As the topic is trending on Twitter, it is becoming more apparent that nurses and doctors are relying on a false-sense of security they learned through nursing and medical school… respirators.
When you are in the medical or emergency medical services, you learn about “universal precautions”. It’s basically a universal guide that healthcare workers use to keep safe on the job and to prevent cross-contamination between the dozens of patients that may have in their patient ratios. Universal precautions is pretty simple, wash your hands before and after each patient contact, treat all bodily fluids as if they are infectious, etc… but then there are three additional levels of precautions.
Contact Precautions – Typically this type of precutions is used for MRSA patients, wound-care, etc… and consist of a single pair of gloves, and an isolation gown.
Droplet Precautions – This is used for diseases that are spread by droplets exhaled, and typically is found being used for when a patient has the flu. A surgical mask is worn, in addition to gloves, and isolation gown, and typically goggles. In some facilities, shoe covers and a hair net may be required to prevent cross-contamination. Usually, this equipment in addition to contact precautions is used to not directly protect the healthcare worker, but usually to prevent spreading the disease from one patient to another.
Airborne Precautions – One of the strictest precautions is airborne. This set of equipment is rarely used, and is mainly for cases of chicken pox, shingles, and tuberculosis. It means that when a patient coughs or sneezes, the infectious particles are too small for a surgical mask to block, so a fit-tested N95 mask is worn, in addition to the above equipment. I is imperative that all users are tested for a tight-seal of the different size face masks to prevent exposure to an infectious airborne disease.
The issue that comes into play is whether COVID-19 is airborne, or droplet. On the CDC.gov website, it lists the coronavirus as “respiratory droplets”, which one may assume is droplet-based. This is most likely correct until you introduce intubation or another series of aerosol-generating procedures, like CPAP or BiPAP (ventilator).
The coronavirus in itself is around 10 microns big, which is why surgical masks are being given to patients, visitors, and staff to wear during their whole stay and shift. This universal masking procedure helps the internal spread of the disease tremendously.
An issue comes up is whether N95’s work for healthcare workers at all, or whether surgical masks are better. In theory, one may think N95’s are the better mask overall but there are several reasons why this is false, one of which being that it simply cannot protect against COVID-19. When a patient is being intubated by the respiratory department, super tiny aerosol particles are being exhaled by the infected person. These particles have been seen as small as 0.05 micron, but not above 0.125 microns.
The size of this virus is important because N95 masks ONLY protect as small as 0.3 micron, which means everyone in the room during intubation will likely become infected.
A powered air-purifying respirator (PAPR/CAPR) is the ONLY device designed to protect healthcare workers when dealing with viruses this small, which is why bio-safety level 3 labs utilize these respirators.
Staff members have been complaining for days on social media platforms that they can barely breathe in surgical masks, let alone N95’s. Nurses are already starting to take their masks off around patients because it is hard to breathe in a 3-ply surgical mask. If nurses are given N95’s, they will almost likely never wear them because they are not used to the endurance required to breathe through one of these masks for extended periods of time.
In addition, surgical masks are easier to produce, are more cost-efficient, and allows for healthcare workers to change them between patients more frequently than a single N95 that may have to be reused for 5-21 days.