Scientists Find Way to Safely Re-Use N95 Face Masks

Battelle photo

A new vapor fogging system capable of quickly re-sterilizing large numbers of N95 medical respirator masks at a time is being hailed as a “game changer” in the global battle against the COVID-19 coronavirus pandemic.

Developed by Battelle, a non-profit research institute based in Columbus, Ohio, the Critical Care Decontamination System works by placing row-upon-row of used masks onto wire metal restaurant kitchen-style shelves inside truck-sized metal shipping containers and then fogging them for over two-and-a-half hours with highly concentrated hydrogen peroxide vapor that is piped in from a generator unit.

Hydrogen peroxide breaks down the microscopic membranes that hold viruses and toxic bacteria together and, according to Bioquell – the Pennsylvania company that invented the vapor technology – it “eliminates 99.9999% of pathogens for a 6-log kill on all surfaces (a 6-log kill means that only one in 1,000,000 pathogens survives).”

N95 face masks (which are called that because they filter out at least 95 percent of all airborne microscopic particles) are among the most critical components of the “personal protective equipment” which comprise the last line of self-defense for healthcare professionals, the men and women who are literally risking their own lives to try and save patients during this global outbreak.

Photo by DANIEL LEAL-OLIVAS/AFP via Getty ImagesStaff wearing PPE of gloves and face masks, as a preactionary measure against COVID-19, disinfect an ambulance after it arrived with a patient at St Thomas’ Hospital in north London, on April 1, 2020

A single microscopic droplet from a coughing or sneezing patient can “shed virus” onto the outer surface of the mask of a person treating them. That’s why under normal circumstances a doctor or nurse would carefully remove their mask after seeing each infected patient, dispose of it in a medical waste bin, and break out a brand new mask before moving on to the next person; however, as more and more hospitals in the midst of outbreak “hotspots” run completely out of fresh masks there have been horror stories of staff either going completely unprotected or being ordered to save one mask and keep it in a paper bag overnight for reuse day-after-day.

It’s not just masks that are in short supply, this weekend staff at a medical center in Brooklyn reported having to use rain ponchos and garbage bags instead of protective gowns because of the on-going shortages. Infuriatingly, there are also reports of doctors having been fired for bringing their own protective masks to work.

In hard-hit Italy nearly one-in-ten of the victims of the pandemic have been healthcare workers, BuzzFeed has reported.

Last week hospitals in the Boston area alone reported that over 500 physicians and nurses have now tested positive for COVID-19 and have been removed from their workplaces to go into self-isolation or, worse, they have been hospitalized themselves – something that in theory should not be happening at all if they had been able to take adequate personal protective measures.

Photo by BRYAN R. SMITH/AFP via Getty ImagesMontefiore Medical Center nurses call for N95 masks and other critical PPE to handle the coronavirus (COVID-19) on April 1, 2020, in New York. – The nurses claim “hospital management is asking nurses to reuse disposable N95s after long shifts” in the Bronx.

Now Each N95 Mask Can Be Re-Used Up to Twenty Times

Large hospital systems in Ohio and at New York’s Stony Brook University on Long Island have already taken delivery of Battelle’s newly approved Critical Care Decontamination Systems which are made from the same 20-foot steel shipping containers that are ubiquitous at container ports and on intermodal railroad and trucking networks around the planet. Additional CCDS systems were getting ready to ship this week to New York City, Seattle and Boston. More are being built as quickly as possible with Chicago and Washington D.C. slated to get the next ones.

According the Columbus Dispatch, the company can make five complete systems per week and is coordinating with the Federal Emergency Management Agency to determine which hospital networks should get them when they are ready to ship.

Using standardized shipping containers as the basis for the system allows it to be trucked right in and deployed in a parking lot somewhere in the general vicinity of the hospitals it is going to serve.

photo courtesy Battelle

In the case of Boston’s Partners HealthCare, which will have their decontamination system up and running next week, the half-dozen containers are being set up in the parking lot of a vacant K-Mart in Somerville, Massachusetts.  The site was requisitioned using powers granted to local authorities as part of the state of emergency Massachusetts declared last month because of the pandemic.

Partners HealthCare told reporters they anticipate their site will be capable of recycling N95 masks for all of Massachusetts’ hospitals and possibly for some neighboring New England states as well.

Battelle actually developed the system back in 2016 and described it at the time in a research report the was commissioned by the federal government.  Emergency managers  wanted to study if it would be possible to re-use N95 respirators in the event of a pandemic – although they’d imagined such an event was more likely to take the form of a virulent influenza outbreak.

Battelle photo

The report did not draw much notice until mid-March when one of Battelle’s engineers brought it to management’s attention and the company shifted into high-gear to make the concept a reality, achieving a record-breakingly fast approval from the U.S. Food & Drug Administration just one week ago on March 29th.

Other Personal Protective Equipment May be Sterilizable

Battelle’s new Critical Care Decontamination Systems can allow the same N95 respirator to be completely cleaned and re-used up to 20 times without degrading the performance of the particle filter.

Healthcare systems will collect the N95 respirators that have been worn each day from their doctors and nurses and then “double-bag” the stacks of masks and ship those bags in cardboard boxes to the decontamination site where Battelle’s sterilization units have been set up.

photo courtesy Battelle

Each of the individual masks will be barcoded to ensure that the hospitals get their own equipment back and the same barcoding will also keep track of how many times each individual mask has been sterilized.

While the actual hydrogen peroxide vapor fogging process takes less than three hours, the entire cycle – beginning with loading the masks into the containers and then packing them back up afterwards -can take up to 12 hours but as many as eight of the containers can be served by the same hydrogen peroxide vaporizer in a day’s time, boosting the total number of masks that can be processed to 80,000 per day by each CCDS.

Although the FDA has not approved any additional uses for the CCDS yet, Battelle is hopeful that the exact same sites will soon be allowed to re-sterilize other forms of personal protective equipment, including googles, face shields and some types of gloves.

Studies by the Word Health Organization have shown definitively that the more protective gear healthcare workers are able to wear correctly, the less likely they are to contract viruses and other diseases.

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