Coronavirus: CDC Updates N95 Respirator Strategy for COVID-19

On February 29, the Centers for Disease Control and Prevention (CDC) updated its strategy for optimizing the supply of N95 respirators for healthcare workers. The CDC also has developed and continues to update guidance for commercial airlines and shipping for handling known or suspected cases of COVID-19, the respiratory illness caused by the novel coronavirus that emerged last year in China. It also has developed interim guidance for businesses and employers that need to plan for and prepare a response to any potential outbreak.

The National Institute for Occupational Safety and Health (NIOSH) has aggregated a list of resources for employers concerned about the disease that includes access to guidance for employers in healthcare, transportation, and other industries collected from the CDC and Occupational Safety and Health Administration (OSHA), as well as the World Health Organization (WHO).

CDC recommends that healthcare facilities assess their current N95 respirator inventory and supply chain and their N95-respirator utilization rates and stay in close communication with state and local public health officials concerning any local COVID-19 cases. CDC emphasized it does not recommend that the general public use N95 respirators.

CDC continues to advise that handwashing is the single most important infection control measure.

New resources include interim guidance for businesses and employers, airlines, and the ship industry. CDC advises all businesses and employers to encourage cough and sneeze etiquette, hand hygiene, and for sick employees to stay home. Employers also should provide routine cleaning services and disposable wipes so employees can wipe down commonly used surfaces, such as desks, doorknobs, keyboards, and remote controls.

Employers should advise traveling employees to take extra precautions. If an employee has a laboratory-confirmed case of COVID-19, the employer should inform other employees of potential exposure while maintaining Americans with Disabilities Act (ADA) privacy protections.

An outbreak caused by community transmission of the coronavirus could result in an increased number of employee absences directly caused by employees’ own or family members’ illness, or closure or dismissal of early childhood programs and K-12 schools. CDC suggests employers prepare now to manage business disruptions during any outbreak. Preparations could include:

• Monitoring absenteeism at the workplace and making plans to continue essential business functions in the event of higher than usual absenteeism;
• Cross-training personnel to perform essential functions so the workplace can operate even if key staff members are absent;
• Assessing essential business functions and the potential impact on clients or customers and the community due to a disruption in products and services; and
• Preparing for the potential need to change business practices to maintain critical operations, such as identifying alternative suppliers, prioritizing clients or customers, or even having to temporarily suspend some operations.

New Resources for Airlines, Healthcare, Ships

New resources also include the CDC’s Personal Protective Equipment (PPE) recommendation for healthcare professionals. Suggested PPE for healthcare workers treating patients with suspected or confirmed cases of COVID-19 include a nonsterile, disposable patient-isolation gown; nonsterile examination gloves, such as nitrile, natural rubber, or polychloroprene gloves; goggles or disposable full-face shield; and NIOSH-approved N95 filtering facepiece respirator.

Existing resources include CDC, NIOSH, and OSHA factsheets and guidance on respiratory protection and the different uses and effectiveness of surgical masks and N95 respirators. Surgical masks, cleared by the Food and Drug Administration (FDA), are intended to prevent sick persons from infecting others. Surgical masks do not provide protection for those who are not ill.

N95 filtering facepiece respirators are evaluated, tested, and approved by NIOSH. OSHA regulations concerning their use require a full respiratory protection program, including medical evaluation before use, fit testing, and training.

Commercial aircraft and ships are required to report any known or suspected cases of COVID-19 to the CDC Quarantine Station associated with the arrival airport or port. CDC advises aircraft cabin crew to treat all bodily fluids as infectious and emphasized that handwashing is the single most important infection control measure and that disposable glove use is not a substitute for handwashing.