More than 60 percent of American hospitals report they are not prepared to handle an influx of COVID-19 patients, says a Premier survey.

The survey found that hospitals are critically short of viral swabs that are needed to perform COVID-19 testing, with more than 60 percent reporting fewer than 250 such swabs on hand.

In addition, 20 percent of hospitals say they are in need of additional ventilators.

According to the survey, hospitals ranked the supply of N95 respirators as their top concern. While the largest number of respondents (about 39 percent) reported having more than 1,000 N95s on hand, a plurality of respondents (23 percent) are burning through more than 100 masks a day, meaning that many systems have less than 10 days’ inventory.

Despite the concerns and the fact that nearly all respondents have implemented at least some conservation protocols for PPE, there is still significant room to further improve conservation measures specific to N95 masks, including extending the wear of N95s (a measure followed by 60 percent of respondents), re-using N95s (40 percent), using expired N95s (33 percent) and using industrial N95s (20 percent).

Hand Sanitizer Shortage

Shortages for hand sanitizer were the second most concerning shortage for survey respondents, with 64 percent reporting an active shortage. An additional 25 percent have less than two weeks’ supply. However, clinicians do have alternatives, as proper hand hygiene with soap and water can be more effective than alcohol-based hand sanitizers.

Surgical Mask Shortage

Surgical mask shortages were the third most concerning shortage for survey respondents. While most respondents (56 percent) reported having more than 1,000 surgical masks on hand, a quarter (26 percent) burn through that amount every day, meaning that the mask supply is generally a day’s supply or less.

Isolation Gown Shortage

Half of survey respondents (50 percent) reported having more than 1,000 isolation gowns on hand, however, about 25 percent also burn through that same quantity each day. In addition, about 17 percent of respondents had fewer than 250 gowns available.

Viral Swab Shortage

Viral swabs are another area of concern, as most respondents (60 percent) have fewer than 250 swabs on hand, while about 21 percent burn through more than 100 swabs a day. The swab shortage was largely due to the fact that one of the top manufacturers is based in Italy, which has been hit particularly hard by the virus. However, the U.S. Air Force has committed to making shipments of the swabs, so the problem may resolve in coming weeks.

Ventilator Shortage

According to the survey results, 20 percent of respondents report needing additional ventilators immediately. Approximately 27 percent can take on an additional one to five patients before they require additional ventilators. About 24 percent can accommodate six to 10 more patients, and about 30 percent can take 11 or more patients before they need additional ventilators.