Summary of KN95 vs. N95 Masks:
KN95 vs. N95 Masks. Due to the shortage of N95 masks, we have to consider using equally effective alternate options. N95 is a certification issued by US authorities. Masks that have equally effective properties as N95 masks go by different names in different countries based on their independent certification systems. (KN95 – China, P2 – AS/NZ, 1st Class – Korea, DS FFRs – Japan). Considering the life and death situation we face in the hospitals, we have to push our health care administrators to consider getting us these equally effective alternative options since N95s are not available. At the end of the day, we have to prioritize our patient’s health, our health and our families health.
Learn about COVID-19 transmission on a separate blog post: How is COVID-19 Transmitted? What is the Right Mask for COVID-19? A Physician-Scientist’s Perspective.
Learn about COVID-19 test sensitivity on a separate blog post: COVID-19 Test Sensitivity is Unclear. How Accurate is COVID-19 Test?
We are in dire circumstances, and dire situations call for ‘out of ordinary’ actions.
I am an internal medicine physician, and I am exposed to patients under investigation (PUI) for COVID 19. Lack of appropriate PPE is putting me at high risk for contracting the virus. This is in turn putting my family and other sick patients I see at risk.
Cutting to the chase, we know that the N95 masks are an appropriate PPE for healthcare providers. Currently, the N95 supply is unable to meet the demand. Appropriately priced N95 masks are not available for bulk order at least until late April or May 2020.
Now, if you do not have access to N95, can you use equally effective alternative options (KN95) in the US hospitals/private practices/providers? Isn’t using these alternative options better than using a “bandana” or a regular surgical mask or a handmade cloth mask?
There are more than a few N95 equivalent masks available worldwide. As per a comparison study performed by 3M – it is reasonable to consider China KN95, AS/NZ P2, Korea 1st Class, and Japan DS FFRs as “equivalent” to US NIOSH N95 and European FFP2 respirators, for filtering non-oil-based particles such as those resulting from wildfires, PM 2.5 air pollution, volcanic eruptions, or bioaerosols (e.g. viruses).
These masks have similar superior properties as N95, but they go by different names based on where they are certified.
The WHO (World Health Organizations) considers N95 equivalent to KN95 and other similar masks. (WHO Article 1. WHO Article 2.)
Although the US authorities recommend using N95 masks, we have to take into account the current situation, and act accordingly. We need to prioritize the safety of our patients, families, and ourselves.
Do we let the current-day US regulations become a factor that determine if you – your family – your patients live or die?
I know it sounds dramatic, but that is the current unfortunate situation.
We should all reach out to our respective hospital/private practice leadership, to promote and advocate the use of equally effective alternate options for N95 masks.
If you own an independent practice, or if you have authority to pick your own PPE, you should strongly consider these equally effective alternate options (KN95 vs. N95) as opposed to other less effective options (bandana/surgical mask/cloth mask). After all, the end result matters in these circumstances, not how you achieve it.
Fit testing for respirator masks:
Mask procurement difficulties:
This topic was excellently summarized in this NEJM correspondence: The New England Journal of Medicine – In Pursuit of PPE
FFP2 or KN95 are a good alternative, however we have the following challenges:
Custom fit KN95 masks:
After jumping through multiple hoops, we finally get hold of FFP2 / KN95 masks. That’s great, now we have masks with a good quality material that can defend us against the virus. Problem is, they are one size fits all – regular size. This results in a poor seal, and a high risk for air leaks. We have to use some street-smart tricks to make sure that the mask creates a good seal.
We have been using two techniques to help customize the masks to the wearer, and secure a tight seal:
The eventual goal is to prevent any air leaks. Unfortunately, the design/material of surgical masks and bandanas (home made masks) create too much air leak. There are many common misperceptions of what masks to use, and when to use. Please refer to this detailed post that summarizes the use of masks in COVID-19 – https://physicianestate.com/what-is-the-right-mask-for-covid19/
I hope we have access to the appropriate PPE that we need to take care of our patients and our families.
Learn about the right mask to use for COVID-19 on a separate blog post: What is the Right Mask for COVID-19? How is COVID-19 Transmitted? A Physician-Scientist’s Perspective.
Learn about the accuracy of COVID-19 test on a separate blog post: How Accurate is COVID-19 Test? COVID-19 Test Sensitivity is Unclear.
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