For an update on some of the information discussed below, please see this post from May 11.

The COVID-19 pandemic continues to provide infection preventionists with unimaginable challenges. The biggest challenge is lack of continued implementation of “best practices” as they relate to use of personal protective equipment (PPE) and ventilators. Ongoing issues with lack of respirators (N95) and facemasks have also created significant chaos.

The Infection Control Consulting Services (ICCS) team is spending a tremendous amount of time monitoring ongoing updates at the federal, state and local levels. We are doing our best to share updates as they are presented, even if they do not align with traditional practices. We are fully aware that in a crisis situation, improvising and prioritizing while considering the safety of everyone is difficult and frustrating for our clients and all providers.

The following is a rundown of some recent updates concerning the novel coronavirus.

KN95 masks: Within the past two weeks, the FDA granted emergency use authorization (EUA) to several companies internationally, including China, to provide the U.S. with KN95 masks. Shipments are currently arriving. To view a list of KN95 EUA masks, click here.

ICCS has been informed of challenges with some of these masks, including them not fit testing properly. Fit testing kits are very difficult to obtain for facilities that have never needed to use them. Facilities with fit testing kits are finding it difficult to obtain the solution used to conduct the test. OSHA has not lifted its requirement for first time fit tests, but it has relaxed its annual requirements. In theory, if a KN95 respirator mask is used for aerosolized procedures (e.g., intubation, suction and nebulizer treatments), it must be fit tested.

At present, ICCS is suggesting that if you are unable to fit test the KN95 masks, use them in lieu of surgical masks and not for aerosolized procedures.

If a facility is going to perform seal fit checks, remind staff that they must not touch the mask before or after completing the test without washing/sanitizing hands. This process should be performed away from direct patient care. For directions on completing a user seal check, click here.

Steris EUA: The FDA has granted Steris an EUA, allowing the company to temporarily provide a distinct option to effectively decontaminate compatible N95 or N95-equivalent respirators up to 10 times using the non-lumen cycle of the V-PRO Low Temperature Sterilization System. Organizations with the V-Pro Low Temp autoclave will find the information in this link helpful.

CDC guidance: The CDC issued guidance late last week advising that critical infrastructure workers may be permitted to continue working to ensure continuity of operations of essential functions following potential exposure to COVID-19 provided they remain asymptomatic and additional precautions are implemented to protect them and the community.