Skip to main content

All Access Subscription

Get unlimited access to our full publication and article library.

Get Access Now

Interested in Group Sales? Learn more

HI Cprevent logo small


This award-winning blog supplements the articles in Hospital Infection Control & Prevention.

As 2009 pandemic flu stockpiles expire, hospitals face 'sticker shock' of replacing respirators

Five years after the H1N1 flu pandemic, hospitals and public health authorities are dealing with a potentially expensive aftermath: Stockpiles of N95 respirators are expiring. Rebuilding pandemic stockpiles could cost many millions of dollars and still might not provide enough protective devices.

That reality is now reshaping pandemic planning across the country.

Based on estimates from the Centers for Disease Control and Prevention, “the number of [disposable] filtering facepiece [N95] respirators that would be needed during a pandemic would be astronomical, so we’re looking at reusable devices,” says Maryann D’Alessandro, PhD, director of the National Personal Protective Technology Laboratory of CDC’s National Institute for Occupational Safety and Health (NIOSH).

Hospitals are purchasing reusable respirators that were previously mostly used in industrial settings, and the federal government is rethinking its stockpile strategy. The Veterans Administration purchased 180,000 elastomeric half-face respirators to protect its health care workers in a pandemic.

While the world is riveted by the Ebola outbreak in West Africa, occupational health experts remain concerned about the risk from respiratory diseases. H1N1 was considered a “mild” flu pandemic, but researchers estimate that it killed as many as 203,000 people worldwide, most of them under the age of 65.1 In the first six weeks of the H1N1 pandemic in the spring of 2009, CDC identified 35 health care workers who became infected at work. Lack of compliance with infection control guidance as well as an inadequate supply of N95 respirators, were cited as factors.2

--Michele Marill

For more on this story see the Oct. 2014 issue of Hospital Employee Health

1. Simonsen L, Spreeuwenberg P, Lustig R, et al. Global Mortality Estimates for the 2009 Influenza Pandemic from the GLaMOR Project: A Modeling Study. PLoS Med 2013; 10(11): e1001558. doi:10.1371/journal.pmed.1001558. Available at

2. Wise ME, De Perio M, Halpin J, et al. Transmission of pandemic (H1N1) 2009 influenza to healthcare personnel in the United States. Clin Infect Dis 2011; 52:S198-S204