Design, Implementation, and Evaluation of an N95 Respirator Decontamination and Reuse Program for Healthcare Workers During the COVID-19 Pandemic.

Early in the COVID-19 pandemic, substantial disruptions in personal protective equipment (PPE) supply chains forced healthcare systems to become resourceful to ensure PPE availability for healthcare workers. Most worrisome was the global shortage of N95 respirators. In response, a collaboration between the Department of Infection Control and Healthcare Epidemiology and the Department of Biosafety at the University of Texas Medical Branch developed a PPE recycling program guaranteeing an adequate supply of respirators for frontline staff. The team successfully developed and implemented a novel workflow that included validated decontamination procedures, education, and training programs as well as transportation, labeling, and storage logistics. In total, 15,995 respirators of various types and sizes were received for recycling. Of these, 12,752 (80%) were recycled. Following the program's implementation, we surveyed 134 frontline healthcare workers who overwhelmingly graded our institution's culture of safety positively. Overall impressions of the N95 respirator recycling program were mixed, although interpretation of those results was limited by a lower survey response rate. In an era of increasing health security threats, innovative recycling programs like this one may serve as a model for other health systems to respond to future PPE supply chain disruptions.

Outbreak of coronavirus disease 2019 (COVID-19) among operating room staff of a tertiary referral center: An epidemiologic and environmental investigation.

OBJECTIVE: Investigate an outbreak of coronavirus disease 2019 (COVID-19) among operating room staff utilizing contact tracing, mass testing for severe acute respiratory coronavirus virus 2 (SARS-CoV-2), and environmental sampling. DESIGN: Outbreak investigation. SETTING: University-affiliated tertiary-care referral center. PATIENTS: Operating room staff with positive SARS-CoV-2 molecular testing. METHODS: Epidemiologic and environmental investigations were conducted including contact tracing, environmental surveys, and sampling and review of the operating room schedule for staff-to-staff, staff-to-patient, and patient-to-staff SARS-CoV-2 transmission. RESULTS: In total, 24 healthcare personnel (HCP) tested positive for SARS-CoV-2, including nurses (29%), surgical technologists (25%), and surgical residents (16%). Moreover, 19 HCP (79%) reported having used a communal area, most commonly break rooms (75%). Overall, 20 HCP (83%) reported symptomatic disease. In total, 72 environmental samples were collected from communal areas for SARS-CoV-2 genomic testing; none was positive. Furthermore, 236 surgical cases were reviewed for transmission: 213 (90%) had negative preoperative SARS-CoV-2 testing, 21 (9%) had a positive test on or before the date of surgery, and 2 (<1%) did not have a preoperative test performed. In addition, 40 patients underwent postoperative testing (mean, 13 days to postoperative testing), and 2 returned positive results. Neither of these 2 cases was linked to our outbreak. CONCLUSIONS: Complacency in infection control practices among staff during peak community transmission of SARS-CoV-2 is believed to have driven staff-to-staff transmission. Prompt identification of the outbreak led to rapid interventions, ultimately allowing for uninterrupted surgical service.