A new system for decontaminating large quantities of N-95 respirator masks—perhaps the most in-demand piece of equipment in the era of coronavirus—could offer stressed-out hospital workers some peace of mind as they have been increasingly asked to reuse or just keep wearing personal protective gear once considered single-use.
Researchers at the nonprofit Battelle Memorial Institute in Ohio have developed the Critical Care Decontamination System, a machine that can decontaminate 5,000 N-95 masks in a single cycle. Two of these units—which are housed in shipping containers— are being installed at Stony Brook University Hospital on Long Island this week, with a total of eight available. Other locations may soon have access to the machines as well, a Battelle spokeswoman told Newsday.
“The shortage we’re all reading about in the news is very real, so that’s why this system is so important,” said Kevin Good, a senior research scientist at Battelle. “As long as [N-95 masks] come back to us in good condition, meaning no tears, no punctures, no holes, no soiling, no makeup, we’re able to decontaminate them and get them back into the health care system.”
The decontamination process involves coating the masks in “a thin layer, a micro-condensation of hydrogen peroxide, in order to kill any viruses or other materials that might be on there,” Good explained. He noted that in order to achieve micro-condensation, the environmental conditions have to be just right, meaning that changes in the temperature or humidity could affect how long a decontamination cycle takes.
“We’re confident in our method and our process,” Good said.
The method was only fully approved by the FDA on Sunday, after Ohio Governor Mike DeWine intervened. The FDA had initially only approved the machines to decontaminate 10,000 masks (per machine) a day; now each machine will be allowed up to 80,000 masks a day.
While some hospitals already have their own methods of disinfecting masks, they generally don’t operate on this scale. For instance, Mount Sinai South Nassau, which hopes to gain access to the machines at Stony Brook, currently sends 300 masks at a time to Oregon for sterilization with ethylene oxide, a process that takes several days.
Battelle did not respond to a request for comment on whether other hospitals are already in talks about using these machines. The New York State Nurses Association is skeptical about these type of techniques. "Nurses need and deserve new equipment every time they care for a patient," said NYSNA health and safety expert David Pratt. "This is a diversion and a sideshow. Frontline healthcare workers need the equipment that will keep them and their patients safe. We have not found a system that fully works without compromising the mask. The best science says they cannot be safely cleaned and decontaminated."
Inside a decontamination unit
New York City’s Health Department issued guidance Tuesday on how to safely reuse or extend the use of PPE, noting that N95 masks can be reused “if they remain functional.”
“Between use, N95 respirators should be stored in a clean paper bag and labeled with the provider’s name,” the city suggested.
In a memo to health care providers Wednesday, the New York City Department of Health and Mental Hygiene made it clear that, even with additional supplies coming in, hospital workers must continue to ration PPE for now in order “to slow the burn rate of these important supplies.”
“Recommended measures to conserve PPE are different than how we use this equipment during non-pandemic times,” Dr. Demetre Daskalakis, the Health Department’s deputy commissioner of disease control, conceded in Wednesday’s memo to health care providers, “but are now necessary to maintain availability of this equipment to care for patients.”
The guidance has been jarring to hospital workers.
“When I was in medical school, if a nurse saw you in the hallway with gloves on, you got screamed at— because as soon as you leave someone's room, you're supposed to throw those gloves away,” a frontline health care worker at SUNY Downstate Medical Center, who declined to use his name because he was not authorized to speak to the press, told Gothamist. “Now, we're going fully gowned in PPE through staircases and multiple different hallways.”
This week, a doctor who was later identified as an obstetrician-gynecologist resident at Montefiore Medical Center revealed in a tweet that she had been handed a Yankees rain poncho to use as PPE.
This story has been updated to reflect a comment from the New York State Nurses Association.
A nurse at NewYork-Presbyterian Brooklyn Methodist Hospital said she worries that reused N-95 respirator masks, in particular, are not providing the protection she needs when treating patients with coronavirus.
“Reusing things is just disgusting,” she said. “I’ve heard people say they think they got [coronavirus] because they reused a mask.”
Additional reporting by Dylan Campbell
