Crowdsourcing Your Next Disaster

One of the most distressing aspects of the COVID pandemic for EMS and ED personnel was the lack of PPE. The vulnerabilities in the nation’s supply chain of N95 masks had been known for decades by leaders in government and healthcare and persisted despite our sounding the alarm. But when COVID hit and the CDC, OSHA, and NIOSH pivoted from conventional guidelines to crisis care standards for PPE, the magnitude of the problem became clear. 

Both science and experience demonstrated why crisis standards of PPE were untenable. If we reused masks, they could no longer achieve the fit we needed for protection. While taking off single-use N95 masks for “sanitizing,” the individual wearing them could be exposed to aerosols and droplets on the surface. Cellulose and polypropylene fibers degraded over time. Countless numbers of our workforce were unprotected and became sick, and sadly thousands died. We will never know the true number of family and friends they inadvertently exposed.

With access to new PPE difficult, those in need turned to any supply they could find, including foreign producers. But many items manufactured overseas were appropriately diverted to their host countries, and here in the U.S. much of the PPE that did arrive was embargoed or confiscated. 

Ultimately less than a fraction of the PPE used in the U.S. was manufactured here, according to a 2020 article in the Journal of International Business Policy. The market was flooded with counterfeit masks, and no one, from major healthcare systems to small institutions, was protected from scammers and fraud. Worse, state and local governments, first responders, and healthcare systems were all left competing for limited supplies, driving prices skyward.

#GetUsPPE

GetUsPPE was a response to the crisis standards that emerged during the early part of the pandemic. In March 2020 a group of 500-plus physicians, nurses, students, coders, and other volunteers banded together under this name and hashtag to form the largest national group to source PPE—gloves, gowns, face shields, and masks. As a nonprofit organization, its goal was to get PPE to those who needed it most, at no cost to the recipient. 

GetUsPPE collaborated with makers and donors to meet the needs of frontline doctors, nurses, respiratory therapists, home healthcare workers, EMTs, paramedics, and more. It processed thousands of requests in every state, delivering millions of units of PPE to long-term care facilities, hospitals, rural healthcare facilities, small clinics, homeless shelters, and indigenous communities. GetUsPPE represented crowdsourcing—a model of how a can-do spirit, coupled with technology and desire to do good, can embody the best of the American ideal.

Crowdsourcing

Crowdsourcing in disasters is not really a new idea. Alexis de Tocqueville first described the idea of community-driven response in his Democracy in America, released in two parts in 1835 and 1840. Since then we have crowdsourced help for disasters ranging from 19th-century barn fires to the 1930 wreck of the Morro Castle to the 2001 attack on the World Trade Center to Hurricane Katrina in 2005. In the face of catastrophe, citizens have heard and answered calls for help.

The tools and methodology have evolved over time, from word of mouth, radio, and television to the Internet. These newer tools have increased the efficiency and organizational ability of anyone to reach the public at large. We have the chance to instantly contact both our next-door neighbors and people five towns over, in the next state, or around the world.

What will you need in a crowdsourcing situation? Think about it in the context of stuff, staff, space, and systems. 

Stuff—PPE, medical supplies, food, water;

Staff—Paramedics, EMTs, RNs, MDs, nonclinical support volunteers; 

Space—Do you need to stand up an aid station in a parking lot? Expand the space of a hospital by converting a parking deck into usable treatment space?

Systems—Bringing together experts and institutions to improve delivery and quality of care. 

Seven Essential Elements 

What are the elements you need to crowdsource a disaster?

1. Framework

If you think you can crowdsource a response on your own, you’re setting yourself up for failure. It takes a team to disseminate a message, organize people, and collect and distribute materials. If you need paramedics and EMTs to staff an aid station, someone needs to credential those people. If you’re collecting food or PPE, you need to sort and ship it.

You and your team may not actually be sorting, packing, and shipping the PPE, but you need people at the ready to organize that process. For small-scale incidents you won’t require a huge infrastructure, but for larger incidents you will need a more robust organization.

