SARS news spurs demand for medical masks

The N95 has been used to protect against biological agents and construction debris. But its newfound cachet is fueling concern about maintaining an adequate supply.

By Victoria Stagg Elliott, AMNews staff. May 12, 2003.

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It's a sign of the times, for sure. Medical masks are in vogue.

When danger rears its head, it seems people reach for a mask. When the World Trade Center came down, volunteers appeared in cotton surgical masks and industrial-grade respirators. When anthrax appeared, the masks came out again.

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This time the danger is severe acute respiratory syndrome, and the mask of choice, as recommended by the Centers for Disease Control and Prevention and the World Health Organization, is the N95 respirator.

Sales of all mask makes and models have jumped 25% at Henry Schein Inc., a distributor of health care products. At Kaiser Permanente, a large HMO based in Oakland, Calif., rumors of shortages of N95 masks led employees to hoard them. Some even shipped some to relatives in Asia. And at Mercy Medical Center in Baltimore, masks are being rationed because the hospital just can't get any more right now.

"They're very difficult to get," said Catherine O'Neill, RN, director of nursing for Mercy's emergency department and chair of its emergency management committee. "We're reserving our N95s for our most-contagious patients."

Clearly, these masks are not just for health professionals anymore. It seems like everyone has an N95 sitting on a desk or tucked in a pocket waiting to be pulled out for that perfect emergency occasion. They've even been handed out in some offices for bioterrorism preparedness.

"Most people prefer to have the N95," said Sergey A. Grinshpun, PhD, director of the center for health-related aerosol studies at the University of Cincinnati. "They're certified. The CDC guidelines recommend it, and they provide 95% efficiency for the worst-case scenario."
 

But does this demand mean that health care facilities may have trouble keeping up their needed supplies?

"With the increased demand in Asia and Canada, we're hearing that U.S. hospitals might begin stocking up," said Collin Tam, an analyst with Frost & Sullivan, an international consulting and marketing firm. "Unless SARS spreads more across the United States, I don't think we need to worry about a shortage of face masks." Most believe, for instance, that Mercy Medical's shortage is an exception. Manufacturers have also pledged that, in the case of a true shortage, health care facilities would get priority.

Meanwhile, experts are concerned that the masks may not be used correctly by the average person. In a health care setting, people are fit-tested and trained before being allowed to wear one. Consumers, obviously, are not. Plus, the instructions in the box may not be sufficient and a bad fit will provide only a false sense of security.

"If they're not fitting properly, they're not going to work," said Marc Siegel, MD, associate professor of medicine at New York University.

The masks are also supposed to be disposable, and constant reuse is counterproductive.

"If you leave one on for hours, it doesn't work at all," said Dr. Siegel. "You could end up transmitting bugs that way."

And, despite its newfound fashionableness, there are no plans to improve the N95's aesthetics -- even though the SARS outbreak in Asia resulted in cotton surgical masks in designer colors and with various characters printed on them.

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Copyright 2003 American Medical Association. All rights reserved.