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Covid is Airborne- Surprised? Nope....

MeganMN specializes in Emergency Room.

Just saw this article today, among others, from the University of Minnesota Center for Infectious Disease Research and Policy:

Global experts: Ignoring airborne COVID spread risky

This is one of the many reasons that I was anxious from the very beginning of this.  Most of the data out of China was showing that it WAS airborne, and then we were given no protections and the CDC did not back it up.  So now what?  Our hospital was having all nursing staff wear N95 masks (albeit the same one all day) for all patient encounters, and now they have gone back to surgical masks.  The shortage still does not seem to be any better for the N95 situation.  So now what?  Your thoughts appreciated!

I believe it's possible for SARS-CoV-2 to spread through airborne particles.  The question is how likely are those particles to cause infection.  Assuming everyone is wearing at least a cloth or surgical mask, the mask is going to stop a lot of those particles.  So assuming some get through the COVID patient's mask, will enough get on another person's surgical mask and get through it, to cause infection?  I think in most public settings, like a grocery store, the risk of transmission via airborne particles remains extremely low.  Not out of the realm of possibility, but low enough that I don't feel like I need to wear an N95 in daily life. 

Obviously, in a hospital setting we are at higher risk.  On COVID floors, we have patients who are in the peak of their symptoms, possibly generating additional airborne particles while coughing or sneezing.  We are in small spaces with poor ventilation (how many negative airflow rooms do we really have for COVID patients?), and we're getting close to our patients for necessary care.  So in those cases, we should all have N95 masks and face shields.  

But for other routine patient care interactions, I think regular surgical masks are fine.  That's assuming your hospital is doing its due diligence in screening patients as they come through.  At my hospital, everyone gets a rapid COVID in the ED.  If they test negative, but have any COVID-like symptoms, have known COVID exposure, traveled to a hotspot, or live in a group care situation, they go to the rule-out floor (where we do full COVID PPE), and they get the sunrise COVID test that takes 24-48 hours to come back.  After two negatives, most will be moved to another floor.  However, some won't ever be moved to a "clean" floor, even after testing negative twice.  They become a PUM (person under monitoring), which usually means we're being extra careful because they came from a facility with known COVID cases.  Because of all that, I feel pretty secure with just a surgical mask if I'm on a "clean" floor.

 

Edited by turtlesRcool

Nurse SMS specializes in Critical Care; Cardiac; Professional Development.

I think we are so far into this that the point is honestly moot. We have widespread community transmission. This virus is in control and the horse is out of the barn.

I am an RN who works at 2 hospitals. Patients are being admitted for medical conditions such as elective surgeries, MI's, trauma's etc. They are being tested for Covid 19 upon admission and then are sent up to the various floors pending the test results (Med Surg, ICU, PCU). Unfortunately, some of these patients test results come back positive. This means that the nurses on these floors have been working with covid positive patients for multiple shifts without the proper PPE (just a blue surgical mask)....as sometimes it has taken days before the test results come back.

 

One of the hospitals I work at does not allow us to bring in our own masks. My work around this is I bought some KN95 masks. I wear one of those KN95 masks and put a blue surgical mask over it. Management hasn't had an issue with this because I'm still complying with their requirement to wear one of their blue surgical masks. Some versions of the KN95 mask are being sold online that are not FDA approved. Anyway, I found a website that does not price gouge and their masks are FDA approved. In addition, they also sell the face shields and blue surgical masks. I am hoping this info will help my fellow nurses/healthcare workers and give them some piece of mind. The website is www.cleansense.us

 

 

MeganMN specializes in Emergency Room.

@telenurse2009 thanks so much! I may order my own face shield as well as masks, I was reading through my facility changes and they are now transitioning to surgical masks for all day use. so not only are we 're-using N 95 masks, but are now going to be re-using surgical masks all day. Ick. Thanks so much!

MeganMN specializes in Emergency Room.

@telenurse2009 I have a stash of old N95 masks (about 50 of them). I am trying to decide if I should use them at work. I was okay with the idea of keeping an n95 all day, but I am just not sure about doing the same with a surgical mask.  Am considering my own n95 under a surgical mask..... Hate that we even have to deal with this stuff....

