With the potential easing of restrictions, many organisations will be turning their attention to how they can reopen their businesses. One of the key issues will be – how can I protect my staff and customers from contracting COVID-19, while interacting with me:
Do I need masks (bad idea, see below)?
If not a mask, then what? A respirator?
What will it cost?
How do I get them?
How do I know I’m getting the real thing?
Your Occupational Health & Safety (OH&S) obligations will mean it’s incumbent on you to provide a safe environment for your staff (and you don’t want to be getting the customer sick either). One of the key pieces of equipment in the fight against the spread of COVID-19 is the use of Personal Protective Equipment (PPE) – particularly masks/respirators.
However, there seems to be a lot of confusion, and some charlatans selling substandard equipment. I will try to debunk the myths and provide some clarity.
What Not to Get
I went shopping early this week and noticed a stall table outside my supermarket selling masks – five for $10. Then yesterday at my local store they had packs of four masks for $10 ($2.50 each).
Personal Protective Equipment (PPE) that will protect you from the coronavirus is not that cheap - and really difficult to obtain and validate. (I happen to know that because I’ve been contacted by a supplier who has a stock and wants help to bring it to Australia). In fact, the World Health Organisation (WHO) and Centre for Disease Control (CD) advise against relying on “masks” to protect you from contracting COVID-19. What you need to avoid contagion is a respirator, not a mask.
PPE helps you prevent coronavirus, but what is the right standard?
Unfortunately, people were still buying them from this stall. They looked genuine - however, when I asked the stallholder about what standard they were, they began to look uncomfortable and suddenly started tidying up the table. I’m all for being entrepreneurial but the danger with these “masks” is that it leads people into a false sense of security that they are being protected from the virus when in fact, they are not.
There is good protective gear – it will have a standard associated with it, such as N95 or FFP2. But first, some terminology:
Masks vs Respirators vs Ventilators – What’s the Difference?
Masks
These are what you usually see in the media and on TV hospital shows. They are designed to prevent large droplets going into open wounds during surgery. Their characteristics are:
Loose-fitting, covering the nose and mouth
Designed for one-way protection to capture fluids leaving the wearer
Usually worn during surgery to prevent coughing, sneezing, etc. while in front of an open wound
Do NOT protect the wearer - only the patient
Help block large-particle droplets such as saliva, splashes, sprays, or splatter
Also called surgical, isolation, dental, or medical procedure masks
Come in a variety of thickness
Generally, do not have standard associated with them
The masks outside my local supermarket had a very dodgy looking certification from the FDA (US, Food and Drug Administration). It looked like it had been photoshopped onto the packet. Dodgy certification or not, masks will not protect you from COVID-19.
Why won’t masks protect you from COVID-19?
The virus is quite small 0.06 – 0.14 microns – COVID-19 will get through the material (https://www.nejm.org/doi/full/10.1056/NEJMoa2001017)
They do not seal well and the virus gets around the mask
Respirators
Respirators are moulded to the face and provides lightweight effective comfortable and hygienic respiratory protection against dust and mists. Their characteristics are:
Tight-fitting, creating a facial seal
May come with our without valves:
Non-valved respirators protect both the wearer and other people
Valved respirators filter the inhalation, but not the exhalation. Thus, they protect the wearer, but not the others
Respirators do protect the wearer
Available as:
disposable (with or without a valve)
half-face
full-face
Respirators protect the wearer, masks do not.
Ventilators
Are the machines that help you breathe, and you often see them used in Intensive Care Units (ICUs). For further explanation on the difference see Respirators vs Ventilators:
Standards
For protection against catching or spreading COVID-19 – you need a respirator of an adequate standard – not a mask. The higher the standard of the respirator, the more particles it filters out – but the harder it is to breathe.
The US Centre for Disease Control (CDC) cites a respirator of N95 or better as part of the Personal Protective Equipment (PPE) that should be used to protect against COVID-19.
The WHO recommends FFP2/P2 for reducing the chances of catching COVID-19. FFP = Filtering Face Piece - this is an EU standard. The other EU standards that apply to respirators are P1/P2/P3 with P1 being the lowest standard and P3 filtering out the most.
Other jurisdictions have other standards – the table below highlights the different jurisdictions and standards. Standards with the same shading are roughly equivalent i.e. the green shading are all equivalent standards - and suitable for protection against COVID-19. The blue rows are an equivalent and higher standard – also suitable for protection against COVID-19.
Table of Equivalent Standards
Notes:
Filter capacity means it removes greater than x% of all particles ≥ 0.3 microns (this is what is recommended)
US Standards are set by the National Institute for Occupational Safety and Health (NIOSH) which is part of the US CDC.
European standards are maintained by European Committee for Standardization (CEN). The EU has two standards FFP and P1/P2/P3
What Standard do you Need to Buy?
What to make of all that? If you are buying respirators for protection against COVID-19, the following standards are equivalent, and suitable according to the CDC and WHO:
N95 (95%) = FFP2 / P2 (94%) = KN95 (95%)
N99 (99%) = FFP3 (99%)
Korea and Japan have their own standards. For the purposes of Australians and New Zealanders wanting to protect their staff the advice from authorities seems to be that: N95/KN92/FFP/P2 is the minimum adequate standard.
Respirators do not Replace Other Protective Actions: How to Prevent Spread
Remember, using a respirator is only one way to prevent spreading the virus. The World Health Organisation provides the latest information on the COVID-19 outbreak as well as tips on how to protect one’s health and others during the pandemic including:
Wash your hands frequently
Maintain social distancing
Avoid touching eyes, nose and mouth
Practice respiratory hygiene
If you have fever, cough and difficulty breathing, seek medical care early
Stay informed and follow advice given by your healthcare provider
Further information can be found at coronavirus disease (COVID-19) advice for the public WHO: Coronavirus disease (COVID-19) advice for the public.
Hints on Obtaining Legitimate Equipment
You need to do your due diligence when you’re purchasing PPE (don’t compete for equipment that is needed for frontline staff). We are looking into respirators and our process is:
Obtain sample respirators – with certification documents
Validate the documents
Validate the respirators
If, and only if, they meet the standard stated in the documentation, place an order.
Ensure all shipments are subject to random sampling and independent testing in Australian laboratories.
If you can’t do this yourself then find someone who can. Remember, just because a respirator has a standard attached to it, doesn’t mean it meets that standard.
For more information: ppe@resilienceworks.com.au.
In Summary:
Surgical masks do not protect against COVID-19
You need to supply your staff with respirators of at least standard N95 or KN95 or FFP2/P2
Respirators with a valve will only protect your staff, not your customers
Respirators without a valve will protect both your staff and your customers (but are harder to breathe in though)
Just because a mask comes with a certification - doesn’t mean it’s genuine
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