Minnesota Covid Aware app

 

One method of slowing the transmission of COVID 19 is to download the Minnesota COVID Aware App.  This app will notify you anonymously if someone that you have interacted with for more than 15 minutes has tested positive for COVID -19. It was fairly easy to download and is available for both Apple and Android phones. 

Why you should download the Covid aware app. - 4 min. 

Broad Pro Mask instruction video

 

Video on Broad Pro Mask

Broad Pro Mask instruction video

Dashboard for Minnesota school models

 

MDE Dashboard on district learning models

COVID Contract Tracing guidelines

MDH - Return to work

MDH - What to do when you are sick for coronavirus? 

MDH - Waiting for coronavirus test results

Coursera: COVID-19 Contact Tracing - Johns Hopkins University

CDC: Contract tracing 

What is contact tracing? - approx. 2 minutes 

Origins of COVID and other Zoonotic diseases

U of Minnesota Origins of COVID and other Zoonotic Diseases


This webinar covers the origin of HIV via the SIV in primates in Africa.  Other wildlife based or zoonotic diseases are also covered. 

Use of Face Shields to Protect Against Transmission of COVID-19

Medical Xpress - Could Face Shields replace masks in preventing COVID-19. 

CDC - Efficacy of Face Shields - CDC report that face shields are protective for health care workers from initial large droplets but provide very little protection over longer periods. 

CDC - Care and use of face shields

MDH - Best practices for masks and face shields for persons with disabilities. - Information on masks with clear openings for lip reading and when face shields are appropriate as sole protection. 

JAMA ...Face Shields and the Containment of COVID-19. The authors suggest that using face shields to prevent COVID-19 transmission would be easy to implement. Data suggest that they may protect the person wearing it from large aerosol transmission. They will not protect against small aerosol transmission. 

Contagion Live - Interview with an author of the JAMA paper. Encouraging the universal use of face shields could reduce the r naught to below one. The use is based on similar diseases but not specifically on COVID-19. 

PMC - Safety Guidelines for Sterility of Face Shields for the COVID-19 outbreak - They list specifications for the design and cleaning of face shields. The chemical list is rather limited. 

Lancet - Physical Distancing, Face Masks, and Eye Protection ... Distances of 2 meters or greater are recommended to reduce transmission. All three of these measures can combine to potentially reduce exposure but not eliminate it. There is a need form more specific COVID - 19 data. 

FDA - Emergency Use Authorization for the production of face shields - The authorization lists the specific approved methods for the production of face shields. 

Interview with Michael B. Edmund on the use of face sheilds - 11:30 min. 

COVID -19 Guidance for Returning to work at Universities and other locations

Duke University has two return to work guides. 

• Return to work for Research Laboratories (Duke University)
• Return to the workplace general guide (Duke University)

The British firm CIPD has produced a return to work guide.

• Returning to work after the coronavirus (CIPD)

The American Industrial Hygiene Association has Back to Work Safely guidelines for several industries. 

• Reopening Guidance for General Office Settings (AIHA)
• Return to Work Construction Guidelines (AIHA)
• Reopening Retail Guidelines (AIHA)
• Reopening Restaurant Guidelines (AIHA)

The University of Minnesota

• COVID-19 Health and Safety Resources (UHS)
• Sunrise Plan for U of Minnesota (UMN)

Summs guide for returning to work - 19 min.

IOSH - guide for health professionals - 1 hour

The use of Heat for SARS-CoV-2 disinfection

There are four main methods to disinfect SARS-CoV-2 the virus that causes COVID-19.

1. Time: The virus eventually no longer will be viable after a period of time. This depends on several things including the surface type, the temperature, and relative humidity. 
2. Ultraviolet light (UV-C) also known as UVGI (Ultraviolet Germicidal Irradiation) at 254 nm works to alter the RNA of the SARS-CoV-2.
3. Vaporized Hydrogen Peroxide 
4. Temperature. Elevated temperatures reduce the viability of the virus.  

