enabling people - fix the covid masks for health care workers

For those working at the COVID front line, respiratory protection is essential. In the USA, the official number of deaths for healthcare workers is difficult to determine, however, the CDC estimates that healthcare workers constitute 11% of the infections representing 90,000 infections and more than 500 deaths.

It is not unreasonable to set an expectation that no healthcare workers are infected as a function of their work. Infection is entirely preventable, given the right protective equipment and infection control procedures are maintained.

A key infection issue has been the lack of effective respiratory protection. Where workers are exposed to the active virus, positive pressure respiratory protection should be the norm. Every effort should be made to meet this standard. Given the nature of a pandemic, this may not be possible to achieve in the present context. The question has to be posed as to why this is not the normal state of operation for work with all highly infectious conditions where there is aerosol or droplet pathway?

The challenge therefore becomes what is a reliable alternative that can be achieved in the current state?. In many situations, the only protection that has been available is disposable ASTM level surgical masks. These masks are not reliable in protecting the wearer, rather, they are designed to protect the patient from potential airborne contagion expired by their treating clinicians.

ASTM-level surgical masks have a sub-micron particulate filtration efficiency of 0.1 microns is ≥95%. The problem is, they don’t seal tightly to the wearer's face. This puts the wearer at risk of viral inhalation. 

In such circumstances, we need to engage people as a solution to harness, employing their knowledge, creativity and ingenuity. For masks, a great example of this principle is the Fix the Mask initiative. Fix the Mask have designed simple modifications that transform the ASTM level surgical mask into to meet the N95 respiratory protection standard. Fix the mask have released two modifications as open-source design. Fix the Mask are working through the NIOSH testing criteria, but this should not stall the sharing of this solution.

As safety experts, we need to encourage and support this initiative, as it has the potential to save health care worker lives. It is not enough to restrain solutions until all administrative hurdles are cleared, where there is a clear benefit for improvement in progress.

Jurisdictions need to establish respiratory protection standards for healthcare personnel working in these contagious conditions. The standard needs to address the different healthcare contexts:

• Treating coronavirus patients

• Working around coronavirus patients (support personnel)

• Primary healthcare services

• Working around potential coronavirus patients (eg Quarantine activities)

• Testing for coronavirus

Clear standards need to be established, that are not diluted to meet competing agendas. If the HWS obligations were applied to the conditions above, work would have to cease. It is a reasonable question to ask as to why should coronavirus work be any different from any other occupational hazard control standard and practice?