U.S. Pandemic Could Severely Strain Face Mask, Other PPE Supply Pipeline

The IOM committee examined various forms of respiratory protection and suggests that N95 filtering face-piece respirators that are NIOSH-certified and properly fit-tested are likely to provide the best protection against influenza to the extent that it may be spread via an airborne route. As well, the committee suggests a closely fitting, high-efficiency medical mask is likely to provide appropriate protection against droplets, whereas a surgical N95 will provide protection against both droplets and aerosols. The IOM report notes, “While recognizing the methodological and data limitations regarding the efficacy of medical masks as a form of respiratory protection against avian influenza, and in the absence of data to the contrary, the committee concluded that masks are likely to provide far less protection against aerosols than an N95 filtering face-piece but may offer better protection than cotton masks, homemade alternatives such as handkerchiefs and scarves, or no protection at all. No device is fail-safe, and its effectiveness depends on fit, level of exposures, and appropriate use. Finally, none of these devices protects against contact transmission, and appropriate hand hygiene is necessary when using and after removing these devices.”²

The IOM committee also acknowledges that during a pandemic, PPE usage may be far from ideal: “With adequate time and planning, stockpiling or ramping up production, or both, would ensure that there would be enough respirators or medical masks for all those who may need them, but with limited resources and time, supplies are likely to be insufficient. Thus, reality may require that disposable N95 respirators and medical masks be pushed beyond their approved uses in the hope that they can offer some level of protection beyond their intended limits of use. Moreover, individuals with no access to respirators or masks, even disposables, may feel driven to invent their own respiratory protection measures; for example, they may don woven masks not approved for medical uses in the United States, or use household items such as towels or sheets.”²

References:

1. Pandemic Influenza Plan of the Department of Health and Human Services. Accessed at: http://www.hhs.gov/pandemicflu/plan/

2. National Academies Press (NAP). Committee on the Development of Reusable Facemasks for Use During an Influenza Pandemic. Reusability of Facemasks During an Influenza Pandemic: Facing the Flu. 2006.

13. Chettle CC. Are you prepared for a flu pandemic? Available at: http://www.nurse.com/ce/anthology.html?CCID=4599&Chapter=3833&ChapNum=4

4. Gihring T. The pandemic prophecy. Minnesota Monthly. April 2006. Available at: www.minnesotamonthly.com/articles/pandemicProphecy.html.