Links:

Consumer Lab: 

WHO - SARS survival (not SARS-CoV-2)

NIH validates methods of respirator decontamination

Decontamination of respirators was effective at 70 degrees Celsius for 60 minutes. These elevated temperatures may cause damage to respirator components.  

Stanford Medicine has done multiple studies decontaminating respirators with UV-C and heat. In there study they found repeated heating of masks with hot air at 75C for 20 cycles did not damage a respirator. An 8 W UVGI (254 nm) for 30 minutes for 10 cycles did not damage the respirator.

As I reviewed the 3M website masks appeared to have different temperature tolerances. 

Guidelines for Reopening Businesses and schools during COVID-19

The deeper you look the more you find - photo N. Carlson

Many places of employment are working through plans to reopen while minimizing transmission of SARS cov 2 the virus that causes COVID-19. The following is a list of guidances primarily from the CDC about opening businesses, schools and Universities. In the near future more specific information will become available, and this information will be added to the post. 

General guidance:

Back to Work Safely - AIHA offers industry specific guidance for getting back to work safely.

Business guide for responding to COVID-19 - CDC

Reopening Guidance for Schools and Businesses - CDC


How to clean and conduct risk management for COVID-19:

Cleaning and Disinfecting Tool - CDC

Disinfect Non-Emergency Vehicle with COVID-19 positive occupant - CDC

Reopening guidance for cleaning and disinfecting areas - CDC

Cleaning and Disinfecting Your Facility - CDC

Guidance for Schools for COVID-19  - CDC

Guidance for Higher Education Administration - CDC

Cleaning for CoVID -19 - Sustainable Mycology summary

LBC - General information on Deep Cleaning for Coronavirus - 3 min. 

Private Sector call on COVID-19 response from CDC 4/29/2020 -46 Min.

COVID-19 School response - March 26, 2020 - CDC - 61 min.

CDC updates symptom list for COVID-19

Symptom Chart Provided by MNChildrens

The above chart helps individuals differentiate between the cold, flu, and COVID-19. The CDC has recently published and updated list of COVID-19 symptoms.  The list previously included the top three symptoms. The symptoms in Bold are new additions to the list.

• Fever
• Cough
• Shortness of breath or difficulty breathing
• Chills
• Repeated shaking with chills

• Muscle pain
• Headache
• Sore throat
• New loss of taste or smell

The CDC has a Coronavirus Self-Checker to help people get a better idea if they have symptoms of COVID-19

Please see below about gastrointestinal symptoms and a recent NEJM publication noting a higher than normal incidents of stroke in younger coronavirus patients in New York City.

A doctor at the Mayo Clinic notes that patients can have gastrointestinal symptoms that are associated with COVID-19 with or without respiratory symptoms.  1 min. 

Washington Post summary of symptoms - 1 min. 

Dr. Justin Springer on the association between COVID-19 and increase incidence of stroke - 3 min. 

Cleaning for COVID-19

CDC guidance for cleaning and disinfecting facilities

There are several guidance documents on general cleaning guidelines for a COVID-19 area of concern.

Role of hand washing and surface cleaning - Click to enlarge graphic

MMWR reported on increased health concerns associated with use of cleaning chemicals.

The CDC has some good general guidelines.

CDC room clearance based on ventilation rates. How long do you have to wait before cleaning and putting another patient in the room?

CDC guidelines for household cleaning.

OSHA has some minimal guidance with references to the CDC. 

The US Army has a very good detailed protocol that may help answer specific questions about what is the proper order to clean an area.  

One minute summary of CDC's cleaning guidelines

How to disinfect home with COVID-19 patient - 2 min.

Portland State University deep cleaning high contact surfaces - 2 min.

UV-C disinfection of hospital rooms

Electromagnetic spectrum - Stanford University

UV-C light in the range of 280 to 200 nm (254 nm the most effective) is a disinfectant used in laboratories and ventilation systems. Direct exposure to the light at this wavelength can severely damage skin and damage vision. UV light can also produce ozone, Ozone health effects are noted by the CDC.

