COVID-19 global pandemic planning: Decontamination and reuse processes for N95 respirators

Abstract

<jats:p> Coronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified as a cluster of respiratory illness in Wuhan City, Hubei Province, China, in December 2019, and has rapidly spread across the globe to greater than 200 countries. Healthcare providers are at an increased risk for contracting the disease due to occupational exposure and require appropriate personal protective equipment (PPE), including N95 respirators. The rapid worldwide spread of high numbers of COVID-19 cases has facilitated the need for a substantial supply of PPE that is largely unavailable in many settings, thereby creating critical shortages. Creative solutions for the decontamination and safe reuse of PPE to protect our frontline healthcare personnel are essential. Here, we describe the development of a process that began in late February 2020 for selecting and implementing the use of hydrogen peroxide vapor (HPV) as viable method to reprocess N95 respirators. Since pre-existing HPV decontamination chambers were not available, we optimized the sterilization process in an operating room after experiencing initial challenges in other environments. Details are provided about the prioritization and implementation of processes for collection and storage, pre-processing, HPV decontamination, and post-processing of filtering facepiece respirators. Important lessons learned from this experience include, developing an adequate reserve of PPE for effective reprocessing and distribution, and identifying a suitable location with optimal environmental controls (i.e. operating room). Collectively, information presented here provides a framework for other institutions considering decontamination procedures for N95 respirators. </jats:p><jats:sec><jats:title>Impact statement</jats:title><jats:p> There is a critical shortage of personal protective equipment (PPE) around the globe. This article describes the safe collection, storage, and decontamination of N95 respirators using hydrogen peroxide vapor (HPV). This article is unique because it describes the HPV process in an operating room, and is therefore, a deployable method for many healthcare settings. Results presented here offer creative solutions to the current PPE shortage. </jats:p></jats:sec>

Effectiveness and Recommendations for the Use of Dental Masks in the Prevention of COVID-19: A Literature Review

“…However, these methods still require further study to ensure preservation of the physical characteristics of the respirators and adequate biosecurity for dentists. 30,[33][34][35][36][37][38][39] There are different studies of the efficacy and recommendations for the use of masks to prevent the spread of COVID-19. 19,21,30 The information described in this study highlights the importance of the resistance of the masks to droplets and aerosols for the prevention of inhalation of contaminating particles, guaranteeing biosecurity to dentists.…”

“…24 Different decontamination strategies, such as sterilization by exposure to ultraviolet germicidal irradiation (UVGI), ethylene oxide, or vaporized hydrogen peroxide, have been shown to be effective in maintaining adequate protective function. 30,[33][34][35][36] In 1 study, different common sterilization methods for masks were performed including heat treatment, cabinet UVGI sterilizer, steam, alcohol solutions, and chlorine-based solutions. The last 2 methods caused degradation of the static charge required by the FFR.…”

Scalable, effective, and rapid decontamination of SARS-CoV-2 contaminated N95 respirators using germicidal ultra-violet C (UVC) irradiation device

“…The copyright holder for this preprint this version posted October 6, 2020. ; https://doi.org/10.1101/2020.10.05.20206953 doi: medRxiv preprint laboratories). The unexpected extent of this pandemic resulted in the long-anticipated shortage of FFR and other facemasks, the need for more PPE supplies across the world escalated significantly 5 . Such a situation negatively impacts healthcare settings, putting frontline workers at a vulnerable position, potentially resulting in a collapse of the healthcare system.…”

Agtech infrastructure for pandemic preparedness

“…In some cases, stockpiles of equipment that have reached their expiry date are pressed into service once performance has been validated 11 . Another valuable approach is the adaption of manufacturers with suitable infrastructure, switching from normal 'peacetime' production lines to emergency manufacturing in response to a pandemic.…”