•
Shortly after
the pandemic
was recognized
as a potential
threat as well
as the emphasis
placed on the
size of COVID-19
droplets and the
ability to settle
on surfaces,
disinfectant
products
became difficult
to obtain as
the demand
outweighed the
supply.
that masks must be discarded if they are
visibly soiled, damaged or become moist/
wet as they will not function effectively.
OSHA (29 CFR 1910.134) requires a
medical evaluation, fit-testing and training
prior to use of N95 masks performed
initially (before the employee is required
to wear the N95) followed by annual
fit testing prior to COVID-19. However,
OSHA did provide Temporary Enforcement
Guidance in response to COVID-19 and
despite the temporary guidance, challenges
with lack of availability of appropriate
sizes for staff members and short supply
of solution for the fit-test kits continues.
A self-administered seal check should be
performed before donning the masks.
Additional FFRs have been authorized
by NIOSH for use including, but not
limited to, “Surgical N95 respirators” and
Powered Air Purifying Respirators (PAPRs).
PAPRs do not have to be fit-tested. Lastly,
hospitals have turned to reusable elastomeric
non-powered air-purifying half
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facepiece (half mask) manufactured to be reused, which has
distinct advantages. They also need a fit-test prior to first use.
Disinfectant Product Shortage
Coronaviruses are enveloped viruses and hence are
extremely easy to kill using the appropriate disinfectant. Novel
coronaviruses are unable to achieve a viral claim in a short
amount of time and usually companies take a year or more to
complete testing. Due to the length of time it takes to achieve
this claim, the U.S. developed a policy based on a hierarchy
for companies, meaning that if a product is effective against
“harder to kill viruses, it is likely to kill COVID-19.” Harderto-kill
viruses encompass the non-enveloped group,including
norovirus, poliovirus, rhinorvirus, feline and reovirus.
Shortly after the pandemic was recognized as a potential
threat, as well as the emphasis placed on the size of COVID-19
droplets and the ability to settle on surfaces, disinfectant
products became difficult to obtain as the demand outweighed
the supply. This included online and in-store purchases as well
as manufacturers and distributors running out of product.
In response to the importance of surface disinfection
and product shortages, the Environmental
Protection Agency (EPA) developed an extensive
list of products shortly after COVID-19 was
exponentially spreading. Known as the EPA’s
“List N: Disinfectants for Use Against SARS-
View List N
CoV-2 (COVID-19), it is constantly updated,
and new products are being added. Facilities
are encouraged to check the list regularly.
Hospitals continue to face shortages of disinfectant wipes
and liquid with no immediate “return to normal” for availability
of supplies. Manufacturers are developing creative strategies
to provide product to healthcare facilities as a priority. The
public has very limited access to supplies on shelves, with
a one-per-person limit in most stores. Online purchase of
products are prioritized for healthcare facilities only and the
public does not have access to them.
Extreme shortages are occurring in non-acute care-based
healthcare facilities at a higher rate than acute care hospitals.
The primary reason in the non-hospital- based facilities is due
to the product manufacturers prioritizing distribution based on
previous use. Acute care hospitals use disinfectants on a much
larger scale than non-acute based facilities. Manufacturers are
reviewing order history together with supply when determining
which facilities receive products and the quantity allocated.
Conclusion
Five months into the pandemic, with record numbers of
cases appearing in many states and no end in sight, infection
prevention challenges will continue to arise. It is incumbent
upon us as healthcare providers, to face these hard times with
strength, skill and perseverance as we continue to work at
providing the support, strength and structure to our colleagues
and patients.
Phenelle Segal, RN, CIC, FAPIC, is president of Infection
Control Consulting Services.
12 august 2020 • www.healthcarehygienemagazine.com