Manitoba hospitals to begin saving used N95 masks for possible sterilization and reuse

Hospitals across Manitoba will begin to save "gently used" N95 masks instead of throwing them out as part of a backup plan in case the supply of the protective equipment becomes limited during the coronavirus pandemic.

"As part of our ongoing efforts to ensure every possible contingency plan is in place to ensure a robust supply of PPE [personal protective equipment], housekeeping at all our acute sites will soon begin to collect gently used N95 respirators from all clinical areas," Lanette Siragusa, Manitoba Shared Health's chief nursing officer, said at a news conference Saturday afternoon.

"Soiled, wet, damp and stained N95 masks will continue to be discarded."

While Manitoba's health minister said on March 25 he didn't know of any particularly low supplies of equipment in the province, health-care workers around the country say they have been rationing respirators while they wait for stocks to be replenished.

Medical masks are designed to filter out aerosol particles, with the N95 respirators providing the best protection against tiny aerosol particles that carry the novel coronavirus.

Earlier this week, a Manitoba research team shared preliminary results of a study that explored four different methods of sterilization on four different commonly found N95 masks.

Study suggests masks can be reused

Led by Dr. Anand Kumar, a professor of medicine at the University of Manitoba, the study said preliminary results suggest some masks could be successfully decontaminated and reused up to 10 times through common sterilization techniques, namely autoclaving.

An autoclave machine uses heat and pressure to disinfect and can be found in most hospital settings.

"I'm glad that people are kind of moving forward and looking at this and storing the masks in these centres," said Kumar, who also works as a critical care physician at Winnipeg's Health Sciences Centre and has a background in infectious diseases.

"I hope it doesn't come to that, that we require this — but on the other hand it's always good to have in your back pocket," he said.

Siragusa said staff aren't being asked to don used masks just yet, but research on the technique will continue.

"We'll have to make sure that with every sterilization that they maintain their integrity," she said.

Once deemed safe, Siragusa said the cleaned masks could be distributed to front-line workers.

While Kumar is overseeing the research component of the mask sterilization method, he said he won't be directly involved in the collection and sterilization of the masks.

His team is also looking at other ways of sterilizing masks, he said, but autoclaving does seem to work well with the types of masks that are commonly used in Winnipeg.

"We're actually fortunate that most of the masks that we see used in the [Winnipeg] Regional Health Authority seem to be of the type that will do well with autoclaving," he said.

The success depends of the type of mask and the materials they are made from, as well as the type of method used.

Province explores vendors other than 3M

Siragusa said the reuse of masks is just one way to ensure a supply of protective equipment should there be a shortage.

On Friday, the Minnesota-based medical device manufacturer 3M revealed that because U.S. President Donald Trump's administration invoked the Defence Production Act — which allows the president to boost industrial production of essential goods — the company is under orders not to send U.S.-made masks to other countries, including Canada. 

Siragusa said in light of the news, the province is looking at other options.

"We are moving to the vendors that are available and have stock, so we are in communication with other vendors globally," she said.

"There's also some work going on — really creative geniuses at work — looking at 3D printing for N95 masks, so we're going from all angles trying to make sure that we maintain our supply."

On Saturday, Prime Minister Justin Trudeau also addressed concerns about the need for personal protective equipment, saying a shipment of millions of masks will be headed to Canada within the next 48 hours.

"We're also working with provinces to transport their medical supplies when possible," Trudeau said.

Public should not rely on masks

The messaging surrounding the use of masks by the general public has changed — with public health officials initially recommending against general use, but more recently softening that position.

However, Manitoba's chief public health officer, Dr. Brent Roussin, said people should not put their trust in masks alone — especially homemade ones.

"If you're making your own masks, they're not going to be certified, so we don't even know if they're effective or not," he said.

"There's a possibility it may prevent you from touching your face as much, but really it shouldn't give you that false sense of security that you can change your current activities," Roussin said.

That means the basic messages still apply — stay home as much as possible, practise physical distancing, avoid touching your face and wash your hands frequently.

Kumar said N95 masks should be reserved for health care workers only and said people should not be trying to decontaminate their personal masks at home.

"I certainly wouldn't recommend trying to decontaminate your mask yourself. We haven't demonstrated that there are other techniques that are effective yet," he said.

"So if you were to try to decontaminate and your method was ineffective you may have actually damaged your mask in the attempt and so [the mask] could even be less effective."