N95 masks are currently the most valuable item among the medical supplies and personal protective equipment (PPE) needed during the COVID-19 pandemic. We’ve been hearing and reading about these masks for over 9 months now on the news or online, with the main question asked is whether or not the United States is properly equipped to face this emergency.
Shortages have been happening all around the country, and it’s safe to say these masks will be necessary for a very long time, and shortages don’t seem to cease. For this reason, the Centers for Disease Control and Prevention (CDC) has published in their website a series of guidelines for the optimization of these masks during shortages. In this article, we’ll break them down.
First, let’s understand why this item is so valuable
The first thing you need to know is that these masks are respirators that have been named that way by the National Institute for Occupational Safety and Health (NIOSH). This is a federal agency that was created as part of the CDC, and they help workplaces around the USA maintain a safe work environment by making recommendations that are based on science. They also regulate respirators, assigning a name based on a two-part naming system.
It takes into consideration two properties: the resistance to oil, indicated with the letters N, for not resistant, R for resistant, and P for oil-proof, and the filtration rate, which can be either 95, 99, or 100%.
N95 respirators are, therefore, those with no resistance to oil that can filter out at least 95% of the particles in the air that are also airborne, meaning their size is 0.3 micrometers in diameter. For this reason, they’re considered the best disposable face mask when it comes to antiviral purposes in the healthcare field, and are better for virus protection than the regular surgical masks medical providers usually wear, protecting against viruses like the flu or the coronavirus. They also protect against particles like dust, pollen, and smoke.
Experts predicted the shortages of this mask before the pandemic was official, and they soon became a reality all over the world. Soon, people started to buy it in bulk and wholesale, with some of the most popular models being the 3M N95 masks in the models 3M 8511 and 3M 8210. Other medical supplies have also been affected by these shortages, like gloves, gowns, surgical masks, KN95 masks, and face shields.
What strategies does the CDC recommend to optimize these supplies?
The CDC’s website offers information on how healthcare centers can make the most use out of their existing supplies. To optimize N95 masks, they offer strategies based on a hierarchy: elimination, substitution, engineering controls, administrative controls, and lastly, PPE, following that order from the most to the least effective.
In the prevention and control of infectious diseases like COVID-19, the first two steps mentioned, which are elimination and substitution, have no use in healthcare settings. The first refers to physically removing the hazard, in this case the virus, and the second one talks about replacing it with a different one. The other three strategies, on the other hand, can be extremely powerful to avoid and reduce the exposure to respiratory microorganisms like the coronavirus.
N95 respirators are the most used devices among the PPE used for controlling exposure to diseases that are transmitted from one person to the other through airborne particles. However, their effectiveness is highly dependent on the proper fit and use of the mask. As disposable face masks, they can only be used once, and should then be discarded and replaced.
A combination of interventions in all levels of the hierarchy is recommended by the CDC for the prevention of airborne diseases, and PPE isn’t the only optimal method for this. This is done with the goal of offering additional protection, so if one of the interventions fail, others will still ensure prevention and control.
They also mention in their website regarding optimization of PPE a concept called “surge capacity”. This refers to the ability a facility has to manage a sudden increase in patient volume, which can exceed or challenge their capacity. To distinguish the daily patient capacity from the surge capacity, there are no official measurements. However, surge capacity is useful to assess the decrease in the supply of N95 respirators experienced during the pandemic. The CDC has a PPE Burn Calculator that was created to help healthcare facilities to plan and optimize the use of their respiratory PPE.
Surge capacity is described in three levels, which are used to conserve as well as measure N95 masks:
- Conventional capacity: it uses engineering, PPE, and administrative control measures, recommended to be implemented in general control and prevention plans of any healthcare center.
- Contingency capacity: used temporarily if a shortage of N95 respirators is expected.
- Crisis capacity: once shortages start happening, these are the strategies that have to be considered.
A wide range of options is offered by the CDC when it comes to optimization strategies during emergencies like the pandemic where supplies and PPE start to run low or are run out. Each level of capacity has a list of strategies that are done following the three last levels on the hierarchy we mentioned at the beginning. All the information is listed on the CDC’s website.
These are trying times, and we need to help our healthcare workers be as safe as possible. Reusable cloth masks are recommended for the general public by the CDC, which includes kids over the age of 2 with the corresponding size for their face. This will help prioritize the medical-grade respirators that are necessary for hospitals and other facilities.