‘N95 masks and personal protective equipment kits are not meant for general public’

Doctors say N95 masks and PPE kits are only needed for healthcare providers dealing with infectious diseases.

Updated Apr 02, 2020 11:26am

Doctors in Pakistan are stressing that N95 masks and specialised personal protective equipment (PPE) kits are not meant for the general public and are only needed for healthcare providers dealing with infectious diseases, including Covid-19.

Infectious diseases experts Dr Azizullah Khan Dhiloo and Dr Shobha Luxmi stress that people must understand that they do not need N95 respirators (N95 masks) and PPEs. Both Dr Dhiloo and Dr Luxmi are directly dealing with Covid-19 patients in Karachi's Civil and Dow Ojha hospitals.

Who needs N95 respirators right now?

The N95 respirators offer protection against aerosol-generating procedure for direct healthcare workers and during handling of respirator samples by lab staff.

The US Centres for Disease Control recommends the use of NIOSH (US National Institute for Occupational Safety and Health) certified respirators equivalent to N95 or greater to prevent the inhalation of infectious particles (e.g. Mycobacterium tuberculosis, Avian influenza, Severe acute respiratory syndrome (SARS), pandemic influenza, and Ebola). The CDC does not currently recommend that the general public use facemasks.

.Doctors in PPE carry out tests on a patient at a hospital in Muzaffargarh. — Photo courtesy: Government of Punjab
.Doctors in PPE carry out tests on a patient at a hospital in Muzaffargarh. — Photo courtesy: Government of Punjab

“The general public definitely does not need to use the N95 masks for coronavirus,” also stresses Dr Summiya Nizamuddin, a consultant medical microbiologist at Shaukat Khanum and the general secretary of Medical Microbiology and Infectious Diseases Society Pakistan (MMIDSP).

"Also, people need to know that they cannot wear this (N95) mask for more than a week and it must be discarded once it’s distorted while surgical ones can be reused but must be thrown away if they get wet."

Who needs the PPE kit?

A PPE kit comprises of disposable masks, gowns, hoods, gloves and shoe covers, face shields, and protective goggles worn by healthcare providers dealing with infectious diseases. Not all these items are needed by everyone in a hospital setting, experts say.

The CDC says "patients with confirmed or possible SARS-CoV-2 infection should wear a facemask when being evaluated medically. Healthcare personnel should use eye protection (e.g., goggles or a face shield) when caring for patients with SARS-CoV-2 infection". These precautions include the use of PPE, including NIOSH-approved N95 respirators, gowns, gloves, face shield/eye protection, etc.

Gloves, gowns, goggles and face shields are needed when seeing suspected cases and carrying out nasopharyngeal sampling.

Gloves, medical masks and sanitisers

PKLI's guidelines for use of personal protection equipment.
PKLI's guidelines for use of personal protection equipment.

Experts say sanitisers, gloves and surgical masks are mandatory for those at the frontline. These include hospital receptionists, hospital guards, doctors and nurses.

Dr Nazimuddin says for doctors and nurses working in OPDs and other areas of hospitals, masks and sanitisers are must.

These items are also needed for hospital guards, attendants, receptionists, cleaners or simply put anyone at the gates — staff that is the most vulnerable and often the most overlooked.

Seeing Covid-19 patients

According to a guideline issued by the Pakistan Kidney and Liver Institute (PKLI), anyone entering the room of a Covid-19 patient must wear gloves, medical mask, a full sleeves gown and goggles to prevent risk of splash.

The guide adds that "routine use of masks by all is not deemed to be helpful and is not recommended".

The Hazmat suit

A Hazmat suit — comprising a medical gown, surgical gloves and boots — is needed for emergency medical services providers. Its splash guard (face shield) and goggles offer medical staff treating Covid-19 patients protection during nasopharyngeal procedure as well as from sneezes and cough.

Best bet for public

According to CDC guidelines, the general public does not need N95 and PPE kits at all. Rather, it stresses on washing one's hands, covering one's cough, and staying home when mildly unwell.

"It’s unfortunate that we have been unable to educate doctors, nurses and the masses about who gets to use PPEs and why basic hygiene — especially hand washing — and social distancing is way better than getting worried about masks," says Dr Shereen Khan, head of Tuberculosis Department at Fatimah Jinnah Hospital in Quetta, who is currently looking after Covid-19 cases in the province.

Washing hands with soap and water for 20 seconds is one small step that is much needed along with adequate social distancing, he stresses.

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The views expressed by this writer and commenters below do not necessarily reflect the views and policies of the Dawn Media Group.

Comments (6) Closed

M. Saeed
Mar 20, 2020 10:12pm
It needs to be explained that, Corona virus, COVID-19 is a very small nano-dimensional object. It is not a living thing and becomes a danger to a person after entering a cell in the body. Once inside a cell, it starts rapidly multiplying and makes the body a factory of Virus production. To understand its size, its dimensions can be explained by saying that, each basic cell of our body comprises of about 10 million healthy viruses of various types. (Source: book.bionumbers.org/how-big-are-viruses)
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Shailesh
Mar 20, 2020 10:33pm
Okay I only need to cover when I sneeze and cough but cover with what....mask, elbow. Do you think cover with elbow guarantees the bacteria/virus won't escape into air and infect other person without mask. And what if I/you not wearing mask and someone positive with covid19 coughs around, I won't get infected right?
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Zeeshan
Mar 20, 2020 11:52pm
@Shailesh, That is why experts are stressing on "social distancing"
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Dr. Doctor
Mar 21, 2020 01:00am
Nothing wrong in wearing protective masks by public. Will keep their sprays to themselves once they sneeze. N95 are not enough for COVID-19 because the diameter of the mask's pores is bigger than the virus but still not a lot will go through, meaning it is not a complete protection. Social distancing, social distancing and social distancing and bug your doctors to give you antimalarial medication!! Regardless anybody in Pakistan with high fever gets treated for Malaria which will eventually benefit many since this might inadvertently treat COVID-19!!!! Good luck.
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Thuthuri
Mar 21, 2020 11:15am
No money no honey
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Lgbtqx
Mar 21, 2020 05:20pm
Even if it is not a requirement it is very helpful to wear a mask when outside to prevent infecting yourself and others.
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