The following links describe the use of UV-C lights for room disinfection.  One of the concerns is making sure that the light exposes all surfaces.  There are also concerns about the length of time needed.  The light does generate heat so no flammable objects can be close to the light. The UV-C light will decay in effectiveness over time. Specific meters are used in the UV-C light range to determine the level of exposure needed to kill the virus. Refer to the Wikipedia article on Ultraviolet Germicidal irradiation

Links:

CDC methods of disinfection  UVC kills bacteria and viruses more easily than bacterial spores.

Research Gate: inactivation of mold spores by UVC Aspergillus niger conidia are difficult to kill with UV-C light

Science Direct -Programmable and low cost UV-C room disinfection

NIH - Using UV-C light to disinfect high touch surfaces in hospitals.

Asian Journal - UVC kills bugs at home.

Indian J. of Med. and Biology - Surface disinfection by germicidal UV-C light

Dangers of UV-C light - 4 minutes

Applications of UV-C disinfection - BBC News - 2 min.

Duke Health: Benefits of room UV-C disinfection - 2 min.

MDH and CDC guidance for using paper bag to extend the life of N-95 respirators but not surgical masks

Paper bag with handles 8.5" x 6.5" x 3.5"  Name and date are clearly marked on the bag

Respirator straps are hung from paper bag handles

The respirator is suspended above the bottom of the bag

A 2 gram desiccant pack is placed at the bottom of the bag to absorb moisture from the mask to slow down bacterial and fungal growth. The amount of desiccant needed may vary dependent on storage conditions.

Please see the disposable respirator post for links to the Minnesota Department of Health and the CDC for the number of times these respirators can be used. Guidance on the number of uses will vary by health care provider. The length of storage time will vary from 5 to 7 days. This is based on the anticipated COVID-19 survival time on surfaces.

Experience from nurses indicate that moisture in the masks is an issue. The straps also tend to wear out after repeated use.

To reduce particle loading on the mask, staff are asked to refrain from wearing make-up in areas that will contact the surface of the mask.

Surgical Masks:  Surgical masks provide some protection from droplets but they are primarily designed to protect the patient from the provider because the mask does not provide a tight face seal. Never reuse, wash or disinfect surgical masks. Please see Delaware Health and Social Services Division of Public Health - Proper use of surgical masks

How long do Coronaviruses Live on Surfaces

WebMD Coronaviruses on surfaces

According to an April 2, 2020 Medscape article on coronaviruses on fabrics researcher still need to study how the virus survives on clothing. The CDC recommends washing clothes on the warmest possible setting and drying the clothes thoroughly. Please review CDC's home cleaning recommendations for a suspected or known COV-19 person in the house. 

Business Insider and Lancet Microbe - April 2020

There are worse jobs than cleaning up a space for COVID-19. The video below from National Geography shows extreme cleaners in action.  Not recommended for viewing by those that are easily nauseated. 

Extreme Cleaning - National Geographic - 3 min. 

UV-C light disinfection of n-95 face masks

In an effort to prolong the life of N-95 face masks, many institutions have been using UV-C light disinfection.  It is being looked at by 3M and they list testing results on their masks. FDA recommends following the guidelines of the manufacturer for UVC decontamination procedures. CDC references a article from the Infectious Disease Journal providing guidance on UVC decontamination. The CDC lists UVC as a method of N-95 respirator decontamination. 

Here are some safety notes to note up front.  UV-C light is hazardous.  Do not expose skin or look at the light as it will cause damage. The light must be turned on remotely without individuals present in the room. The lamps can get hot, and ozone may be produced.

There are concerns with making sure all parts of the mask are disinfected. There are also concerns that the UV-C light will cause the material to photo degrade and loose its effectiveness.

Not all UV lights are equivalent (notes from Nancy Rolstad and Wikipedia UV)

• UV-A lights (the ones used in a tanning bed) do not have sufficient germicidal properties (long-wave UV) It is associated with skin aging
• UV-B light is a shorter wavelength of light associated with skin burning.
• UV-C lights are necessary for disinfection. (aka UVGI germicidal irradiation or shortwave UV)
• UV-C light bulbs efficiency is reduced over time. A UV meter is necessary to measure the quality of the light source. 
• UV-C light is absorbed by the ozone layer and the atmosphere. That is why the sunlight that reaches the earth does not have good disinfecting properties for COVID-19.

