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UVa adjusts guidance on masks in order to conserve supply

As Virginia faces a shortage of respirator masks, the University of Virginia Medical Center has recommended its staff use ear-loop masks to in order to conserve respirators.

Respirators can filter small particles from the air, according to the Centers for Disease Control, while simpler ear-loop masks protect against droplets, splashes and larger particles.

In an email sent Sunday, the hospital reiterated a requirement that staff use personal protection equipment, specifically gowns, gloves, eye protection and an ear-loop mask.

The use of ear-loop masks is a change from earlier Centers of Disease Control and Prevention guidelines, which encouraged the use of respirators — such as an N95 mask — instead of simpler face masks, in order to prevent contraction of the novel coronavirus.

Surgical masks — which do not filter contaminants and are designed to prevent the wearer from infecting sterile environments — were labeled an “acceptable alternative” in the absence of respirators by the CDC.

Eric Swensen, a spokesman for the hospital, wrote in an email to the Progress that respirators are being conserved for use during the care of elderly patients and for procedures that may generate aerosol, which pose the highest exposure risk to staff.

“Together with hand hygiene, eye protection, gowns and gloves, face masks only replace respirators for routine care, where large respiratory droplets (for example, due to coughing) can expose the mouths, noses and eyes of persons in close (less than 6 feet) proximity to persons infected with COVID-19,” Swensen wrote.

Swensen also cited a 2019 study published in the Journal of the American Medical Association that indicated facemasks are equally as effective as respirators in preventing the spread of viral respiratory diseases.

A March 2020 study also cited by Swensen and published in the Journal did not find the virus that causes COVID-19 in air samples of hospital rooms of patients with the virus but did find the virus on surfaces in the room before room cleaning.

Both studies were considered by UVa when it made its PPE recommendations, Swensen said.

UVa’s recommendations also follow an estimated $2.7 million order of respirator masks made by the state last week as part of its ongoing effort to respond to the growing spread of COVID-19, according to Virginia Mercury.

However, the state isn’t sure when the shipment will arrive. According to the Mercury, Virginia was one of dozens of states to place an order for the masks as the country scrambles to respond to the spreading viral outbreak.

The federal government has sent the state tens of thousands of respirators, gowns, gloves and other protective gear for health care providers, according to the The Associated Press, but it’s not enough, and it’s still not entirely clear what should be best practice for a disease experts are still trying to figure out.

Recent evidence suggests that transmission is linked to close contact with infected patients — the first known person-to-person transmission of COVID-19 in the U.S. was a woman who spread the disease to her husband after returning from travel in Wuhan, China.

“Viral droplets” from infected patients are also a concern, and health workers who come in contact with patients have been advised to wear N95 respirator masks.

The federal Food and Drug Administration has already issued guidelines to health care providers with strategies for conserving their supply.

Virginia Health Commissioner Dr. M. Norman Oliver said last week that the state of emergency declared by Gov. Ralph Northam would also allow the state to bypass federal restrictions on equipment, such as respirators, for medical providers.

Charlottesville has one confirmed case of the novel coronavirus; the woman is being quarantined at home, local officials said Monday. On Tuesday, state officials said there were 67 confirmed cases in the state.


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