According to a small study from Singapore, after a median 6-minute of contact by the healthcare staff with laboratory-confirmed COVID-19 admitted patients not needing ICU care under airborne isolation, all the samples taken from the selected PPEs (N95 masks, goggles, and shoes) were negative for SARS-CoV-2 (1).
Whether reuse of gown and gloves has same implications and whether multiple use (more than twice) would also have same results is unknown? Also, whether results would be the same after contact with COVID-19 cases that are not isolated in a negative-pressure rooms, is still unknown?.
Should we reuse N-95 masks and goggles or wait for a bigger studies is open to questions?
1. Absence of contamination of personal protective equipment (PPE) by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). Accepted manuscript in Infection Control & Hospital Epidemiology 2020.
N95 masks should not be reused to reduce spread of infection and prevent infecting your self
I agree with Varsha Hirani N95 masks should not be reused. Maintaining a tight seal is critical to prevent viral exposure around the mask. After use and removal the straps are loosened and so a tight seal can not be guaranteed.
Moreover N95 respirators should not be recommended for use in emergency medical service procedures. FFP3 respirators should be wornfor airborne precautions.
N95 masks should not to be reused because because we can't guarantee the function as well as before
I agree. this type of equipment should be disposable.
otherwise Centers for Disease Control and Prevention recommends using respirators in low-risk and high-risk situations, the World Health Organization recommends using masks in low-risk situations and respirators in high-risk situations.
Thanks all for your valuable inputs:
However, best use of masks will vary according to situation:
a. Asymptomatic people should not use N95 masks, but can use surgical masks if they are having symptoms or are confirmed patient of COVID-19 (but see below).
General public may wear a surgical mask
Although it is not recommended to for general public to use any type of mask (unless the person is SARS-Cov-2 positive), China, and some other countries mandated the use of surgical mask successfully. New reports are indicating that a COVID-19 patient (whether asymptomatic, presymptomatic or having mild symptoms) may be able to spread infection by breathing or talking.
https://www.sciencenews.org/article/coronavirus-covid-19-breathing-talking-enough-spread-airborne
3. Use or reuse of N95 should be according to economic or logistic situation:
a. In an ideal situation, where there is no economic, supply or other logistic issues, I would also recommend a single use of N95 masks.
b. If economic or supply constraints exist, I would recommend use of N95 masks use to be extended to care of multiple COVID-19 in the same ward, or when it becomes uncomfortable or painful to use (up to 4 hours).
c. I would recommend bundling of care activities for patients diagnosed with COVID-19, when there are cost or supply constraints for not only the N95 masks but also the other PPEs.
d. In worse scenarios, although not recommended N95 masks are being used by one person for an extended period of time (I know that happening in Pakistan), healthcare workers are using even trash bags as gowns, and are given one N95 mask to be used for 14 days). Ways have been devised to reuse N95 masks after sterilization.
These are the excerpt from the latest advisory from WHO (19 March 2020):
https://apps.who.int/iris/handle/10665/331498
- N95 mask, although disposable, can be reused by healthcare workers as advised by WHO
- To avoid wastage, WHO suggests healthcare workers to minimize the use of PPE by by bundling their activities
Preprint Investigating COVID-19: Quantifying recurring methodological...
Good ideas
I completely agree that N95 shouldn't be reused. It is difficult to reassure for IPC. I think it needs larger studies.
masks should not be used repeatedly. then there is a risk of colonization on the surface of the bacterial and virus mask, and the filter material itself loses its properties over time
If you have contacted a COVID 19 patient as a health care worker you have to dispose mask and full PPE kit.
Using minimum number of doctors and nurses is one option to minimise wastage of PPEs.
But in a limited resource setup it may adviceable to reuse N95 mask and goggles after proper disinfection procedure.
https://www.avma.org/resources-tools/animal-health-and-welfare/covid-19/guidelines-ppe-covid-19-pandemic-demand-exceeds
Definitely should not be re-using. Imagine all the issues around collecting, knowing how long they have been used and whether they have been managed appropriately? What a nightmare and then if there is even one infection that is traced back to it, how would you feel?
This is usually possible after appropriate disinfection and observance of appropriate epidemiological and sanitary safety rules. If certain medical and protective materials and devices can be decontaminated with detergents at a temperature of min. 60 degrees Celsius are likely to be sanitized and safe and can be reused. But each device is different and this type of assessment should be made individually for each type of medical device.
Greetings,
Dariusz Prokopowicz
There have been many innovative helpful suggestions how to save or reuse the PPE in response to JAMA editorial.
Article Conserving Supply of Personal Protective Equipment—A Call for Ideas
There should be large scale studies on the contamination/risk/infectivity. If there will be no option of reusing, Biomedical waste management will be a big menace in the future. Disinfection, etc can be beneficial and allow for judicious use.
There is absolutely no point of reusing the PPE which has been used in contact with a COVID-19 positive patient. In laboratories while dealing with sample collection and testing of samples either by RDT or RT-PCR, all the PPE has to be discarded at any cost. We still don't know the results by that time but we follow maximum precautions. The same should be done in ICU and wards where we have isolated COVID-19 patients. Till now despite several studies we have not been able to find any definite means of sterilizing these PPE.
Only after adequate sanitation. EPPs are essential for the protection of health workers. Article COVID-19 and Italian Healthcare Workers From the Initial Sac...
Reprocessing N95 masks
According to this JAMA review article, N95 facemasks can be reused if properly reprocessed:
https://jamanetwork.com/journals/jama/fullarticle/2777342
