CHA – Children’s Hospital Academic Medical Organization
CHA-20-011 – Addressing the shortage of N95 and surgical facemasks during COVID-19
At the beginning of the COVID-19 pandemic, I recognized the potential for our hospital and other health institutions in our community to run out of Personal Protective Equipment (PPE) and advocated for the development of a PPE innovation committee at our hospital (CHEO) to explore and develop solutions. Leveraging our research experience and the insightScope systematic review crowdsourcing platform developed by our team, we rapidly completed four systematic reviews evaluating the available literature on decontamination of N95 and surgical masks. These four systematic reviews (listed below) were completed in an average 2-week time period from protocol preparation to completed manuscript, placed on Open Science Framework (OSF), and subsequently all published in the Journal of Hospital Infection.
• Decontaminating N95 masks with Ultraviolet Germicidal Irradiation (UVGI) does not impair mask efficacy and safety: A Systematic Review – Completed in 7 days, 3460 downloads from OSF, cited 36 times
• Efficacy and Safety of Disinfectants for Decontamination of N95 and SN95 Filtering Facepiece Respirators: A Systematic Review – Completed in 16 days, 1160 downloads from OSF, cited 14 times
• Microwave- and Heat-Based Decontamination of N95 Filtering Facepiece Respirators: A Systematic Review – Completed in 11 days, 1078 downloads from OSF, cited 15 times
• Decontamination Interventions for the Reuse of Surgical Mask Personal Protective Equipment: A Systematic Review – Completed in 19 days, 507 downloads from OSF, cited 15 times
This work was quickly identified and requested by multiple government agencies inside and outside of Canada to inform policy recommendations (Ontario Health, Public Health Agency of Canada, Office of the Chief Science Advisor, etc.). Further, the systematic reviews were highlighted by COVID-END as the prominent source of evidence on this topic. This work received considerable local, national, and international media attention (Ottawa Citizen, CBC, MacLean’s magazine, National Post – USA, New York Times – USA, The Guardian – UK). CHEO used our findings to develop and implement an in-house process for mask collection and decontamination, which was used to create a repository of hundreds of decontaminated masks for insurance purposes. In collaboration with the Perley Rideau Health Centre, our team then performed a double-blind randomized controlled trial in 57 health care workers to evaluate mask fit following three decontamination methods (analysis in progress).
Finally, recognizing the need for a high-performance reusable mask, we partnered with Ecoequitable and Dessuis Consulting to develop a reusable facemask that meets ASTM specifications for a consumer mask, called The Ottawa Mask.
• Particle Filtration: While ASTM set >50% as the ideal target, filtration for The Ottawa Mask is 88% new and stays above 70% after 30 launderings.
• Fit testing: While evaluating particle penetration due to passage through & around the mask, The Ottawa Mask (14%) was equivalent to medical grade surgical masks in use at CHEO (17%).
Importantly, The Ottawa Mask is safe to reuse making it environmentally friendly (testing shows ~75-80% filtration efficiency after 50 wash cycles). Another key aspect of this project was the development of masks suitable for children and youth. In April, 2020, we scaled up production of The Ottawa Mask to make it available for the broader Ottawa community and sold 10,000 units as a fundraiser for CHEO, ultimately raising 15 K.
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