With the increased need for disposable N95 respirators, Bay Area hospitals have been trying to conserve equipment by decontaminating respirators for reuse — upsetting nurses on the front lines.
According to Centers for Disease Control and Prevention guidelines, disposable filtering facepiece respirators, or FFRs, are not approved for routine decontamination and reuse “as standard of care.” These procedures, however, may be considered to ensure facepiece availability as a crisis capacity strategy.
“Based on the limited research available, ultraviolet germicidal irradiation, vaporous hydrogen peroxide, and moist heat showed the most promise as potential methods to decontaminate FFRs,” the CDC guidelines webpage states.
Several medical institutions in the Bay Area have commented on the use of Food and Drug Administration-approved decontamination methods utilized at their institutions.
According to Amy Herr — a UC Berkeley professor of bioengineering and a member of research consortium N95 Decon, which seeks to provide scientific consensus on face mask sterilization methods — the CDC guidelines on mask reuse are not ideal but may be helpful when equipment grows scarce.
John Muir Health has been procuring personal protective equipment since the beginning of the pandemic and has a sufficient supply of N95 masks, according to John Muir Health spokesperson Ben Drew.
“At this time, we are simply proactively collecting used N95 masks for sterilization and reprocessing following the FDA approved guidelines in case there is an urgent need,” Drew said in an email. “Masks that have been reprocessed are not currently in circulation and will only be used in the case of a supply shortage due to a significant patient surge.”
Kaiser Permanente uses an FDA-authorized process to sterilize FFRs, according to Kaiser Permanente’s national infectious disease leader and spokesperson Dr. David Witt. The process includes using hydrogen peroxide at a low temperature, which has been proven to be effective at disinfection, Witt added.
According to UCSF spokesperson Kristen Bole, UCSF Health is not sterilizing masks for reuse at the moment.
National Nurses United, or NNU, a union and professional association of registered nurses in the United States, released a press release April 6 alleging that the decontamination of masks endangers health care workers. NNU urged the CDC to strengthen guidance to better protect health care workers on the front line of the pandemic, according to the press release.
The union remains opposed to guidelines issued by federal authorities that condone the use of hydrogen peroxide to decontaminate N95 FFRs. According to the press release, the safety and effectiveness of this method have yet to be adequately demonstrated.
“There is no validated, scientific evidence that multiple re-use or decontamination of N95 respiratory masks is safe, and will protect a health care worker from being infected when exposed to a patient with the virus,” the NNU states in the press release.