Grassroots campaigns across the US are urging residents to sew face masks at home for the medical community and for your own family’s protection. The trend comes at a time when the stock of certified — the protective equipment used by health care workers fighting the — is critically low.
There’s just one problem: Handmade masks won’t be as effective at protecting you from the coronavirus, no matter how extreme the shortage of proven N95 masks. A self-made cotton mask certainly won’t harm you as long as you understand its limitations, but assuming it will shield you from, the disease caused by the coronavirus, could put communities at greater risk if you’re not following other protocols to keep safe.
While many argue that using a homemade mask is better than nothing, staying away from senior citizens andare more surefire ways to keep them safe. For people who don’t work in health care, staying home in or , frequently and and practicing appropriate are the best ways to lower the risk of exposure for you, your family and your community.
Global leaders and medical professionals ask that you please not buy N95 masks for yourself, so as to save them for the medical community that’s in desperate need. For example, Target has apologized for selling N95 masks amid the shortage.
If you do have a supply of N95 masks on hand, consider donating them to a health care facility or hospital near you. Here’s how toto hospitals in need — and why you should also .
N95 masks fit to your face and go through certification
N95 respirator masks differ from other types of surgical masks and face masks because they create a tight seal between the respirator and your face, which helps filter at least 95% of airborne particulates. They might include an exhalation valve to make it easier to breathe while wearing them. and be transmitted from person to person through vapor (breath), coughing, sneezing, saliva and transfer over commonly touched objects.
Each model of N95 mask from each manufacturer is certified by the National Institute for Occupational Safety and Health. N95 surgical respirator masks go through a secondary clearance by the Food and Drug Administration for use in surgery — they better protect practitioners from exposure to substances such as patient blood.
In US health care settings, N95 masks must also go through a mandatory fit test using a protocol set by OSHA, the Occupational Safety and Health Administration, before use. This video (linked) from manufacturer 3M shows some of the key differences between standard surgical masks and N95 masks.
Homemade masks are unregulated.
Who handmade masks are for
Hospitals and medical centers are taking nontraditional steps to resupply their stock, asking for community donations of items like N95 masks, protective goggles and nitrile gloves. Some that do request hand-sewn masks note that donated masks will go to worried patients and nonclinical staff, not physicians and nurses.
Protective equipment is in such short supply at other hospitals and medical care centers that they’re now driven to use surgical masks or other masks if there’s no other option — and only during COVID-19 conditions. Some health centers suggest their preferred patterns and request that masks have four layers of fabric to better block out particulates. In these cases, personnel are asked to maintain a high level of caution (more on this in the CDC section below).
Harvard Medical School Teaching Hospital and the Boston Children’s Hospital shared a joint video about making a homemade reusable respirator mask in response to the current shortage. However, the design is currently limited to a pilot program and is not certified for official use. Here’s the legal disclaimer:
The device created as part of this publication should NOT be used as a replacement for conventional and approved Personal Protective Equipment. The device has not been industry tested nor has it been NIOSH approved. The publication of this article shall not constitute or be deemed to constitute any representation by the authors, their affiliates, and Boston Children’s Hospital and is intended for educational purposes only. The decision to use this device is solely your own.
Handmade masks: Cotton and elastic
The DIY projects that provide patterns and instructions for sewing face masks at home tell you to use materials like multiple layers of cotton, elastic bands and ordinary thread.
By and large, the patterns contain simple folds with elastic straps to fit over your ears. Some are more contoured to resemble the shape of N95 masks. Still others contain pockets where you can add “filter media” that you can purchase elsewhere.
It’s the belief of people who make their own masks that adding filters will help protect against transmission. However, there isn’t strong evidence that the masks will conform to the face tightly enough to form a strong seal, or that the filter material inside will work effectively. Standard surgical masks, for example, are known to leave gaps.
Homemade masks weren’t originally intended to protect you from COVID-19
Many sites sharing patterns and instructions for homemade masks were created as a fashionable way to keep the wearer from breathing in large particles, like car exhaust, air pollution and pollen during allergy season. They were not conceived of as a way to protect you from acquiring COVID-19.
