Implementation of an Elastomeric Mask Program as a Strategy to Eliminate Disposable N95 Mask Use and Resterilization: Results from a Large Academic Medical Center

Abstract

BACKGROUND: The COVD-19 global pandemic has placed a large demand on personal protective equipment for healthcare workers. N-95 respirators, required to perform aerosolizing procedures, are in short supply and have increased significantly in cost. The lack of a clear end to the pandemic requires hospitals to create a long-term, cost effective solution to the N95 shortage. We initially used previously described methods to reuse and resterilize N95 masks; however, we found they did not solve the issues related to just-in-time fit-testing and cost. STUDY DESIGN: We initiated a program with the aim to reduce our dependence on N95 masks by initiating a phased program to acquire industrial style elastomeric P100 masks as a substitute for reuse and resterilization of disposable N95s. We created an allocation strategy based on availability of the masks, as well as an operational plan to fit test, educate, and disinfect the masks. RESULTS: Within 1 month, we were able to reduce the number of N95s needed by our network by 95%. We also found that the cost was, conservatively, 10 times less per month than purchasing disposable N95s, and the cost benefit increases the longer they are needed. CONCLUSIONS: Establishment of an elastomeric mask program is feasible and less expensive than programs focused on reusing and disinfecting disposable N95 masks. A well thought out elastomeric distribution and disinfection program does not pose greater operational challenges than an N95 reuse and resterilization program. In addition, elastomeric masks can be stored for future surges and should be considered an essential part of all healthcare facilities' supply of personal protective equipment. Implementation of the program has eliminated our dependence on disposable N95s to maintain normal operations during the global pandemic.

Reciprocal Personal/Public Protection for COVID-19 with Facepiece Discriminating Mouth and Nose

“…MDMN, featured with high efficiency protection, high degree comfort, easy wearing, tight-fitting, easy facial recognition & communication, reusability, cost-effective, environment friendly and scale manufacturing more readily and widely etc., is a simple and sustainable solution, the core principle behind MDMN is "less is more", while most of the innovations on mask for Covid-19 add something to it resulting more complexity [16,[118][119][120][121][122][123][124][125][126][127][128], MDMN try to get the mask with as less things as possible by focusing on the main function without any sacrifice, but only with significant improvement such as efficiency and comfortability, and simplify it to the great extent, which is essential for ordinary people to keep wearing it properly for protection.…”

Equipo de protección personal y COVID-19

“…26,27 Existe un estudio que evidencia su uso sistemático en hospitales en Estados Unidos reportando 94% de eficiencia operacional y una disminución de costos de 10 veces en comparación con el uso de respiradores filtrantes, además de una sustentabilidad ecológica. 28 En la Tabla 2 se describen los escenarios en los cuales son útiles los aditamentos de protec-…”

Elastomeric respirators for all healthcare workers

“…Cost savings of 90% in the first month continued to accrue with each subsequent month. 4 As well, every healthcare worker can be guaranteed access to a personal, fit-tested respirator whenever need arises. 4.…”

“…5 We are aware of several healthcare settings where elastomeric respirators have been used successfully to protect employees from infectious respiratory diseases, including tuberculosis, H1N1 influenza, and COVID-19. 4,5 The minimum level of respiratory protection for OSHA compliance officers during COVID-19 inspections is a fit-tested half-mask elastomeric respirator with an N95 filter. 6 Employers with comprehensive respiratory protection programs already in place for N95 FFRs can readily adopt elastomeric respirators, with the addition of procedures for inspecting, cleaning, and disinfecting elastomeric respirators between uses and shifts.…”

“…Cost savings of 90% in the first month continued to accrue with each subsequent month. 4 As well, every healthcare worker can be guaranteed access to a personal, fit-tested respirator whenever need arises. Supplies of N95 FFRs could be freed up for use in lower risk healthcare settings and in other workplaces.…”