J. of 

The University of Nebraska has excellent guidance on the use of UV-C light for COVID-19 disinfection including information on a COVID-19 UV-C decontamination process They also looked at using the UV-C lights in biological safety cabinets to disinfect masks.  The University of Nebraska produced specific information on UV-C light respirator decontamination. The AMA has a brief description of the process. 

Stanford University also has a UV-C COVID-19 disinfection process.

In Science Daily: Researchers report a 99.9% reduction in surface COVID-19 levels with a 30 second dose of UV-C light.  The dose was not specified.

U of M's CIDRAP has weighed in on N-95 reuse. Current methods are for an emergency use only to extend the amount of stock available. The UV-C light does begin degrading the material. Under the emergency circumstances they recommend 5 cycles at 1 J/cm2 per cycle.

Conversion of milliwatts/cm^2 to Joules/cm^2 Milliwatts to Joules converter

Papers:

Journal of Occupational and Environmental Health - Effects of UVGI on N95 Respirator filtration performance and structural integrity.  - July 2015.

Applied Environmental Microbiology - This was a study on the use of biological indicator strips to verify sterilization with plasma, UV-C, and blue light.

American Journal of Infection Control - UVGI decontamination of respirators with influenza virus - 2018.

ECRI - N-95 respirator decontamination by UVC for COVID-19.  Contains extensive list of peer reviewed references. 

NIH publication on UV-C disinfection for COVID-19

American Medical Association - Tackling the shortage of N-95 respirators with Novel Decontamination.

Omaha hospital using ultraviolet light (UV-C) to disinfect masks - 3:32 min. 

Duke Health - Benefits of UV-C disinfection of patient rooms  - 2:17 min. 

DIY disinfection of masks with 30W UV-C light (Not FDA approved) 11 min.
I am working with a health physicist to verify the calculations. 

DIY COVID-19 PPE Ideas

Check out the NIH DIY 3D printer COVID-19 page for some original solutions to PPE problems.

Cloth face masks:

Allina health has looped face masks that they are accepting for donations.

There is an upgraded DIY mask from Allina Health with a built in pipe cleaner to improve the fit of the mask around the nose.   I will give it a try.  I could not locate 1/4 inch elastic bands because all stores were sold out.  I will try with larger elastic bands and see how it goes.

Face shields

St. Cloud State converted plastic overhead projector sheets into face shields.

I will be adding to this page in subsequent days.

A DIY video from Blue Cross/Allina on making the looped face mask - 19 minutes 

Cleaning and disinfecting 3M versaflow Powered air purifying respirators

3M versaflow for health care- 3M 

If available, the proper use of a HEPA filtered powered air purifying respirator (PAPR) can be used to reduce the use of N-95s by health care workers as the HEPA filter on the device may be used for an extended period of time without changing.  The face shield and covers can also be disinfected.  These series of videos show proper assembly, donning and doffing of one style of 3M PAPR.

These supplemental notes to the videos on PAPR use and decontamination were developed by Nancy Rolstad from the BioSafety group at University Health and Safety.

Before Starting:

Eyeglass users: 

Consider a strap retainer to hold the eyeglasses in place. This may take a little adjusting as the hood is donned and more care when doffing to not be tempted to reach for glasses before hand hygiene is performed.  People may also use medical tape over the frame to their temples too but not without some discomfort.

There are also silicone retainers to slide on frames to help eyeglasses stay in place. https://www.amazon.com/Benvo-Eyeglasses-Retainers-Anti-slip-Protectors/dp/B07TTW1LD7/ref=sr_1_3?dchild=1&keywords=eyeglass+retainers&qid=1585941102&sr=8-3

Precheck:

Test airflow with the ball tube  (set out of the way so it doesn't become contaminated during doffing)

Hand over the output to test alarm  (shown in the video posted below)

Verify that there is enough battery power

The battery may need a good thump to get it locked in on the respirator, try pulling it off to verify it's tight.

