Friday, March 20, 2020

Question:

We are all told that n-95 (or any other kind) of facemask doesn't help with prevention re: Covid-19.

(Which I call "Bullshit" on, as the disease, we are told, is spread by droplets from sneezes and coughs, and anyone who has worn a dust mask knows that, while they don't stop all particles, they do stop the majority....)

But since we are told the masks don't work, then why is the Health Care industry screaming that they need those same masks? That without them, they will all get sick and die?
Which is it? Either they work, or they don't.

Also, Have you ever watched to see how those masks are used? They (caregivers) go in to a patient's room, masked, gloved, gowned.
Once done, when they leave, they remove ALL of the PPE (mask, gloves, gown) and then put on the PPE before entering another patient's room.
Now I can see gloves, cause they are touching the patient, but mask and gown being completely replaced for EACH patient?
I'm no doctor, but I have to ask why new mask, new gown every time. Especially when the next patient is also sick with the same virus.
I find it hard to believe that 5 minutes of use renders that (doesn't work anyway!) mask less effective.

It is no wonder they are running out of masks and gowns.

A suggestion: Lots of closed restaurants...they have gloves, if nothing else.

Can any medical professional clarify my questions on PPE? 

6 comments:

Jester said...

Some of the disposal comes from what one patient might have can be transmitted to the next patient. It's not always just one uniform stage of a disease or even single disease. Patient 1 might have two or three different things going on that are entirely different from patient 2, even if they share on disease between them.

Jester said...

It also has to do with the stuff is supposed to be disposed of in the room of each patient. With this stuff you don't want to be taking it outside the room if at all possible or for that matter any number of other diseases.

B said...

interesting.

No one has addressed the "Masks don't work" bit though.

Aesop said...

Anyone who said, point blank, "N95 masks don't work", without further explanation, was wrong.

N95 masks work:
1) if you've been fit tested
2) if you've been trained in putting it on and taking it off properly, without self-infecting or self-contaminating
3) if you know how to make sure it's seated and sealed properly, every time, and do that
4) if you're clean-shaven (or close to it), rather than having facial hair that prevents a good seal

Having it "mostly" on right means you're going to get infected too, which makes it pointless, especially for droplet or airborne precautions, which Covid-19 is.

I can tell you that 20-25% of hospital staff routinely fail annual fit testing, and have to rely on other options (whole-head hoods and PAPRs) any time they need to wear isolation PPE.

So extrapolating that to society at large, at least that many will have the same problem.
Add in the facial hair blocking a seal, no training, and no verification via fit testing, and N95s won't work for a substantial portion of society at large.

For the rest, particularly anyone who uses them routinely and understands what they're doing, they'll work just fine.

And everything Jester told your regarding cross-contamination is exactly correct as well.
Back in the day, doctors moving from patient to patient, before sanitary procedure was well-known, infected and cross-contaminated their patients, and killed them.
It took 100 years and a lot of dead patients to beat that lesson into the medical profession.

Simple ER patients that I deal with every day, long before the current flap, have all variety of contagions. MRSA, C. diff, VRE, Staph aureus, Staph candida, etc.
The point is not to give anything to patient B that you might have picked up from patient A.
So everything goes, every time.

The only exception is hard gear that can be wiped down or sterilized.
Gloves, gowns, and masks are made to be disposable.
But one nurse treating one patient in a shift will routinely go through a box of each in a shift. Sometimes more.

We routinely run out of stuff we should have in normal times.
With current shortages, and accelerated usage, it's far, far worse.

Fair enough?

Jester said...

@aseop

This is going to expose the true idiocy of the just in time stock/reorder method for the medical industry. I've been associated with it since 2011 have fought it tooth and nail at the VA for such reasons as this. Hell, we could not even use our pandemic stash due to it going out of date. (some morons apparently forgot to rotate that stock in to our normal stock and replenish the pandemic stash) This is a routine thing everyone. This is nearly every medical facility. So yes even in good times there is a very limited amount of PPE in the pipeline. Times like this? All I can say is you have facilities running out of stuff. Gloves especially. Those also are worn by your cleaning staff as well as your medical folks, fyi. I've stated that the minimum amount of stock at hand is to be able to provide everyone in the facility with supplies at a pandemic level for a minimum of 90 days with the expectation there would be no resupply in that time.

B said...

The fitment issues I can understand.....sorta.

But Some filtration of droplets is still better than nothing. One does not generally get a virus from one single virus, but rather from too many at once..

And if you are in a ward where the patients are all sneezing the same disease, how does a new mask really help?
If everyone has the same virus, then what difference does it make, except to use up masks faster so that eventually the staff runs out?

I asked my niece who is a nurse, and she just replied that it is protocol and that is just what they do, but could not address my questions.

At some point, having healthcare professionals stay healthy is more important that the low probability of cross infection in a ward of folks already sick with the same virus.

If y'all need gloves though...restaurants use even more per person than likely even the health profession. Not, perhaps blue ones, nor as "good" nor approved, but still, gloves that are effective and will likely last for your single use before disposal.