ICCS COVID-19 Update: KN95 Masks, Steris EUA, CDC Guidance

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.

ICCS COVID-19 Update: Shortage of Face Protection

Infection Control Consulting Services (ICCS) continues to update clients as this highly fluid pandemic evolves. This week's update includes caring for COVID-19 patients in your facility (now and future) with the main focus on critical issues related to the shortage of face protection.

ICCS recommends reviewing the following resources:

• Recommended Guidance for Extended Use and Limited Reuse of N95 Filtering Facepiece Respirators in Healthcare Settings — Access resource >

• Strategies for Optimizing the Supply of Facemasks — Access resource >

• Duke Starts Innovative Decontamination of N95 Masks to Help Relieve Shortages — Access resource >

• What Healthcare Personnel Should Know about Caring for Patients with Confirmed or Possible COVID-19 Infection — Access resource >

• Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings — Access resource >

• Aerosol Generating Procedures — See chart below

COVID-19: Debunking Potentially Dangerous Myths

Many myths as to prevention of and treatment for the novel coronavirus (COVID-19) infection are circulating and increasing in intensity. They serve no purpose except to cause confusion, potential injuries and even death.

The origins of these myths include a combination of old wives tales, self-made ideas due to lack of understanding of the virus itself, cultural beliefs and profit. The copycat syndrome is included in the spread of non-scientific information.

In addition to a list of myths released by the World Health Organization, which we strongly encourage you to review, the Infection Control Consulting Services (ICCS) team has been asked to comment on the following six myths.

1. Drinking alcohol can kill the virus. This is a myth and a potentially dangerous at that. The amount of alcohol ingested that would be needed for such a study is lethal and not a scientifically viable option.

2. Zinc lozenges can prevent the coronavirus and most other virus from multiplying in your throat and nasopharynx. The myth claims that it is "best to lie down and let the lozenge dissolve in the back of your throat and nasopharynx." This is a myth introduced by a pathologist and has no basis for prevention of any viruses, according to scientists. It is particularly concerning that anyone would advocate for sucking on a lozenge while laying down and running the risk of choking, besides the lack of evidence that zinc prevents any viruses from replicating.

3. COVID-19 causes a productive cough and drinking hot water will loosen the phlegm. This is a myth as hot water does not affect COVID-19. If the water is hot enough, it can burn a person. In addition, COVID-19 typically presents as a dry cough and not a productive cough.

4. Blowing a hairdryer up your nose will kill the viruses in your nose. This is a ridiculous claim and has no basis. Furthermore, an individual taking such an action runs the risk of burning themselves from the hot hairdryer.

5. Certain medications have been approved in the United States for treating COVID-19. This is a myth as, at the time of publication of this piece, there are no Food and Drug Administration (FDA)-approved medicinal treatments for this illness. Several trials are underway with a few medications. Unfortunately, information was released by the White House that has caused a nationwide shortage in an autoimmune condition medication, placing people with rheumatoid arthritis and lupus in jeopardy if they cannot obtain their medication. In addition, one person has died and their spouse hospitalized after they ingested large doses of a medication in a different form.

6. Silver kills the coronavirus within 12 hours. This is a myth peddled by at least one televangelist who also claimed that his "Silver Solution" strengthened the immune system. As the Mayo Clinic notes, "Colloidal silver isn't considered safe or effective for any of the health claims manufacturers make. Silver has no known purpose in the body. Nor is it an essential mineral, as some sellers of silver products claim." While rare, excessive doses of silver can cause serious health issues. 

Reputable Sources of COVID-19 Information

ICCS stresses the importance of relying upon only healthcare-related updates, including those concerning COVID-19, issued by reputable organizations, including the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), Federal Drug Administration (FDA) and National Institutes of Health (NIH).