To facilitate decontamination, install a plastic sleeve over the tube and secure with twist ties, tucking ends of twist ties in a way to prevent snagging.  (Consider taping, with a tab for easy removal as another option)

Check the hood for leaks before donning by gathering up the shoulder shroud (as if choking it) to verify it fills with air and you don't hear or feel any air pushing out any little holes. 

Donning:

Shroud Layering- Leave the longer shroud inside the disposable gown to help protect in from contamination

Use the gown to cover the unit to help protect it from contamination as shown in the video.

Doffing:

Follow the demonstration in the video with respect to doffing the disposable gown and gloves to prep for decontamination between patients or end of the shift.

Assure that there is a large enough space for two people.

Decontamination post doffing:

All items to be disinfected must remain visibly wet for the contact time listed on the (EPA approved) disinfectant's container and left to air dry. Do not attempt to wipe it dry. 

Wipe down the plastic sleeve being careful not to poke gloves with the twist tie ends which may be pointy.  Wipe down and carefully remove and properly dispose of the plastic sleeve at the end of the shift or if it becomes damaged.

Gently hang shroud to dry for next use. 

Wipe down table. 

Battery:

Battery connection points can become corroded if they get wet during decontamination. Avoid contact with disinfectant and battery connection points, if they do get wet be sure the battery contact points are dry before starting to charge.

Verify the battery is charging.

If there seems to be a connectivity issue a soft pencil eraser on the copper contact points can help to gently remove residue.     

Locate the battery charger in a place where it will not come into contact with items being doffed/ decontaminated.

Versaflow TR300 Mask 3 min. 27 seconds.

S- series head cover information.  View the first 2 minutes and 15 seconds

Donning, Doffing and disinfecting 3M PAPR breathing apparatus - 10 min. Please note this head cover is different from the s-series head cover in the previous video.  

There is a Cleaning Reusable Respirators-and-PAPR-assemblies document available from 3M

Home made face masks and COVID-19-

This is an early prototype of a two layer cloth mask made by my sister. The final mask will reposition the straps and have a twist tie sewn in above the nose bridge to get a better fit. I will be offering support for her to make masks to prolong the life of N-95 respirators, and to help protect others from people who do not know they have symptoms. The newer mask is an updated version of the Olson Mask

The fabrics used in a mask as well as the mask air leakage affect the ability of the cloth mask to filter out large and small particles. Combining multiple layers of different fabrics improves the mask filter efficiency. ACS Nano April, 2020.

MDH (Minnesota Department of Health (interim guidelines on alternative face masks) Wash dirty masks between each use. Wash in hot water with regular detergent. Dry completely on hot setting.  It contains guidance for when the respirators are appropriate to use and several websites with suggested designs. 

The University of Minnesota has a MN COVID Mask Sewist Group. You participate by making masks or requesting a cloth mask.  It also has a Face covering FAQ on the requirement that all people on campus are required to wear face coverings.  Please also see the UHS guide for fabric face coverings. 

Research paper (NIH) that does a comparison of cloth mask materials - Testing the efficacy of home made masks. It is interesting that the results of this study is slightly different from my current limited tests of recent home made mask designs. 

Lisa Brosseau offers a commentary that masks for all is not based on sound science. Filter efficiency and fit are key to the effectiveness of respirators. The filtering efficiency and face fit of the cloth mask is variable and deficient when compared to a properly fitted N-95 respirator. 

A recent summary at Fast.ai suggests that combining social distancing with cloth mask usage appears to be helpful in flattening the curve in some countries notably the Czech Republic. The video below explains how the Czech republic successfully established their Masks4All program  using the phrase, "I protect you. You protect me."

Home Made Face Mask Use - Czech Republic

The calls for general public mask use are increasing. In Australia grocery shoppers must wear masks - Reuters. The CDC has issued guidelines on the voluntary use of cloth face coverings. They emphasize the use of these cloth face coverings is an addition the maintenance of social distances and proper hand hygiene.

