Use N95 Masks for All COVID-19 Inpatient Care. Period.

Healthcare professionals caring for COVID-19 sufferers ought to put on N95 respirators always, versus medical or surgical masks, researchers argued, as N95 masks supply superior — not simply comparable — safety.

Numerous organizational pointers agree N95 respirators needs to be worn for aerosol-generating procedures for COVID-19 sufferers, however present proof signifies N95 respirators needs to be used for all elements of COVID-19 inpatient care, wrote Harry Peled, MD, of St. Jude Medical Center in Fullerton, California, and colleagues.

“Guideline recommendations that do not support N95 use for all inpatient COVID-19 management should consider reevaluating the existing data or at least acknowledge the issues raised,” they argued in an opinion piece in Annals of Internal Medicine.

They detailed how N95s are superior to medical masks, writing that N95 respirators “achieve better filtration of airborne particles than medical masks if used properly and continuously.”

Peled and colleagues then pointed to prior analysis that has helped to form insurance policies about N95 respirators in contrast with medical masks, most of which focused on influenza transmission. They famous a number of of those research “mixed outpatient and inpatient data” that underestimated the advantage of N95 respirators in inpatient settings. Moreover, present pointers don’t take note of evolving proof about aerosol transmission of SARS-CoV-2, the virus that causes COVID-19.

“It is apparent that the risk for [healthcare worker] infection is related to duration and magnitude of exposure,” the authors wrote. “A COVID-19 inpatient unit with multiple patients coughing and breathing will have far higher exposure to droplets, re-suspended droplets, and aerosols than an outpatient setting.”

Rather than pointers “based on inappropriate extrapolation of studies,” the authors advisable extra analysis to guage COVID-19 transmission within the inpatient setting. Specifically, they pointed to an ongoing randomized scientific trial the place researchers are particularly evaluating N95 respirators versus medical masks for COVID-19.

The authors then famous the “dilemma of healthcare administrators,” who need to work inside these pointers, which have claimed medical masks are acceptable for non-aerosol producing procedures in COVID-19 sufferers. They advisable industry-level modifications, corresponding to allocating assets to provide extra N95 respirators, including they’re cheaper “over a wide range of reasonable assumptions.” This would stop healthcare professionals from having to work with “substandard protection,” they stated.

“Use of N95 respirators to protect [healthcare workers] should not merely be a preference or a recommendation based on availability,” the authors concluded.

  • Molly Walker is an affiliate editor, who covers infectious ailments for MedPage Today. She has a ardour for proof, knowledge and public well being. Follow


Peled and co-authors disclosed no related relationships with {industry}.

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