Association between 2019-nCoV transmission and N95 respirator use

Wang, Xinghuan; Pan, Zhenyu; Cheng, Zhenshun

doi:10.1101/2020.02.18.20021881

Cited by 53 publications

(54 citation statements)

References 3 publications

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“…Reduces penetration of ultra-fine viral particles 30 No SARS-CoV HCW infections when N95 used in high-risk areas 28 No COVID-19 HCW infections when N95 used 31 CDC recommends N95 for patient contact and aerosol generating procedures 19 Uncomfortable, poorly tolerated by HCWs for >6-7 hours 32 Limited availability Airborne -Elastomeric facepiece respirators (''gas masks'')…”

Section: The Risk To Healthcare Workersmentioning

confidence: 99%

“…23 A study specifically examining critical care nurses also found no differences in the rates of becoming infected when using a surgical mask compared to an N95 mask. 29 Wang et al 31 published healthcare worker infection rates from Wuhan University from December 2019 and showed that none of the 278 staff members who wore N95 masks became infected. Doctors and nurses on surgical floors who did not interact with COVID-19 patients were considered low risk and did not wear masks, and 10 of 215 (4.6%) of these individuals ultimately became infected.…”

Section: Surgical Face Masksmentioning

confidence: 99%

“…Doctors and nurses on surgical floors who did not interact with COVID-19 patients were considered low risk and did not wear masks, and 10 of 215 (4.6%) of these individuals ultimately became infected. 31 Currently, the CDC recommends use of an N95 mask when caring for a patient with known or suspected COVID-19 if available and recommends an N95 or higher respirator when performing or present for aerosol-generating procedures. 19 In Korea, N95 masks at minimum have been recommended for all hospital interactions except disposal of medical waste.…”

Section: Surgical Face Masksmentioning

confidence: 99%

“…Extended single use of FFR is favored over limited reuse because of the risk of self-inoculation. 31 For extended single use, this is most practical when patients are cohorted (patients with a common diagnosis in the same unit). 51 It has been shown that donning an FFR up to 20 times maintains good fit; however, quality of fit decreases with subsequent uses and best fit was seen after the first 5 donnings.…”

Section: Surgical Face Masksmentioning

confidence: 99%

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Personal Protective Equipment and COVID-19

et al. 2020

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There is a long history of personal protective equipment (PPE) used by the surgeon to minimize the transmission of various pathogens. In the context of the present coronavirus disease 2019 pandemic there is significant controversy as to what forms of PPE are appropriate or adequate. This review aims to describe the pathogenic mechanism and route of spread of the causative virus, severe acute respiratory syndrome coronavirus, as it pertains to accumulated published data from experienced centers globally. The various forms of PPE that are both available and appropriate are addressed. There are options in the form of eyewear, gloves, masks, respirators, and gowns. The logical and practical utilization of these should be data driven and evolve based on both experience and data. Last, situations specific to surgical populations are addressed. We aim to provide granular collective data that has thus far been published and that can be used as a reference for optimal PPE choices in the perioperative setting for surgical teams.

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Section: The Risk To Healthcare Workersmentioning

confidence: 99%

Section: Surgical Face Masksmentioning

confidence: 99%

Section: Surgical Face Masksmentioning

confidence: 99%

Section: Surgical Face Masksmentioning

confidence: 99%

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Personal Protective Equipment and COVID-19

et al. 2020

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“…N95 respirators (the equivalent in Europe is FFP2 respirators) are recommended for health workers conducting aerosolgenerating procedures during clinical care of COVID-19 patients, while surgical masks are recommended for non-aerosol generating procedures (139). The importance of masks for health worker protection was emphasised in the early phases of the global pandemic in hospitals in China (140). Strategies to manage this critical shortage of PPE have included exploring sterilization and re-use of respirators, and appeals to the public to reduce their use of medical masks.…”