One site, CraftPassion, includes this disclaimer:
Due to recent coronavirus attacks across the world, I have been receiving a lot of requests on how to add nonwoven filter inside the face mask. Disclaimer: this face mask is not meant to replace the surgical face mask, it is a contingency plan for those who have no avail to surgical mask in the market. Proper use of a surgical mask is still the best way to prevent virus infection.
Centers for Disease Control and Prevention’s stance on homemade masks
The CDC is the US authority on coronavirus protocols and protection. Along with the World Health Organization, the CDC is the authoritative body that sets guidelines for the medical community to follow.
Acknowledging a shortage of N95 masks, one page on the CDC website suggests five alternatives if a health care provider, or HCP, doesn’t have access to an N95 mask. Handmade masks are not one of them. However, alternatives like wearing a full face shield or isolating the patient with a ventilated headboard are.
In settings where face masks are not available, HCP might use homemade masks (e.g., bandana, scarf) for care of patients with COVID-19 as a last resort [our emphasis]. However, homemade masks are not considered, since their capability to protect HCP is unknown. Caution should be exercised when considering this option. Homemade masks should ideally be used in combination with a face shield that covers the entire front (that extends to the chin or below) and sides of the face.
A different page on the CDC site appears to make an exception, however, for conditions where no N95 masks are available, including homemade masks.
HCP use of non-NIOSH approved masks or homemade masks
In settings where N95 respirators are so limited that routinely practiced standards of care for wearing N95 respirators and equivalent or higher level of protection respirators are no longer possible, and surgical masks are not available, as a last resort, it may be necessary for HCP to use masks that have never been evaluated or approved by NIOSH or homemade masks. It may be considered to use these masks for care of patients with COVID-19, tuberculosis, measles, and varicella. However, caution should be exercised when considering this option.
Homemade masks aren’t sterilized
Factory-made masks from brands like 3M, Kimberly-Clark and Prestige Ameritech go through certification and are considered sterile out of the box, which is crucial in hospital settings. With handmade face masks, there’s no guarantee the mask is sterile or free from an environment with coronavirus.
The CDC considers N95 masks contaminated after each single use and recommends discarding them. However, the severe shortage of N95 masks has caused many hospitals to take extreme measures in an attempt to protect doctors and nurses, like attempting to decontaminate masks between use. One medical center in Nebraska, for example, is experimenting with ultraviolet light treatments to sterilize N95 masks.
The danger: Not knowing the limits
If you still want to make your own face masks for personal use because it provides you a project and peace of mind, there’s no harm in that. What’s important to understand, however, is that sewing your own face mask may not greatly reduce your chances of acquiring the coronavirus, especially if you’re also engaged in risky behavior like going to crowded places.
Since the coronavirus can be transmitted from someone who appears to be symptom-free but actually harbors the virus, it’s crucial to the health and wellness of people over 65 and those with underlying conditions to know which proven measures will help keep everyone safe.
For more information, here are, how to and .
Newfoundland and Labrador releases coronavirus projections – The Globe and Mail
Models projecting the impact of the COVID-19 pandemic in Newfoundland and Labrador suggest cases could peak around mid-November and ICU bed capacity could be exceeded by mid-July if current preventive measures remain in place.
That scenario, run by the Canadian Institute for Health Information, looked at the possibility that 32 per cent of the population would be infected with COVID-19 over two years.
Health Minister John Haggie, Premier Dwight Ball and Janice Fitzgerald, the province’s chief medical officer of health, addressed the province by video on Wednesday along with Dr. Proton Rahman, a clinical scientist and professor of medicine at Memorial University of Newfoundland.
The presentations showed that, even with a rapid rise in cases over the last month due to a cluster that spread from a funeral home, the curve of the outbreak has been flattening over the last week.
