Hospitals might compete with the public for masks

Guidance needed on community measures

During a pandemic, masks and respirators will be in great demand from health care facilities across the globe. But hospitals also may be competing with the general public and businesses that believe they need the protective equipment.

Federal guidance is weak on what measures should be taken to prevent community spread of pandemic influenza, says Scott D. Holmberg, MD, MPH, senior infectious disease epidemiologist with RTI International, a Research Triangle Park, NC-based research institute. State pandemic influenza plans vary greatly in their approach to such issues as closing schools or prohibiting mass gatherings, according to his analysis of the state plans.1

"The federal government needs to convene experts to come up with clear recommendations for community control," he says. "Clearly, we need to do epidemiologic studies to determine which strategies in a community will be effective."

There is no scientific evidence on the effectiveness of mask use in the community to prevent the spread of influenza. The U.S. Department of Health and Human Services' Pandemic Influenza Implementation Plan does not recommend mask use "as a public health measure." However, it states, "Nevertheless, persons may choose to wear a mask as part of individual protection strategies that include cough etiquette, hand hygiene, and avoiding public gatherings. Mask use may be most important for persons who are at high risk for complications of influenza and those who are unable to avoid close contact with others or must travel for essential reasons such as seeking medical care."

The Centers for Disease Control and Prevention in Atlanta plans to hold regional meetings to work through some of the community issues, says Deborah Levy, PhD, MPH, senior advisor for health care preparedness. Computer modeling, tabletop exercises, and input from the agency's ethics advisory committee will help shape future recommendations, she adds.


1. Holmberg SD, Layton CM, Ghneim GS, et al. State plans for containment of pandemic influenza. Emerg Infect Dis [serial on the Internet]. September 2006. Available at