ISSAQUAH, Wash. (AP) — Two doctors in Washington state, which leads the U.S. in coronavirus deaths, have tested positive for the disease as hospitals scramble to make due with a shortage of masks and other equipment needed to keep them from getting sick.

In the area of Seattle that’s been hardest-hit, some nurses in emergency departments are washing and reusing surgical masks, gloves and gowns. They may work on a patient for hours or more before learning they tested positive for COVID-19.

“I’ve got a two-day supply of masks, so we’re trying to be conservative,” said Dr. Stephen Anderson, an emergency physician at the MultiCare Auburn Medical Center in suburban Seattle. “You get one in the morning. You clean it and reuse it.

“I tell my staff to guard your mask with your life, because it is your life.”

Many hospitals also lack the more efficient N95 respirator masks, which quickly sold out once the virus reached the U.S. Vice President Mike Pence on Tuesday urged construction companies to donate any N95 masks — which they use to protect workers from fumes — to their local hospitals.

The death toll in the U.S. from COVID-19 passed the 100 mark on Tuesday, and Washington state accounts for more than half of those fatalities.

The federal government has sent some extra masks and other equipment to the state, though it’s unclear when it will be distributed.

This week, a 40-year-old emergency room physician at EvergreenHealth Medical Center in the Seattle suburb of Kirkland was in critical condition after testing positive for COVID-19, officials said.

Anderson said that physician was breathing on a ventilator, but was stable.

A nearby nursing home has been the epicenter of the outbreak in Washington state, and many of its residents who got sick from COVID-19 were sent to EvergreenHealth. The hospital has handled more than 100 coronavirus cases since the end of February, and 25 of those patients died, the facility said Tuesday.

A physician at the University of Washington Medical Center in Seattle also has tested positive for the coronavirus, hospital spokesman Brian Donohoe said Tuesday. He did not immediately have information on the doctor’s condition.

Elsewhere, a 70-year-old emergency physician from Patterson, New Jersey, tested positive for the coronavirus and was isolated in the intensive care unit, according to William Jaquis, president of the American College of Emergency Physicians.

“I am deeply saddened by this news, but not surprised,” Jaquis said in a statement. “As emergency physicians, we answer the call to care for our most vulnerable, even at great personal risk.”

Anderson noted some infections among ER doctors and nurses are inevitable because of their high risk of exposure.

“In any battle, when you’re on the front lines, you’re going to suffer the most causalities,” Anderson said. “The emergency departments are the front lines.”

Anne Piazza, with the Washington State Nursing Association, said the proper equipment is critical, especially since nurses can be exposed to infected patients before they’re even tested for the disease.

“I’m hearing reports from nurses being asked to reuse masks,” Piazza said. “They have to use the same mask throughout their shift. That’s unsafe.”

Like many U.S. hospitals, the MultiCare Auburn Medical Center has begun screening arriving patients for the coronavirus, then dividing them into those with respiratory ailments and those with things like broken toes or other injuries, Anderson said. The doctors and nurses treat the patients while waiting for the results of the COVID-19 tests. If they’re positive, they put on a mask and are moved to a more secure location.

The process is similar at Providence Sacred Heart in Spokane, which serves a large area of eastern Washington. When patients test positive for COVID-19 there, they’re moved to the Special Pathogens Unit, which is designed to handle people with infectious diseases. Medical staff in that unit wear suits that include hoods with a separate oxygen source, a full face shield and gown.

Anderson said his hospital does not have a special pathogens unit. Instead, it uses four “negative pressure” rooms to isolate patients with infectious diseases.

They’re full, he said. And so are his facility’s ventilators.

President Donald Trump said states needing respirators, masks and other equipment for medical professionals should first try to acquire the items on their own before turning to the federal government for help.

The American Medical Association sent a letter to Pence on Tuesday expressing concerns about the supply shortage and urging him to launch a “Manhattan Project”-style effort to expand manufacturing of masks, gowns and other gear.

“The AMA continues to hear from physicians across the country about short supplies and limited access to personal protective equipment, which is necessary to keep the health care workforce safe and to protect the health of patients,” the letter said. “Physicians are reaching out to their state and local health departments, but their supplies of PPE are also inadequate.”

The federal government has sent Washington state more than 500,000 N95 respirators and a similar amount of masks, along with gowns and gloves. The equipment is being dropped at the Washington Army National Guard’s site called Camp Murray, said Mike Faulk, a spokesman for the governor’s office.

But it wasn’t clear when it would be distributed. Health department officials did not immediately respond to a request for that information.

They won’t last long once released, Anderson said.

“You’d be surprised how fast you’ll burn though a half a million masks,” he said.

Anderson used to own an N95 mask, but his disappeared a month ago so he makes due with a simple surgical mask, even when doing procedures on infected patients.

“I would love to go to Home Depot and buy one,” he said. “That’s where we used to get them. Painters use them. But they’re all sold out.”

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