It’s now similar to other provinces such as British Columbia, suggesting public health measures like contact tracing and non-essential service shutdowns have been effective so far.
The funeral home cluster, which represents 75 per cent of the province’s known cases, created a challenge for modelling, officials said.
Two people have died from COVID-19 in Newfoundland and Labrador, making the sample too small to project for a possible number of deaths.
In the short term, the Newfoundland and Labrador Centre for Health Information projects that under current measures, a “best case” scenario would see approximately 25 hospitalizations due to the illness by April 30.
In a “worst case” scenario, without public health measures, approximately 200 people would be hospitalized by April 30. Both scenarios are manageable with the province’s current bed capacity, the projections note.
Projections related to ICU beds, which looked at 57 of 98 ICU beds as available, predicted that a best-case scenario would see about 10 patients occupying intensive care beds by April 30.
In a worst-case scenario, the province would exceed its ICU capacity by the same date, with approximately 65 people in ICU beds with COVID-19.
Assuming 32 per cent of the population contracts the illness, the Canadian Institute for Health Information predicts that Newfoundland and Labrador will need more ICU beds by July.
However, the same model predicted the province would stay within its acute care and ventilator capacity over the next year.
Another scenario, in which 51 per cent of the population contracts COVID-19, cases would peak in September, ventilator supply would be exceeded by mid-July and ICU capacity would be exceeded in mid-June. Acute care needs would exceed capacity in July in that scenario.
Newfoundland and Labrador has the second-highest number of infections per capita across Canadian provinces and territories, after Quebec, according to the presentation that used numbers from Tuesday.
Among the 17 people hospitalized, six have gone into the ICU.
The province reported four new confirmed cases of COVID-19 on Wednesday, bringing the provincial total to 232.
Saskatchewan Health Authority released health system readiness model for COVID-19 – Assiniboia Times
The Saskatchewan Health Authority (SHA) released their health system readiness model on Wednesday during a presentation covering varied outcomes for different levels of the COVID-19 outbreak in Saskatchewan.
The presentation used three separate variable models of different varieties to show the impact the outbreak could have on Saskatchewan’s healthcare system. The SHA said the dynamic modelling is not a prediction, it provides a range of ‘what if’ scenarios to guide planning going forward.
The modelling scenarios were based on our best knowledge at this time and will continue to be updated with Saskatchewan data. For all three scenarios, the key variable used to predict numbers were a high range, meaning one person could infect up to four people with the virus, a mid range where one person could infect 2.76 and a low range where one could infect 2.4.
According to the SHA, in a high-range estimate, 4,265 COVID-19 patients are required in acute care. Of those hospitalized, 1,280 COVID-19 patients will be in the ICU with 90-95 per cent requiring ventilation.
On the low side, the SHA presentation said at peak, 390 patients are in an acute care simultaneously. Of those hospitalized, 120 patients will be in the ICU with 90-95 per cent requiring ventilation.
According to the SHA’s presentation, on the high end of the model, the province could see up to 408,000 total cases with 215 ICU admissions daily and a cumulative total of 8,370 deaths. On the low end, there’s 153,000 total cases with 20 ICU admissions daily and up to 3,075 deaths.
The SHA believed the current demand for daily ICU across Saskatchewan would be 57 beds with 98 total capacity. For acute care, there might be a daily demand of 1,396 with a total capacity of 2,433.
The SHA’s model reported an estimated total of 890 ICU patients at peak across the province. The model added the co-ordinated provincial approach for critical care patients from rural and north Saskatchewan to be admitted to urban sites when local ICU capacity was exceeded.
In addition, the SHA currently has 450 ventilators available to meet COVID-19 model demands for low and mid-range scenarios. The planned capacity ventilator requirement of 860 created a gap of 410, but the SHA added there are confirmed orders for 200 with 100 expected n the next two to three weeks.
The SHA said they are basing their response to COVID-19 on a strategy of contain, delay, mitigate and population health promotion. Their desired goal is to promote health, prevent disease and ensure healthcare services remain available. The SHA also said their key strategies for public health were to increase testing, identify cases early, expand contact tracing and enforce chief medical health officer orders.
