How many masks are needed in a pandemic?
How many masks are needed in a pandemic?
Calculations estimate PPE, other needs
Stockpiling of personal protective equipment is an important component of pandemic planning. But how do you know just how many respirators to stockpile?
Start with some assumptions about your patient surge, the demographics of your patient population, and their likely length of stay, says Lewis J. Radonovich, MD, director, Center for Occupational Safety and Infection Control at the Office of Public Health and Environmental Hazards of the Veterans Health Administration in Gainesville, FL.
FluSurge software from the Centers for Disease Control and Prevention can help hospitals estimate their patient population, based on the virulence and disease incidence of the pandemic. Radonovich and his colleagues in the Veterans Integrated Service Network (VISN) 8 then estimated how many encounters the health care worker would have with a patient per day, which varied based on the occupation of the health care worker. For example, a nurse caring for a patient on a ventilator in the ICU would have 24 encounters with the patient in a day, while a physician would have four encounters with the patient.1 (The estimates are based on a severe, 1918-like pandemic.)
That model quickly produces a daunting number of respirators. "We basically abandoned the idea that we would buy enough disposable N95 respirators for the staff," says Radonovich, who published the methodology in Emerging Infectious Diseases in June. "If you look at any number of projections that were put out about the needs for the whole country or the world in a full-fledged pandemic, it becomes obvious that soon after the pandemic becomes severe, the world runs out of respirators."
The VISN 8 decided to purchase half-face elastomeric respirators, which are reusable, for staff with prolonged exposures, such as physicians, nurses and respiratory technicians. Although elastomeric respirators are more expensive than N95s, the reusable respirators could be cost-effective over time, he notes.
With limited funds, the VISN 8 set priorities for purchases to prepare for a severe pandemic. The top priority, Category A, included personal protective equipment as well as basic life-support items and antiviral medications.
Even completely funding the highest-priority purchases was too expensive, but the VISN 8 made a significant investment in the preparedness items. "We're trying to find a way to make sure every health care worker has enough personal protective equipment and enough supplies to treat anyone who comes to the hospital sick," says Radonovich. (Editor's note: The CDC software is available at: http://www.cdc.gov/flu/tools/flusurge/.)
Reference
1. Radonovich LJ, Magalian PD, Hollingsworth MK, et al. Stockpiling supplies for the next influenza pandemic [online report]. Emerg Infect Dis [serial on the Internet]. 2009; Available at http://www.cdc.gov/EID/content/15/6/e1.htm. Accessed on July 23, 2009.
Stockpiling of personal protective equipment is an important component of pandemic planning. But how do you know just how many respirators to stockpile?Subscribe Now for Access
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