N95 Face Mask Extended Use and Reuse Recommendations

From CDC recommendations to the realities medical professionals face in the field, CovCare takes a closer look at why extended use of N95 respirators is favored over re-use and provide less risk of contact transmission of the Coronavirus.

This March marks one year since the World Health Organization declared the Coronavirus a global pandemic and the first cases were reported in the United States in 2020. Within that time, CovCare has become the most trusted medical supplies and logistics company with the number one goal of delivering face masks and Personal Protective Equipment (PPE) as quickly and affordably as possible. 

A year later, CovCare continues to flatten the curve and save lives after surpassing 100,000 orders placed in 2020 and donating face masks and PPE to hospitals, schools, and non-profit organizations around the world.

Part of being able to help keep people safe with CovCare is being able to better understand the features and benefits of widely popular PPE items, including the N95 face mask or respirator. N95 respirators and surgical masks are designed to protect the wearer from both airborne particles and from liquid contaminating the face, with the Centers for Disease Control and Prevention (CDC) National Institute for Occupational Safety and Health (NIOSH) and the Occupational Safety and Health Administration (OSHA) also regulating N95 respirators.

With CovCare you can choose between N95 respirators to purchase including NIOSH certified N95 face masks and FDA approved N95 masks.

An N95 respirator includes a very close facial fit and efficient filtration of airborne particles. The edges of the respirator are designed to form a seal around the nose and mouth, while surgical N95 respirators are commonly used in healthcare settings and are a subset of N95 Filtering Facepiece Respirators (FFRs), often referred to as N95s. The stats and numbers truly detail the features and benefits of the N95, as the 95 refers to the fact that these masks filter out 95% of the tiny particulate matter in the air. For those N95 face masks used by professionals who manage respiratory protection programs in healthcare institutions and protect health care workers from job-related risks of exposure to infectious respiratory illnesses, existing guidelines are recommended for extended use and re-use of NIOSH-certified N95 respirators:

• Minimize the number of individuals who need to use respiratory protection 

• Use alternatives to N95 respirators where feasible

• Implement practices allowing extended use and/or limited re-use of N95 respirators, when acceptable

• Prioritize the use of N95 respirators for those personnel at the highest risk of contracting or experiencing complications of infection

The NIOSH certified N95 masks from CovCare (read more here about the difference between mask certifications) are lightweight in construction to promote greater worker acceptance and help increase wear time. Made of several layers of special non-woven polypropylene (synthetic polymer) fabric, N95 respirators are produced by melt blowing and forms the inner filtration layer in the N95 mask that filters out hazardous particles. 

According to the CDC, extended use is favored over re-use of N95 respirators because it is expected to involve less touching of the respirator and therefore less risk of contact transmission. Extended use alone is also unlikely to degrade respiratory protection, as there’s no way of determining the maximum possible number of safe re-uses for an N95 respirator. Because the Coronavirus can lose viability significantly after 72 hours, some organizations have promoted a rotation and re-use strategy assuming there is no soiling and minimal to no viral contamination to the mask. The CDC also suggests that masks can be reused up to 5 times by adhering to strategies that include mask rotation and reprocessing/decontamination.

Extended use refers to the practice of wearing the same N95 respirator for repeated close contact encounters with several patients, without removing the respirator between patient encounters. Extended use may be implemented when multiple patients are infected with the same respiratory pathogen and patients are placed together in dedicated waiting rooms or hospital wards. Extended use has also been recommended as an option for conserving respirators during previous respiratory pathogen outbreaks and pandemics.

Reuse refers to the practice of using the same N95 respirator for multiple encounters with patients but removing it (‘doffing’) after each encounter. The respirator is stored in between encounters to be put on again (‘donned’) prior to the next encounter with a patient. Even when N95 respirator reuse is practiced or recommended, restrictions are in place which limit the number of times the same respirator is reused. 

The decision to implement policies that permit extended use or limited reuse of N95 respirators should be made by the professionals who manage the institution’s respiratory protection program, in consultation with their occupational health and infection control departments with input from the state/local public health departments. One particular study from the CDC clearly describes the importance of limiting the risk of contact transmission from just touching the surface of a contaminated respirator, as nurses averaged 25 touches per work shift to their face and eyes, or the N95 respirator. Although extended use and re-use of respirators have the potential benefit of conserving limited supplies of disposable N95 respirators, concerns about these practices have been raised within the last year and is a major reason why CovCare remains diligent about educating people on the N95 respirator and other PPE items. 

CDC guidance remains that it "does not recommend the use of N95 respirators for protection against COVID-19 in non-health care settings because N95 respirators should be reserved for health care workers”. According to Get Us PPE, a national organization to get PPE to frontline workers, at least 62% of health care facilities needed N95 masks just last month. 

Considered the gold standard in Personal Protective Equipment because they block 95% of aerosols that may contain viruses like coronavirus, the N95 level of protection has been essential to frontline workers responding in high-risk transmission environments. Before the spread of the Coronavirus pandemic last March, medical providers followed manufacturer and government guidelines that called for N95 respirators to be discarded after each use in an effort to protect healthcare professionals from catching infectious diseases. However, as the coronavirus spread through the spring and summer of 2020, demand for N95 respirators surged to unprecedented levels and the masks disappeared from stockpiles and distributors' shelves. For frontline workers and health professionals, hospitals and distributors looked overseas to fill the need. That dire need for N95 respirators was even more reason to adjust accordingly. 

Once N95s started running low, the CDC adjusted those guidelines to allow for extended use and reuse when supplies are limited. 

Prior to COVID-19, the demand for N95 masks was reportedly 1.7 billion per year, with 80% going to industrial uses and 20% into the medical field. In 2021, demand for N95 masks for medical use is estimated by industry sources to be 5.7 billion.