The key strategies to further the SHA’s approach include expanding Healthline, delivering more services through virtual care models of which 750 clinicians are set up and expanding testing and assessment centres.
There are currently 38 SHA operated testing sites across the province, five assessment sites in operation with 21 planned to open in coming weeks.
ICU beds main challenge in COVID-19 projections – The Telegram
ST. JOHN’S, N.L. —
Local Journalism Initiative Reporter
The short-term outlook for COVID-19 spread in Newfoundland and Labrador looks promising under current health emergency measures.
But even the best-case long-term projections suggest a likely squeeze for intensive care unit (ICU) beds by the fall.
The projections were presented to reporters and to the public Wednesday by Dr. Proton Rahman, a clinical scientist with Eastern Health. The information was assembled through various local agencies with help from the University of Toronto and the Canadian Institute of Health Information (CIHI).
Even with current emergency health measures, long-term modelling showed the province needing about 200 ICU beds at peak coronavirus levels in November. That’s three times what is currently available, although there would still be enough ventilators.
Overall bed capacity would not be exceeded in this scenario, but Rahman said ICU care depends primarily on the number of nurses and specialists available.
“It’s not just about beds,” he said. “With each individual bed there’s human resources involved, such as respiratory technicians, which is going to be critical to this. We really have to rethink, to some extent, how to deliver these services.”
A more dire scenario presented Wednesday, in which half the population got sick, showed catastrophic results, with not nearly enough beds, staff or ventilators to go around.
“We will simply not be able to cope without drastic changes, and even then it is unlikely we would be successful,” Health Minister Dr. John Haggie said during a later video address.
Rahman warned that the CIHI models are likely “off a fair bit.”
“We’re looking well beyond the time frame that we have any certainty about.”
He said Newfoundland and Labrador is at least three weeks behind other provinces in terms of usable date.
In particular, while tragic in themselves, the fact there has only been two deaths so far makes it impossible to offer accurate projections of mortality rates.
He said the higher rates of high blood pressure and diabetes in this province don’t bode well, since those underlying conditions increase the chance of severe symptoms or death.
But the virus can affect anyone.
“The experience that’s been reported in numerous states in America and also in Canada (is that) a lot of young, healthy people are actually ending up in the ICU. Most don’t, but it can happen to anyone,” Rahman said. “The people that we’re worried about the most are the old, the vulnerable, people with multiple medical conditions, but anyone can get in trouble and you really have to respect what this virus can do.”
Rahman said the Caul’s Funeral Home cluster — a mid-March exposure that accounts for 75 per cent of subsequent COVID-18 hospitalizations — also makes it difficult to interpret the province’s numbers with any accuracy.
Models are usually based on more evenly distributed infections.
Rahman said emergency measures imposed by the province could buy time to accommodate demand ahead of the surge.
“The time is key in terms of the health care capacity to be able to manage large amounts of patients,” he said. “The other reason why time is important, if we’re looking at an 18-month to two-year time period, lots could happen in terms of maybe a potential therapy, something that’s been repurposed in terms of a drug coming into it, some antibodies that you can take or possibly a vaccine. You’re buying time for potentially a therapy and you’re also buying time in terms of our health care capacity to adapt to this.”
Rahman wouldn’t speculate on how long current health measures would be in place, especially if the peak doesn’t arrive until November.
But he cited a scenario posed by some experts in which individual measures could be lifted temporarily and re-imposed if the number of cases rises again.
Chief Medical Officer of Health Dr. Janice Fitzgerald was not available for questions during the Wednesday evening briefing.
For now, Rahman said, it’s important to stay put.
“It just takes one small indiscretion to create a large increase,” he said.
“So, please, please follow the health guidelines put in place by Dr. Fitzgerald.”
With files from David Maher
Peter Jackson is a Local Initiative Reporter covering health care for The Telegram
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