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Falling short, AIIMS tells staff to use N-95 masks at least 4 times

April 08, 2020 05:53 AM


Falling short, AIIMS tells staff to use N-95 masks at least 4 times
Anonna Dutt

New Delhi : The All India Institute of Medical Sciences (AIIMS) New Delhi has asked its staff to reuse their N-95 respiratory masks at least four times in order to make their quota of the gear last longer, bringing into focus fears of shortage of personal protective equipment (PPE) that is crucial for front line health care workers tending to coronavirus disease (Covid-19) patients.

The direction, issued through a circular released on Tuesday, was followed by a set of guidelines that appeared to acknowledge that the reusing was not ideal, while at the same time telling staff how the devices must be disinfected after each use.

“It is imperative that in accordance with evidence-based scientific literature, these N-95 masks are to be disinfected by individual users (by keeping them in open after use or by other methods) and re-used at least four times each, whereby these will suffice for about 20 days,” it said.

Doctors and nurses at the country’s premier medical institute are allotted a particular quota of PPEs, which in the case of N-95 masks is five. With an average shift lasting 8-12 hours, the guidelines suggest they reuse each mask four times to last a total of 20 days.

“We will shortly share the protocol for disinfecting the masks with everyone; N-95 masks do not need to be thrown away after one use,” said Dr DK Sharma, medical superintendent of the hospital, before the conflicting guidelines were issued.

Doctors at the institute slammed the directive. “We have been writing to the administration about the shortage of PPE and N-95 masks since March. Not only have we not received any concrete answers on how they are dealing with the shortage, they have now issued guidelines for using the masks four times. How is a doctor supposed to carry the infected mask home? How are they individually supposed to disinfect it? This should happen at the hospital level to curtail the spread of. the infection and even then only when there is no other option available,” said Dr Srinivas Rajkumar T, general secretary of Resident Doctors’ Association at AIIMS.

The guidelines later released by AIIMS said: “Currently, decontamination of PPE for purposes of reuse is not recommended, primarily because of concerns that decontamination would degrade the performance especially of the respirator”.

But, the document went on to say, “as an extraordinary last resort method in the event of imminent shortage of PPE”, the devices must be disinfected in bulk: the PPE is to be collected in ‘red bags’ used for biomedical waste, hung on a clothesline in a sealed room, and decontaminated using diluted hydrogen peroxide vapour.

“The circular does not clarify whether the same will be applicable for people working in the Covid-19 wards and those screening the patients for respiratory symptoms – as they are at a higher risk of carrying the disease home with the masks. If we are at this stage even before community transmission has begun, what will happen when there is a deluge of patients? This will take active doctors out of duty,” said Dr Srinivas.

Similar directions have been issued by the United States’ Centers for Disease Control, but that has come after many American hospitals reached near-capacity

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