The FDA wrote in a public statement on Sunday: "In response to public health and safety concerns about the appropriateness of decontaminating certain respirators, the agency is reissuing certain emergency use authorizations (EUAs) to specify which respirators are appropriate for decontamination. Based on the FDA's increased understanding of the performance and design of these respirators, the FDA has decided that certain respirators should not be decontaminated for reuse by health care personnel."
RN and MNA President Donna Kelly-Williams said in response to the FDA reversal: "Government officials and healthcare executives wasted time and resources and put frontline workers at risk chasing the unproven and dangerous dream of mask decontamination. Nurses and healthcare professionals caring for patients during this pandemic knew all along that these processes lacked rigorous evidence, could damage N95 masks and may create lasting health problems.
"The MNA spoke out strongly against decontamination early on, instead urging government and healthcare leaders to make sure every frontline healthcare worker had a new N95 mask to protect them against exposure and limit the spread of COVID-19," Kelly-Williams said. "The FDA's reversal on decontamination is a glaring example of why nurses and healthcare professionals on the frontlines must be heard.
"Prioritizing the opinions of healthcare executives and hospital lobbying groups over the guidance of those fighting in the trenches of this pandemic has placed nurses and patients in jeopardy," Kelly-Williams said. "As healthcare facilities re-open additional services, it is absolutely essential – for the safety of caregivers, patients and the public – that the recommendations of those on the frontlines are heard and implemented."
The MNA has taken a leadership position in opposing the use of these products due to the risks to the health and safety of nurses and other healthcare workers who are caring for patients. In a position statement released to the public on April 29, the MNA called for the halt of decontamination of masks, and that nurses and healthcare professionals have the right to consent or refuse to use decontaminated masks.
"The lack of reliable information on these practices, as well as the potential safety risks of these decontamination procedures pose risks to the health and safety of health care workers, as well as the general public at large require that these practices be halted," reads the MNA position statement.
The reversal of the FDAs position has resulted in the agency's reissuing of the Emergency Use Authorizations (EUAs) for the following products:
"…decontaminated respirators should only be used when new FDA-cleared N95 respirators, NIOSH-approved N95 respirators, or other FDA authorized respirators are not available. The decontamination systems are only authorized to decontaminate non-cellulose compatible N95 respirators. As such, health care personnel should not reuse a respirator that is incompatible with an authorized decontamination system but has nonetheless been decontaminated. Users of any respirator (whether or not decontaminated) should always assess for proper fit after placement. Respirators with poor fit, visible soiling, or damage should not be used."
These changes prohibit the decontamination of N95 respirators that were manufactured in China, which accounts for the majority of available products utilized across the globe. The MNA is calling on healthcare organizations to act immediately to procure an adequate supply of new personal protective products (PPE) that meet the standard that had been in place pre-pandemic.
The MNA also calls on the state to follow the FDA's lead and prohibit all hospital systems for utilizing decontaminated masks, and for the federal government to fully activate the Defense Production Act to mobilize immediate production of safe and appropriate N95 masks to allow for the safe reopening of health care services, as well as to prepare for a potential second wave of COVID-19 exposure in the fall. If proactive steps are not taken to secure these products now, the risks to public health and worker safety may be irreparable.
Founded in 1903, the Massachusetts Nurses Association is the largest union of registered nurses in the Commonwealth of Massachusetts. Its 23,000 members advance the nursing profession by fostering high standards of nursing practice, promoting the economic and general welfare of nurses in the workplace, projecting a positive and realistic view of nursing, and by lobbying the Legislature and regulatory agencies on health care issues affecting nurses and the public.