Amy L. Baxter, MD in a Medscape article asks Is it Time that We All Start Wearing Face Masks?
She offers strong arguments that it will reduce the efficiency of transmission from an infected individual to another person.

My comments:

The cotton masks do not work as well as a properly fitted and worn N-95 respirator.  However a multi-ply cloth respirator covering the mouth and nose will limit the amount of droplet aerosols produced during coughing, speaking, sneezing, or singing. Wearing a cloth mask will reduce a person's ability to infect another person. It will also make it more difficult for a person to directly touch their nose or mouth.

Breathing through a mask can cause more resistance from breathing. If you have questions about the use of one of these masks consult with your super busy health care provider.

Hand hygiene after mask removal is important. These masks will need to be washed and dried daily in a dryer on high temperature setting. Others have recommended washing, drying, and steam ironing for additional disinfection.

Maybe this will be another way we can all do our part to flatten the curve.

------------------------------------------------------------

COVID-19 Michael Osterholm March 2020 interviews

Joe Rogan Experience with Michael Osterholm (1 hour 34 min.) - 3/16/2020

I've been fortunate to hear Michael Osterholm speak many times. He is an intelligent, articulate expert on the the progress of infectious disease outbreaks. This video has been viewed over 13 Million times on YouTube since the middle of March.  

Radio Show Host Dan Barreiro and Michael Osterholm talk coronavirus - 15 min. 3/23/2020

The above discussion is from a radio broadcast toward the end of March with local Twin Cities radio host Dan Barreiro.

Michael Osterholm Bloomberg Australia interview talks about balancing health and economics - 8:24 minutes.


CIDRAP Global Coronavirus Response - podcast 38:48 minutes

On March 31, 2020 COVID-19 response Michael Osterholm discusses the current condition with the virus. He does not find a model that would support seasonality.  He gives counsel on how to best ride out the storm. We need to base our decisions on science and telling the truth. We need to care for each other. 

COVID - 19 Resources at the University of Minnesota

U of Minnesota Clinical trials

The University of Minnesota has extensive resources for the COVID-19 response. The main link for all responses is the Safe Campus

COVID-19 Page U of Minnesota

University COVID-19 Action Network

CIDRAP (Center for Infectious Disease Research and Policy

COVID-19 Clinical Trials at the U

COVID-19 Guidance for the research community

Health Emergency Response Office (HERO)

Safe Campus COVID-19 updates

U of Minnesota Transforming ideas into trials - Dr. Tolar 3/30/2020 - 2 min. 

COVID-19 U of M Ventilator update 3/26/2020 - 2 min. 

CDC guidance on room air changes COVID-19 and surface cleaning

Wyoming Department of Health

The CDC has provided guidance about the number of minutes a room needs to remain unoccupied between patients based on the number of air changes per hour in the room. More in depth information is provided with the CDC link below.

Room air changes and airborne contaminant removal COVID-19

Surfaces in the space will also need to be cleaned in between patients. See section 6 in the CDC Infection Prevention Control Guidance.  The chemicals used would need to be included in the CDC list of approved chemicals for disinfecting COVID-19

Environmental cleaning of high touch surfaces in patient care rooms - U of Nebraska - 5 min. 

OSHA guidance for workers who remain on the job

Preparing workplaces for COVID-19 - OSHA

As some employees are required to remain working on the job while many others work from home, OSHA has developed a tiered response for the remaining workers. OSHA specifies ventilation, administrative and personal protection equipment for each risk level.

Guidance on Preparing Workplace for COVID-19

Cleaning workplace - CDC

Some locations at work may need to be cleaned after a person with COVID-19 has occupied the space. The CDC has provided guidelines for cleaning and disinfecting these non clinical environment spaces.

