A simple surgical mask modification to pass N95 respirator-equivalent fit testing standards during the COVID-19 pandemic.

BACKGROUND: The COVID-19 pandemic has infected hundreds of millions of people resulting in millions of deaths worldwide. While N95 respirators remain the gold standard as personal protective equipment, they are resource-intensive to produce and obtain. Surgical masks, easier to produce and obtain, filter ≥95% submicron particles but are less protective due to a lack of seal around a user's face. This study tested the ability of a simple surgical mask modification using rubber bands to create a seal against particle exposure that would pass N95 standards. METHODS AND FINDINGS: Forty healthcare workers underwent TSI PortaCount mask fit testing using an ASTM Level 1 surgical mask modified with rubber bands. Fit Factor was determined after testing four standard OSHA N95 fit testing scenarios. Performance of the properly-modified surgical mask was compared to that of a poorly-modified surgical mask, an unmodified standard surgical mask, and an N95 respirator. Thirty-one of forty (78%) healthcare workers passed Fit Factor testing using a properly-modified mask. The Fit Factor success rate significantly improved by subsequent test date (p = 0.043), but was not associated with any other participant characteristics. The average Fit Factor score for the properly-modified mask was 151 (SD 65.2), a significantly better fit than the unmodified mask score of 3.8 (SD 3.1, p<0.001) and the poorly-modified mask score of 24.6 (SD 48.4, p<0.001) but significantly lower than a properly fitted N95 score of 199 (SD 4.5, p<0.001).do. CONCLUSIONS: Rubber bands, a low-cost and easily-accessible modification, can improve the seal and protective ability of a standard surgical mask to the level of an N95 respirator. This could mitigate N95 respirator shortages worldwide and provide individuals in under-resourced regions a practical means for increased personal respiratory protection.

Utilizing Google Trends to Track Online Interest in Elective Hand Surgery During the COVID-19 Pandemic.

Introduction Elective hand surgery encompasses a large volume of orthopaedic cases annually. Carpal tunnel syndrome, ganglion cysts, and trigger digits are some of the most common pathologies treated by hand surgeons. In the midst of the COVID-19 pandemic, patient's interest in elective hand surgery for these conditions is uncertain. The objective of this study is to use Google Trends to track online interest in elective hand surgery in the United States during the COVID-19 pandemic. Methods Online search trends regarding elective orthopaedic hand surgery were obtained via Google Trends from November 2019 to November 2020. Three common hand pathologies in lay terms ("carpal tunnel," "'ganglion cyst' + 'wrist cyst,'" and "trigger finger") and three hand surgery-specific keywords ("hand surgery," "carpal tunnel surgery," and "trigger finger surgery") were used as search terms. The search volume index (SVI) graphs for the United States for both sets of search terms were then generated from the Google Trends data and compared to the seven-day average of new COVID-19 cases per day as reported by the CDC. A separate SVI graph was then created for the search term "coronavirus" and was compared against both sets of search terms as above. Results Search trends for all elective hand pathologies and surgery-specific keywords remained constant from November 2019 to the beginning of March 2020 and then decreased significantly within a one-month period following the peak in COVID-19 cases the week of March 15, 2020. Search trends for these keywords increased to baseline levels over the next few months. The search trend for "coronavirus" demonstrated a small search volume index peak of 13 during January 2020 followed by the maximum peak of 100 during the week of March 15, 2020, corresponding to the decrease in search trends of elective hand surgery at that time. Conclusions Online interest in elective hand surgery remained constant prior to the COVID-19 pandemic; however, there was a marked decrease in search trends of elective hand surgery with the rise in daily reported COVID-19 cases, suggesting that patient's interest in elective hand surgery decreased with the onset of the pandemic.