2. Achievable Objectives

What do you need? People to assist with health monitoring at a shelter? Money to ship supplies across the country? Trucks to move equipment? How many, how much, what is the dollar amount, when do you need it, how long do you expect it to last, and what do you need to accomplish your objective?

All this must be clear and easily understood. If you are requesting people, let them know you’re providing food and PPE. Trucks? Drivers need to know who will cover the cost of gas. If such things aren’t being provided, let those partners willing to step up know that as well.

3. Messaging and Transparency 

Twitter, TikTok, Facebook, YouTube, and Instagram: Social media tools allow us to organize, craft our message, and deliver it around the clock. The ability to communicate with experts and hear directly from others in real time about their experiences allows us to self-correct and adjust instantaneously. Think about how you’ll reach your audience and craft your message to use that platform successfully.

Members of the public may not know what kind of mask you need, but photos and videos will do better than a written description at telling them. Anything written should be brief and to the point.

People, and especially the organizations and individuals supporting your efforts, are by nature curious. They want to know the “how” of what you’re doing. They will share your efforts with others in their orbits. This will generate more interest and assistance.

4. Responsiveness 

Listen to people from outside your normal circle. People may illuminate a problem previously unforeseen or, even better, offer a solution that hasn’t occurred to you. Listen to feedback from anyone who has provided any type of assistance, equipment, money, or personnel. Be especially receptive to those who are ultimately receiving the assistance you’re offering. This is your chance to improve your service delivery—or, if you’re using nontraditional sources of goods, improve their handiwork. Answer every e-mail, comment, and social media mention. During this event you are constantly refining your processes—take advantage of the opportunity and engage with every piece of feedback.

One caveat: Don’t feed crazy. Anyone who has been attacked online or in-person during the pandemic for wearing a mask, for example, knows about this experience. Answer questions and be responsive but do not try to confront anyone who wants to attack you or the mission you’re trying to accomplish.

5. Coordination/Collaboration 

Do not discount anyone. If you are of the mind-set “We tried that once and it didn’t work,” then crowdsourcing isn’t for you. If you have an open mind, you will encounter people with unique skill sets who may help save the day. The can-do attitude of the American people is inspiring.

For example, during the pandemic makers—people who had the capability and capacity to produce products—became part of the lexicon. Girls Scouts with 3D printers made face shields; small shops that made shower curtains turned to producing gowns. Collaborate with as wide a circle as possible—you never know whose idea will help solve your problem.

6. Organization 

The organizational capabilities of GetUsPPE were incredible. In some instances institutions were able to connect with makers or people who had sharable stockpiles within their communities.

Remember to utilize your larger community to assist with organizing: gathering people, shipping supplies, distributing food. You may not need to task EMTs and paramedics with creating your organization; you probably have members of the community with this skill set who are willing to step in and get it done. 

7. Acknowledgement 

Thank your donors directly, multiple times, in phone calls, e-mails, and publicly. Send them letters. Take photos of their donations, if possible, showing them being put to use. Make sure those photos are included in any communication with the donor. 

Some people will want to remain anonymous. Send them a letter or e-mail to acknowledge their contribution. Acknowledge these donations in your social media posts without mentioning names.
Just as your request went out over social media, use it to show the fruits of your labor being used. It will inspire others to step up and help as well.

One Final Point

The next incident is right around the corner. Don’t wait—be prepared. It helps if the essential framework to crowdsource a response already exists. The people who stepped up for GetUsPPE stood up an organization within days. If you have key elements of the framework already in place, you can execute your response in a much nimbler fashion. 

The author would like to acknowledge Megan Ranney, MD, MPH, and the team at GetUsPPE—their work in service to our country cannot be qualified in words or quantified in metrics. 

Daniel R. Gerard, MS, RN, NRP, is EMS coordinator for Alameda, Calif. He is a recognized expert in EMS system delivery and design, EMS/health-service integration, and service delivery models for out-of-hospital care.