Section: Implementation Considerationsmentioning

confidence: 99%

Face Masks Against COVID-19: An Evidence Review

Howard¹,

Huang²,

Li³

et al. 2020

Preprint

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The science around the use of masks by the general public to impede COVID-19 transmission is advancing rapidly. Policymakers need guidance on how masks should be used by the general population to combat the COVID-19 pandemic. In this narrative review, we develop an analytical framework to examine mask usage, considering and synthesizing the relevant literature to inform multiple areas: population impact; transmission characteristics; source control; PPE; sociological considerations; and implementation considerations. A primary route of transmission of COVID-19 is via respiratory droplets, and is known to be transmissible from presymptomatic and asymptomatic individuals. Reducing disease spread requires two things: first, limit contacts of infected individuals via physical distancing and other measures, and second, reduce the transmission probability per contact. The preponderance of evidence indicates that mask wearing reduces the transmissibility per contact by reducing transmission of infected droplets in both laboratory and clinical contexts. Public mask wearing is most effective at reducing spread of the virus when compliance is high. The decreased transmissibility could substantially reduce the death toll and economic impact while the cost of the intervention is low. Given the current shortages of medical masks we recommend the adoption of public cloth mask wearing, as an effective form of source control, in conjunction with existing hygiene, distancing, and contact tracing strategies. Because many respiratory droplets become smaller due to evaporation, we recommend increasing focus on a previously overlooked aspect of mask usage: mask-wearing by infectious people ("source control") with benefits at the population-level, rather than mask-wearing by susceptible people, such as health-care workers, with focus on individual outcomes. We recommend that public officials and governments strongly encourage the use of widespread face masks in public, including the use of appropriate regulation.

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Decontamination Methods for Reuse of Filtering Facepiece Respirators

Su-Velez

Maxim

Long

et al. 2020

JAMA Otolaryngol Head Neck Surg

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ith each passing day, the novel coronavirus disease 2019 (COVID-19) pandemic escalates around the world. First identified in Wuhan, China, the disease is caused by a novel coronavirus: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). 1 Globally, health care professionals have been infected at high rates (63% of all cases in Wuhan as of February 11, 2020, were health care professionals; in Italy, 20% of health care professionals responding to the pandemic were reported to be infected) and are also dying of COVID-19. [1][2][3][4][5] These high rates are likely due to transmission of the virus through droplet, contact, and even airborne modalities, similar to the 2002-2003 SARS pandemic, 6 as well as by asymptomatic individuals. A study by Zou et al 7 has shown similar viral loads present in both asymptomatic and symptomatic patients, with the highest viral load being identified in the nasal cavity. Subsequently, it is not surprising that otolaryngologists have been identified as a high-risk group among health care professionals, given their level of exposure to the upper aerodigestive tract. [8][9][10] The risk of infection for health care professionals is compounded by shortages of personal protective equipment (PPE), including filtering facepiece respirators (FFRs), in particular, N95 respirators. 2,11 Early studies report that adequate PPE and hand hygiene provide good protection from infection, especially in cases of high-risk procedures in which SARS-CoV-2 can be aerosolized. 12,13 The N95 respirators were widely used in previous SARS and influenza outbreaks to prevent both droplet and airborne transmission. 6,14 At UCLA Health, the use of N95 respirators along with a gown and eye protection or face shield is required for any invasive otolaryngologic procedure involving mucosal surfaces, in line with recent guidelines based on international experience. 8 In the US, the supply of necessary PPE has been unable to keep up with the rapid increase in the number of patients with COVID-19 owing to the disruption of the global supply chain. 2,15 The Centers for Disease Control and Prevention (CDC) has estimated that more than 90 million respirators would be required for health care professionals alone in a pandemic lasting 42 days. 16 As of March 2020, the US Department of Health and Human Services estimated that 3.5 billion N95 respirators would be needed in a severe event, but only 35 million were available. 17 Previously, the CDC set guidance for extending the use of single-use PPE in times of high demand and more recently released new guidelines on decontamination methods for N95 IMPORTANCE The novel coronavirus disease 2019 (COVID-19) has proven to be highly infectious, putting health care professionals around the world at increased risk. Furthermore, there are widespread shortages of necessary personal protective equipment (PPE) for these individuals. Filtering facepiece respirators, such as the N95 respirator, intended for single use, can be reused in times of need. We explore the evidence for dec...

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Association between 2019-nCoV transmission and N95 respirator use

Cited by 53 publications

References 3 publications

Personal Protective Equipment and COVID-19

Personal Protective Equipment and COVID-19

Face Masks Against COVID-19: An Evidence Review

Decontamination Methods for Reuse of Filtering Facepiece Respirators

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