By Mike McEvoy
I think responders need to consider several aspects. First, the CDC has recommended since May, when H1N1 first started, the use of N95s when dealing with suspected cases. They are very unlikely to change this recommendation in the immediate future.
At least half of the states, have taken a position opposing the CDC guidance and told their health care workers that N95s are not necessary for suspected flu cases for a couple of reasons.
Primarily, we don’t use N95s for seasonal flu, which is five times more deadly and causes much greater illness than H1N1. It’s not logical to use greater levels of protection against a less severe virus.
Secondly, supplies of N95 masks are all but depleted. There continue to be illnesses, such as tuberculosis, that require caretakers to protect themselves from exposure with N95 masks. It makes little sense to stress an already exhausted supply chain by adopting an essentially unproven recommendation to use this level of protection for a virus that causes only mild illness.
We also remain uncertain of how H1N1 is transmitted. There is quite reasonable suspicion that it is transmitted by respiratory droplets, but the possibility exists that an entirely different mode of transmission such as fecal material (diarrhea, sewage) could be responsible for spreading H1N1. The virus is too young and the research too sparse to confidently know all the routes of H1N1 transmission. That said, many experts believe that encouraging health care workers to wear N95 masks could provide a false sense of protection.
I do believe that states’ advice to apply a surgical (simple) mask to both patient and health care worker makes the most sense. H1N1 is less of a threat than seasonal flu. It’s illogical to use more protection for an illness that is less severe.
Mike McEvoy, PhD, REMT-P, RN, CCRN, is the EMS coordinator for Saratoga County and the EMS director on the Board of the New York State Association of Fire Chiefs.