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Respirator Madness

May 17, 2007

N95 Mask

Neither a facemask nor a respirator will give complete protection from the flu.

-CDC, Interim Public Health Guidance for the Use of Facemasks and Respirators in Non-Occupational Community Settings during an Influenza Pandemic, May 2007

The U.S. Food and Drug Administration (FDA) today cleared for marketing the first respirators that can help reduce the user’s exposure to airborne germs during a public health medical emergency, such as an influenza pandemic.

-FDA, FDA Clears First Respirators for Use in Public Health Medical Emergencies, May 2007

As preparedness folks, emergency managers and responders, we all know the dangers of sending mixed messages. The above statements are a wonderful example of that danger. While in form the message is similar, in spirit it is quite muddled.

The worst case scenario of a pandemic flu is simply beyond the scope of human reasoning. A few thousands highly publicized deaths are unfathomable. More than that is unbearable. Give this potential danger, what should I do to protect my family? The FDA tells me that stocking up on 3M brand N95 respirators is my duty. To paraphrase Jon Stewart, “The CDC? Eh, not so much.”

In the event of a pandemic, the public will be bombarded with bad information and snake oil salesmen; the government should aspire to speak with a consistent voice, serving as a rock in the storm. But these messages are much worse than just bad information.

Three of the worst places one could be during a pandemic are schools, hospitals and long-term care facilities. Amateur and professional planners both understand that schools will probably close in a pandemic situation, so what are hospitals and long-term care facilities to do? Should they stock up on respirators even though the CDC says they might only be useful in certain situations, and even in those situations (healthy in crowded places, already ill and take care of the infected) we don’t know if they’ll be any help? What if they buy the wrong (read: unapproved) respirators (which some places have already done)? Would these facilities be liable for the subsequent infections and deaths? Being that the devices are, “approved … to reduce a user’s risk of becoming ill during an influenza pandemic,” and that the Director of the FDA’s Center for Devices and Radiological Health says, “Minimizing exposure to [the pathogen in the next public health emergency] will help reduce health risks,” I would imagine that any lawyer worth his salt could get damages awarded against a hospital that had the wrong, or not enough, respirators stockpiled.

Recommending a certain brand and type of respirators as protective against pandemic influenza just because the instructions for achieving a proper fit (which, coincidentally, is the single most important part of wearing N95 respirators) are better is counterproductive, dangerous and potentially devastating.

Resources: CIDRAP report
Effect Measure post

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