Should surgical masks be reused?

The Centre for Disease Control and Prevention (CDC) strictly recommends the use of surgical masks to slow the spread of coronavirus. During the pandemic, the demand for surgical masks is significantly increased. All front line health care providers are at high risk of getting this life-threatening virus. 

For the safety of all health care practitioners, the proper supply of surgical face masks to the health care settings is mandatory. To solve this issue, the extended use of surgical masks is recommended. The only common question is: Should surgical masks be re-used?

Surgical masks:

The surgical masks and N95 masks are the type of personal protective equipment (PPE). The surgical mask, which is commonly known as medical procedure masks is widely used by health practitioners during surgeries. Surgical masks are disposable devices. Surgical masks are designed to cover the nose and mouth area. Surgical masks are not sized for an individual fit. They are loose fitted. 

The primary function of the surgical mask is to prevent the patient from the wearer’s respiratory secretions and saliva. Surgical masks are protective in nature by working as a barrier for microorganisms, harmful airborne infections. It is used in health care settings, including hospitals, emergency departments, outpatient facilities, residential care facilities, home health care delivery. It is used to prevent and stop the spread of infections. The filtration efficiency of surgical masks is very high. 

During the outbreak of COVD-19, it was recommended for the general public to wear surgical masks on public transport, in shops, and at work to control the spread of this disease. The U.S. Food and Drug Administration (FDA) regulates surgical masks. It evaluates their performance for safety and effectiveness. The FDA requires good manufacturing practices.

Surgical masks re-used?

All surgical masks are manufactured for one-time use. It means you should throw away the mask after a single-use.  In an emergency situation when there is a shortage in the N95 mask, there are a lot of methods which were introduced to disinfect the masks. 

Contingency Strategies

Contingency strategy simply stands for the strategies that were recommended at the time before the crisis came. The strategy includes: 

  • Face masks should be used for a longer period. All nurses and health care practitioners should use surgical face masks during the visit of more than two patients before being removed (whereas, the conventional N95 respirator is allowed to be used for one patient contact then discarded).
  • Surgical face masks should be used for a longer time duration beyond the manufacturer designated mask life to fit, testing, and training.

 This recommendation was made to control the shortage of filtering face masks in the future, but it will soon fail due to the rapid increase in the number of coronavirus affected persons.

Crisis Strategies

After the implementation of all contingency strategies, the problem of the shortage of N95 respirators is still not subsided. To meet the demand for N95 respirators in the pandemic CDC also recommends a crisis strategy.  The strategy includes:

  • Filtering Facepiece respirators, including all N95 respirators and surgical face masks, should be used beyond its manufacturer designated shelf life.
  • All respirators can be used in health care settings that are similar to the NIOSH approved respirators but not NIOSH approved. They can be approved by any country’s standard.
  • To meet the demand for surgical face masks and N95 respirators. It was recommended to all health care practitioners to take their masks in a paper bag between the visit of the patients.
  • N95 respirators should only be recommended in health care setups and not for general public use.

Extended Use Recommendation

This method is highly preferred over reuse because it involves less touching of the face masks and respirators therefore contain less risk of contact transmission. To maintain safe extended use, the respirator should have a proper fit and function. Extended use of surgical face masks will be allowed in health care setups with proper instructions. It was clearly mentioned to discard the respirator if the mask became damaged and the wearer feels difficult to breathe through.

Reuse Recommendation

The reuse of surgical face masks is not considered to be safe. It is not a highly recommended method, because by every donned and doffed the face masks and respirator loses its efficiency. However, there is also a guideline that is recommended by the manufacturer for the reuse of surgical face masks that includes strict adherence to hand hygiene, proper donning and doffing techniques, physical inspection, and user seal check.

Conclusion:

All above-mentioned recommendations and strategies have been given by the CDC and NIOSH to ensure the continuous availability of filtering face masks in all health care settings. Although, these recommendations have many potential benefits but also have some risks. Many respirators and devices have not been cleared by the FDA (Food and Drug Administration). The main concern for the extended use of the surgical face mask is that it can cause additional discomfort to the wearer. 

The extended use and re-use of single-use surgical masks and respirators (with or without reprocessing) should only be considered in situations of critical shortage. Where extended use or re-use is being practiced, health care organizations should ensure that policies and systems are in place to ensure these practices are carried out as safely as possible and in line with available guidance. For the re-use and extended use method, proper guidance should be given to the health care worker or it may require further attention and investigation.

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