Environmental Cleaning and Disinfection - CDC

Disinfection workplace if someone is sick - CDC

Lists of approved cleaning products for disinfection COVID-19: Keep in mind that some chemicals require the surface to be wet approximately one minute prior to wiping (0.5% hydrogen peroxide) or four minutes with quaternary ammonia compound solutions.  Please consult the manufacturers labels for contact time. 

Center for Biocide Chemistry List for COVID-19

Center for Disease Control List for COVID-19

WCCO TV interviews Mark Hegberg from the U of MN about cleaning surfaces - 3 min. 

Hand hygiene and glove removal

Proper handwashing is an disease prevention technique  for the flu, COVID-19, or many other bacterial or viral illnesses. The Center for Disease control has a CDC Hand hygiene page with in depth information about the science of proper hand washing.

Soap and water and drying with a paper towel remain the best method of assuring proper cleaning of the hands.  Videos below illustrate proper hand washing techniques and proper glove removal.




Handwashing WHO technique 1 minute and 49 seconds

Glove removal technique - 49 seconds

COVID - 19 Disposable Respirator Guides from NIOSH

Face fitting respirator - NIOSH

The Minnesota Health Department has issued Strategies for Optimizing the Supplies of PPE as of April 2, 2020

CDC has issued Guidance for PPE Optimization and Guidelines for respirator decontamination

Update Lancet article on Stability of SARS CoV-2 in different environmental conditions.  April, 2020. Survival up to 7 days for surgical masks. 

Guides for Decontamination of N-95 respirator. from N95 decon.org

Vaporized Hydrogen peroxide sterilization of respirators from San Antonio, Texas is underway. The respirators with obvious visual contamination are discarded.  The respirators can be reused by the same person up to 5 times. The hospital can process 50 respirators a day.

Amy Herr from UC Berkley and David Rempel from UC San Francisco respond to an extended Q and A session on issues with N-95 respirator decontamination from the North Coast Journal.

NIOSH guidelines for decontaminating and reuse of filtering facepiece respirators.

I have recently been helping health care providers with disposable respirator fit testing. Part of the procedure involves teaching the providers how to put the mask on and fit it to their face. Helpful tips based in this experience include:

• Remove earrings or other body jewelry that may interfere with the seal of the respirator or cause problems with putting on or taking off the respirator. Hoop earrings were particularly problematic. 
• For long hair, consider placing it in a pony tail, braid it, or cut it. Pull back the hair from the face to prevent the hair from getting in between the seal of the respirator. 
• Make sure to put the respirator on underneath the eyeglasses. The eyeglasses can be used to check the face fit as they will often fog up during the positive pressure test.
• Keep facial hair out of contact with the respirator seal. I've included a link to the NIOSH guide for respirator facial hair.
• Use the two finger method shown above to help adjust the nose piece. Do not pinch the ridge with a thumb and index finger as it will often create an air gap at the bridge of the nose. 

The guides recommend complying with applicable laws with respect to respirator fit testing. This fit testing helps assure that the respirator will properly fit your face and provide the protection when properly put on.  On March 14, 2020, OSHA has temporarily suspended the requirement for annual fit testing of health care workers to preserve the stock of respirators.

Links:

NIOSH Respirator Face Seal Check

NIOSH How to Properly Put On and Take Off a Disposable Respirator

NIOSH/CDC guide to facial hair and respirators

Donning and Doffing Respirators UNMC - 5 minutes

Fantastic Fungi Directed by Louie Schwartzberg

Fantastic Fungi Trailer - Approx. 3 minutes

Just saw the movie Fantastic Fungi directed by Louie Schwartzberg over this past weekend. The time lapse photography in this film is visually stunning The a computer animation sequence illustrating threes use of mycorrhizal to communicate was fascinating. The film focuses on how fungi interact with other species of plants and animals often performing necessary work to decompose other creatures at the end of life.

There is also a book, Fantastic Fungi: How Mushrooms Can Heal, Shift Consciousness, and Save the Planet based on the movie. I just recently purchased it and will review it at a later date. 

Fantastic Fungi Trailer Andrew Weil - Approx. 3 minutes



Fantastic Fungi Trailer The forbidden fruit - Approx. 3 minutes