# 648
While the use of masks by non-medical personnel during a pandemic is controversial, there is little dispute over their necessity for those directly treating influenza patients. The only argument is over the type; whether surgical masks are adequate, or whether the better fit and filtration of N95 masks are required.
Surgical masks are cheap, compared to the N95 masks, but many doubt their effectiveness. Both are disposable, and are only good for a few hour's wear. Hospitals, clinics, nursing homes, and EMS personnel will run through them quickly.
With no vaccine, and limited effectiveness of antiviral treatments, the use of PPE's, or Personal Protective Equipment, are the only defense health care workers, and others on the front front line, will have. This includes LEOs (Law Enforcement Officers), EMS, and other emergency management personnel.
It is not known, however, just how protective masks of any kind will be. The use of masks, even N95's, require a bit of a leap of faith. They must be properly fitted, and care must be taken when taking them off so as not to contaminate the wearer.
Some health departments, hospitals, and agencies are stockpiling these PPE's, but few are doing so in enough quantity to last in a pandemic. The numbers required are, if not staggering, at least impressive.
No one knows how long a pandemic would last, but the federal government is working on the assumption that we could see 3 or more waves, each lasting up to 12 weeks, over a year or two.
Assuming a 12 week wave is correct, we'd need enough masks and gloves to cover all front line personnel for three months. And we'd have to hope that we could resupply before a second wave struck. Given that nearly all of these supplies come from overseas, that isn't exactly assured.
Many health care workers have expressed deep reservations over working during a pandemic, but the ones who will work, expect and deserve the proper protective equipment. Without out that, I can't imagine very many would work at all.
Technically, a doctor or a nurse, or anyone caring for an infected patient, should change out their mask and gloves in between seeing each patient. That won't happen in a pandemic, of course. They will likely be worn as long as the wearer feels they are offering them protection.
In a 12 hour shift, however, I'd expect at least 3 or 4 changes of masks to occur. Gloves will likely be changed more often.
Here in the United States, there are roughly 7,600 hospitals employing 5.1 million people. Additionally, there are 18,000 nursing homes in this country. Altogether, there are probably somewhere in excess of 5 million registered nurses, LPN's, and nurse's aids in this country, caring for 2.5 million patients.
Just for the mental exercise, let's assume that we retain half of these employee's during a pandemic. The rest would be out sick, caring for a loved one, or simply unwilling to work in a pandemic.
That's roughly 2.5 million nursing personnel. And let's assume each requires an average of 4 mask changes per 12-hour shift. That isn't optimum, but it is probably doable.
You'd need 10 million disposable masks per day. Seventy million masks a week, and just over 300 million masks a month. And this doesn't include doctors, lab personnel, housekeeping, clerical, kitchen, or other support staff.
It also doesn't include patients. Patients? Well, infected patients spread the virus by coughing and sneezing. It would make sense to have as many of them wear surgical masks as possible. And uninfected, non-flu patients, in a hospital or nursing facility would likely expect masks, too.
According to a press release by The Trust For America's Health from last year, the HHS had 100 million N95 masks on order for the National Strategic Stockpile. They strongly recommended the US find ways to increase that amount, pointing out how inadequate that supply would be in a pandemic.
The point of all of this is three fold.
First, if you are a nurse, or work in a health care environment, you need to know if your facility is stockpiling PPE's, and in what quantity. Somewhere between 150 and 300 masks and twice that many pair of gloves, per employee, would seem to be a minimum needed to handle a pandemic wave. Added to that would be gowns, and eye protection.
Second, if you are an administrator of a facility, you need to realistically figure out how much you need in protective gear, and get it. There won't be enough in the Strategic Stockpile, and resupply during a pandemic will be unlikely.
And third, anyone considering buying masks for their own use, or for their company, had better get them while they are still available. Once a pandemic begins, they will be nearly impossible to get.
It sounds like an impossible task, having the proper PPE's, but it really isn't. The numbers are huge when taken on a national scale, but when broken down by facility, they are manageable.
Surgical masks cost about 7 cents a piece. N95's, less than a dollar. Gloves, about a nickel a pair. A few hundred dollars per employee would provide basic protection.
Yes, I know, for a hospital it might involve an outlay of $100,000 or more to protect their employees.
But as expensive as that is, they really can't afford not to.
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