish” and “the first.”

Lots of commercials feature nurses right now. And no wonder. Nurses have been picked in Gallup polls as the “most ethical profession” in the United States for the last 18 years. Gallup reported in January:

Currently, 85% of Americans say nurses’ honesty and ethical standards are “very high” or “high,” essentially unchanged from the 84% who said the same in 2018. Alternatively, Americans hold car salespeople in the lowest esteem, with 9% saying individuals in this field have high levels of ethics and honesty, similar to the 8% who said the same in 2018.

Only about 28% of the people Gallup surveyed rated journalists as “high or very high” in honesty and ethics, so you probably won’t see a lot of images of hard-working reporters in the “thank you hard workers of America” ads. You should, but you won’t.

Look at this lovely ad from WLEX-TV in Lexington, Kentucky, the heart of the thoroughbred horse industry.

Notice the subtle tones of “My Old Kentucky Home, Goodnight” easing into the spot at the end as the images come into full color. I am not sure if it affects everyone the way it touches this Kentucky native’s heart. But I love it. It says to me this TV station “gets me.”

Uber started running an ad a few days ago that thanks people for NOT riding with Uber.

There are some others that make me say “huh?” Dr. Scholl’s, the maker of the shoe inserts, has an ad honoring health care workers. Sunsweet prunes also wishes your family is “healthy and safe.” I am just glad they aren’t making some reference to returning to “regular business.” Burger King urged people to be “Couch Potatriots.”

But why advertise at all? Because there are lots of people watching. Nielsen research said, “Staying put in our homes can lead to almost a 60% increase in the amount of content we watch in some cases and potentially more depending on the reasons.” And Nielsen said:

“Nielsen data suggest that employees that work remotely during a typical Monday through Friday work schedule connect over three hours more each week with traditional TV than non-remote workers, 25 hours and 2 minutes to 21 hours and 56 minutes respectively.”

The most successful messages will be those that are authentic, not braggadocious, focus on workers and customers more than the company, send an optimistic tone and barely mention the sponsor by name.

When there is narration, there is a delicate balance that the commercials are trying to strike. The best commercials I have seen so far use soft voices, but they are not overly dramatic. They follow the advice that legendary WPSD-TV (Paducah, Kentucky) news director Tom Butler gave to me 40 years ago when I did a story on some awful thing that happened. He said, “You are covering a death, but it is not yours. Lighten up the drama.”

The lessons behind the Instagram #bestNYaccent challenge

It seems that we all need a challenge that is not totally silly and also builds a sense of community pride. Enter the Instagram challenge that has New Yorkers explaining a “New York accent” with great pride. The New York Times summarized the whole thing here if you do not want to plow through the individual posts on Instagram.

I could easily imagine corollary challenges in Boston, Maine, Kentucky, Louisiana, Texas and Wisconsin. They would all be fun and very different. And I bet when you embed that content on your website that “time spent on site” will be pretty good.

The way we work now

I think it is interesting how our families are watching us work and finally figuring out what we journalists actually do for a living. Our jobs, especially for TV producers, is a mystery to our families because you do so many things it can sound like nobody else is doing anything. So, don’t be surprised when your kids follow in your footsteps during the lockdown.

We’ll be back tomorrow with a new edition of Covering COVID-19. Sign up here to get it delivered right to your inbox.

Al Tompkins is senior faculty at Poynter. He can be reached at atompkins@poynter.org or on Twitter, @atompkins.