ANA: N-95 Respirator Shortage Unacceptable

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Hat tip H. Branswell's Tweet
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In a letter to the CDC, ANA expressed deep concern about shortages of the fitted N-95 respirators, the equipment CDC recommends as the minimum level of respiratory protection for health care workers who could be exposed to the H1N1 virus. Several state nurses associations have told ANA that nurses are indicating difficulties in obtaining the N-95 respirators on the job, and hospitals in their states are reporting shortages of the N-95 respirator.

ANA also questioned a strategy outlined by CDC whereby N-95 respirator use would be prioritized for health care personnel where shortages exist, leaving other workers to use facemasks. ANA said it is widely acknowledged that facemasks were not intended to be "personal protective equipment," calling facemasks merely a "better than nothing" device since they don't filter airborne particles and they do leak.

"Registered nurses want to come to work and do our jobs to take care of patients - we historically have put patients' needs ahead of our own," said ANA President Rebecca M. Patton, MSN, RN, CNOR. "So it's absolutely essential to have adequate protection from exposure to the H1N1 virus. If nurses get sick and can't come to work, who will take care of patients? It is reasonable to hold our employers accountable for providing necessary equipment to protect the safety of health care employees and our patients."

"Considering all the national planning that has taken place in the past few years to prepare to respond to a pandemic, it is inexcusable to be facing shortages of personal protective equipment at this stage," Patton continued. "Employers need to improve their commitment to support and protect RNs and all other direct health care workers so we can safely care for patients without putting ourselves and patients at undue risk and harm."

To read ANA's letter to the CDC, go to: http://www.NursingWorld.org/LetterToCDC

Full article: http://www.medicalnewstoday.com/articles/169519.php

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Re: ANA: N-95 Respirator Shortage Unacceptable

Spring of 2009:
The quantity of non-pharmaceutical interventions for pandemic influenza in the SNS, such as N-95 respirator masks and surgical masks, falls far short of what may be needed. As of the spring of 2009, the U.S. stockpile contained 105.8 million N-95 respirators and 51.7 million surgical masks. CDC reports that 25 million N-95 respirator masks were distributed from the SNS during the spring, reducing the nationally-available number of N-95s to 79.7 million. The SNS also contains 37.7 million surgical masks, which are not considered effective protection against H1N1. This is short of the number that many expertsbelieve would be adequate, but no action has been taken to replenish this supply and there are some questions if additional respirator masks are available due to limited availability.

http://healthyamericans.org/reports/h1n1/TFAH2009challengesahead.pdf

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May 2, 2009
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Prestige Ameritech is the only surgical mask manufacturing company in the United States.

More than 1 million will be made in one day inside Prestige Ameritech's manufacturing facility near Fort Worth, Texas.

For the first time in the company's history, it will be manufacturing masks 24 hours a day, seven days a week. orders for masks are coming in from around the world.

"Surgical masks are used in hospitals. They're not used in the general public," Bowen said. "So when the general public starts wanting face masks, the supply gets short really quickly."

He added: "If there's a pandemic, America won't be able to supply its own needs, because we're pretty much it."

The shortage of American surgical-mask manufacturers is a critical weakness in the country's ability to battle a pandemic outbreak, he said.

http://www.cnn.com/2009/HEALTH/04/30/swine.flu.masks/index.html

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May 19, 2009

The Department of Health and Human Services (HHS) says the nation would need more than 30 billion masks - 27 billion of the simple surgical kind, which can be worn safely for only about two hours before needing replacement, and 5 billion of the sturdier respirator variety, which also requires regular replacement - to protect all Americans adequately in the event of a serious epidemic.

But the Centers for Disease Control and Prevention (CDC) Strategic National Stockpile currently contains only 119 million masks - 39 million surgical and 80 million respirator. That's less than 1% of the goal health officials set in 2007 following the devastation of Hurricane Katrina, which highlighted the country's shortages of vital medical gear.

U.S. has 1 mask for every 3 Americans
Australia has 2.5 masks per resident
Great Britain has 6

http://www.time.com/time/health/article/0,8599,1899526,00.html?xid=rss-health

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June 2009 Stockpiling Supplies for the Next Influenza Pandemic

We used some of the assumptions made by FluSurge version 2.0 as follows: average length of stay (not in ICU) of 5 days per patient, an additional 10 days for those requiring an ICU stay, and an average time receiving mechanical ventilation of 10 days.

We assumed that sole use of disposable N95 respirators would be prohibitively expensive or otherwise not possible because of global shortages (14). Instead, we decided that staff with prolonged periods of exposure (e.g., physicians, nurses, respiratory technicians, selected housekeepers) would be issued and that just-in-time fit testing, a reusable elastomeric half-face mask with 3 sets of filters, would be used. We estimated that we would need ≈1,000 of these masks and reusable goggles for each 50,000 patients served (on the basis of the size and catchment population of one of our medium-size facilities). Disposable masks would be limited to the beginning of the pandemic and to personnel with infrequent exposure. Using these principles, we calculated the workload, supplies, and medication required to care for typical influenza patients. Accordingly, estimates were produced for the average needs of influenza patients requiring >1 types of services, including outpatient, inpatient medical ward, or ICU settings with or without mechanical ventilation.

One supplier of personal protective equipment indicated that shipment would be delayed by 6–9 months, affirming predictions of shortages of personal protective equipment. This experience underscored making purchases well in advance of the date when the items were expected to be used for patient care.

http://www.cdc.gov/eid/content/15/6/pdfs/08-1196.pdf