I do not know how a hospital administrator is supposed to address this news— it seems like game over from a management perspective. Nobody has enough supplies and isolation rooms for a virus that is officially airborne and may also be asymptomatic. For example, my work is an FQHC. We are a huge building; we have two negative pressure exam rooms.  How are they going to handle the enormous flood of lawsuits from staff and patients who say they weren’t adequately protected from this airborne disease?  Every incoming patient identifies himself as having been “possibly exposed to Covid” because, (as the prior commentor posted) with high levels of community spread, everyone has been exposed and everyone is suspected of having it. Where exactly are we supposed to put people who are “under investigation” for Covid, when that is half the people who walk in the door?

herring_RN specializes in Critical care, tele, Medical-Surgical.

Your Mask Cuts Own Risk by 65 Percent

A range of new research on face coverings shows that the risk of infection to the wearer is decreased by 65 percent, said Dean Blumberg, chief of pediatric infectious diseases at UC Davis Children’s Hospital. “On the issue of masks, I’d like to restart — because we’ve learned a lot,” Blumberg said. “We’ve learned more due to research and additional scientific evidence. What we know now is that masks work and are very important.”...

...   There are two primary methods of transmission, they said. The first is via droplets a carrier expels, which are about one-third the size of a human hair but still large enough that we can see them. Masks create an effective barrier against droplets. “Everyone should wear a mask,” Blumberg said. “People who say, ‘I don’t believe masks work,’ are ignoring scientific evidence. It’s not a belief system. It’s like saying, ‘I don’t believe in gravity.’ 

“People who don’t wear a mask increase the risk of transmission to everyone, not just the people they come into contact with. It’s all the people those people will have contact with. You’re being an irresponsible member of the community if you’re not wearing a mask...

...   The second major transmission method is via the aerosol particles we expel when we talk. Those are about 1/100th the size of a human hair and are more difficult to defend against. Social distancing and staying outdoors, where there is more air flow, are helpful, Blumberg and Ristenpart said.

“Studies in laboratory conditions now show the virus stays alive in aerosol form with a half-life on the scale of hours. It persists in the air,” Ristenpart said. “That’s why you want to be outdoors for any social situations if possible. The good air flow will disperse the virus. If you are indoors, think about opening the windows. You want as much fresh air as possible.”

This is why, he said, places like bars are particularly hazardous for aerosols, on top of the likelihood of minimal distancing. “The louder you speak, the more expiatory aerosols you put out,” he said...

...   Both scientists said the evidence has become even more powerful for wearing masks and social distancing. For instance, research shows that about 30 percent of infections are caused by people who do not know they have COVID-19 because they are asymptomatic or their symptoms have not appeared yet.

“So we don’t know who might spread it,” Blumberg said. “We do know social distancing reduces the risk of transmitting the virus by 90 percent, and wearing masks decreases the risk by 65 percent.

“Wearing a mask affects everyone,” he said. “If you care about your family or friends, or if you care about your community, wear a mask.”...

https://www.ucdavis.edu/coronavirus/news/your-mask-cuts-own-risk-65-percent/

Quote

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis

https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext#seccestitle10

 

It's why I went out and got my own KN95 masks to protect myself and not rely on management and their decisions. I always believed this was airborne and that the blue surgical masks would not be enough. A while back, a friend sold me some N95 masks for $5 a mask....her husband got them from China and unfortunately they did not pass the fit test for me....plus those ones were big and clumsy, they weren't from 3M.

The KN95 masks I found at www.cleansense.us fit me better, are FDA approved, and they are at least one step up from the  blue surgical masks, as far as protection goes, and they fit well underneath the blue surgical masks (as one of the hospitals I work at has a policy about having to wear the masks they provide, so I wear the KN95 underneath the blue surgical mask). 

5 hours ago, CommunityRNBSN said:

I do not know how a hospital administrator is supposed to address this news— it seems like game over from a management perspective. Nobody has enough supplies and isolation rooms for a virus that is officially airborne and may also be asymptomatic. For example, my work is an FQHC. We are a huge building; we have two negative pressure exam rooms.  How are they going to handle the enormous flood of lawsuits from staff and patients who say they weren’t adequately protected from this airborne disease?  Every incoming patient identifies himself as having been “possibly exposed to Covid” because, (as the prior commentor posted) with high levels of community spread, everyone has been exposed and everyone is suspected of having it. Where exactly are we supposed to put people who are “under investigation” for Covid, when that is half the people who walk in the door?

This. Exactly. It's a nightmare with no end in sight.

Jackdaniels80 specializes in Cardiac PCU.

I am having issues with my face sweating with a mask on for 12 hours. I have broken out and have trouble breathing. I walked 18,000 steps during one shift at hospital, my mask gets wet from sweat. Any advice on dealing with this issue?

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