Level of respiratory protection for healthcare workers caring for coronavirus disease 2019 (COVID-19) patients: A survey of hospital epidemiologists

Studies of influenza and seasonal coronavirus virus have revealed that surgical masks are not inferior to N95 respirators for source control.2,4,5,7,8 Studies of SARS-CoV-1 have demonstrated no significant difference between surgical masks and N95 respirators with respect to protection of exposed HCWs.3,7 Surgical masks for patient source control and worn by HCWs, especially coupled with HCW use of face shields, protect HCWs involved in routine COVID-19 patient care who are not participating in aerosol-generating procedures (AGPs).5,6 Given that N95 respirators are superior to surgical masks in protecting the user from inhalation of small-particle aerosols, their use has been typically reserved for AGPs.2,4,5 Methods On October 6, 2020, we performed an online survey of infection control leaders regarding their respiratory PPE policies for general routine patient care, general care of patients with confirmed or suspected COVID-19, and care for patients undergoing AGPs. Personal Protective Equipment (PPE) Use Among Respondent Hospitals and Hospital Systems Hospital Respiratory PPE Used While Caring for Patients With Confirmed or Suspected COVID-19 Respiratory PPE for General Patient Care Respiratory PPE Use for AGPs Retest COVID-19 Patients Non-VA hospitals or health systems (n = 24) N95 respirator (n = 15) Surgical mask (n = 9) N95 respirator (n = 2) Surgical mask (n = 20) N95 respirator, regardless of SARS-CoV-2 status (n = 20) Surgical mask if known negative SARS-CoV-2 test (n = 2) Yes, if symptomatic (n = 10) Yes, if before procedures (n = 11) Yes, every 5 d (n = 1) Yes, on day 5 if from high risk setting (n = 1) Yes, every 3 d if in multiroom or behavioral health unit (n = 1) VA hospitals or health systems (n = 5) N95 respirator (n = 4) Surgical mask (n = 1) N95 respirator (n = 0) Surgical mask (n = 4) N95 respirator, regardless of SARS-CoV-2 status (n = 2) Surgical mask if known negative SARS-CoV-2 test (n = 1) Yes, if symptomatic (n = 3) Yes, if before procedures (n = 1) Variability in respiratory PPE was reported in the care of patients with proven or suspected COVID-19. [...]most hospitals and hospital systems responding to our survey use N95 respirators when caring for patients with proven or suspected COVID-19 and when aerosol-generating procedures are performed.