Right now, there are millions of reusable elastomeric respirators in homes and businesses across the United States. Some are just sitting on shelves and gathering dust. Most already have the right filter cartridges needed to protect healthcare workers from COVID-19. Replacement filters are generally available, even at this late hour of our need.

Hospitals around the country are running out of N95 disposable respirators that healthcare workers rely on to protect themselves from the SARS-CoV-2 virus. These respirators allow healthcare workers to stay on the job and continue to provide care to patients.

During this pandemic, every healthcare worker counts.

There has been much discussion about the critical need for protective respirators for healthcare workers, but very little discussion has focused on one specific kind of respirator that could be crucial during this pandemic:

Reusable elastomeric respirators.

Reusable respirators can last for years. Filter cartridges have been used for up to one year in a US hospital setting (1). The protection that reusable respirators give is at least as good and can be even better than the disposable respirators they replace. They are not commonly found in most hospitals, but some US hospitals do use them (1).

Reusable respirators are inexpensive, costing around $30 each, including filters. They can be cleaned and sanitized repeatedly (2). They do not need any batteries. And most importantly:

Every healthcare worker in America could be issued one respirator and one set of filters that could last them an entire year.

Right now, there are numerous reports from hospitals that disposable N95 respirators are in critically short supply, or even worse, they have already run out. Some healthcare workers have reported rationing, being issued one disposable respirator for an entire week, even for providers at the highest risk, working in intensive care units filled with very sick COVID-19 patients.

Disposable N95 respirators are generally used for no more than eight hours and then thrown away (3). They are not designed to be cleaned and attempts to clean them may damage their ability to protect the user (4,5). The situation right now is so dire that some healthcare workers are resorting to unapproved methods to attempt to clean and reuse respirators that were never meant to be used in this way.

Healthcare workers and hospitals are most familiar with disposable respirators because that is what hospitals usually provide. There are estimates that one healthcare worker can use up to 20 disposable N95 respirators per day when used as intended (1). That level of use is unsustainable during a pandemic. It is estimated that at least 3.5 billion N95 disposable respirators are needed during the COVID-19 pandemic (6). Part of the reason that so many are needed is because they are disposable and not designed for reuse.

If careful consideration is made to properly train workers on reusable respirators, ensure that they fit well, and support regular cleaning, then reusable respirators could help provide nearly indefinite protection for our healthcare workers during this pandemic (7).

Every nurse, every respiratory technician, every attending physician, every resident, every intern, every patient care technician, every EMT, every paramedic, and every other healthcare worker that is on the front lines fighting this pandemic deserves proper PPE.

Reusable elastomeric respirators may hold the key to solving this critical need.

References:

National Academies of Sciences. Reusable Elastomeric Respirators in Health Care: Considerations for Routine and Surge Use. 2019. Free PDF available at: https://www.nap.edu/…/reusable-elastomeric-respirators-in-h…
Lawrence, C. et al. Assessment of half-mask elastomeric respirator and powered air-purifying respirator reprocessing for an influenza pandemic. Am J Infect Control 45, 1324–1330. 2017. https://www.ncbi.nlm.nih.gov/pubmed/28844381
CDC. Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings – NIOSH Workplace Safety and Health Topic. 2020. https://www.cdc.gov/…/hcwcon…/recommendedguidanceextuse.html
3M. Disinfection of Filtering Facepiece Respirators, Technical Bulletin. 2020. https://multimedia.3m.com/…/disinfection-of-disposable-resp…
Occupational Safety & Health Administration (OSHA). Guidance on Preparing Workplaces for an Influenza Pandemic. 2009. https://www.osha.gov/Publications/influenza_pandemic.html
Whalen, J. Change in U.S. law will make millions more masks available to doctors and nurses, White House says. The Washington Post. 2020. https://www.washingtonpost.com/…/change-us-law-will-make-m…/
Mason, D. J. & Friese, C. R. Protecting Health Care Workers Against COVID-19—and Being Prepared for Future Pandemics. JAMA Health Forum 1, e200353–e200353. 2020. https://jamanetwork.com/ch…/health-forum/fullarticle/2763478
Disclosures: No conflicts.

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