Heat and Humidity for Bioburden Reduction of N95 Filtering Facepiece Respirators.

Introduction: The coronavirus disease 2019 (COVID-19) pandemic has caused a global shortage of single-use N95 filtering facepiece respirators (FFRs). A combination of heat and humidity is a promising method for N95 FFR decontamination in crisis-capacity conditions; however, an understanding of its effect on viral inactivation and N95 respirator function is crucial to achieving effective decontamination. Objective: We reviewed the scientific literature on heat-based methods for decontamination of N95 FFRs contaminated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and viral analogues. We identified key parameters for SARS-CoV-2 bioburden reduction while preserving N95 fit and filtration, as well as methods that are likely ineffective. Key Findings: Viral inactivation by humid heat is highly sensitive to temperature, humidity, duration of exposure, and the local microenvironment (e.g., dried saliva). A process that achieves temperatures of 70-85°C and relative humidity >50% for at least 30 min is likely to inactivate SARS-CoV-2 (>3-log reduction) on N95 respirators while maintaining fit and filtration efficiency for three to five cycles. Dry heat is significantly less effective. Microwave-generated steam is another promising approach, although less studied, whereas 121°C autoclave treatments may damage some N95 FFRs. Humid heat will not inactivate all microorganisms, so reprocessed N95 respirators should be reused only by the original user. Conclusions: Effective bioburden reduction on N95 FFRs during the COVID-19 pandemic requires inactivation of SARS-CoV-2 and preservation of N95 fit and filtration. The literature suggests that humid heat protocols can achieve effective bioburden reduction. Proper industrial hygiene, biosafety controls, and clear protocols are required to reduce the risks of N95 reprocessing and reuse.

Human-Centered Design as an Approach for Place-Based Innovation in Public Health: A Case Study from Oakland, California.

PURPOSE: This case study provides a high-level overview of the human-centered design (HCD) or "design thinking" process and its relevance to public health. DESCRIPTION: The Best Babies Zone (BBZ) initiative is a multi-year project aimed at reducing inequities in infant mortality rates. In 2012, BBZ launched pilot programs in three US cities: Cincinnati, Ohio; New Orleans, Louisiana; and Oakland, California. The Alameda County Public Health Department (ACPHD), the lead for the Oakland BBZ site, identified HCD as a promising approach for addressing the social and economic conditions that are important drivers of health inequities. HCD is a process for creating innovative products, services, and strategies that prioritizes the needs of the intended population. ACPHD partnered with the Gobee Group (a social innovation design consultancy) to develop the Design Sprint. The Design Sprint was a 12-week pilot in which 14 professionals from nine organizations used the HCD process to develop concepts for stimulating a vibrant local economy in the Oakland Best Babies Zone. ASSESSMENT: Thirty- to sixty-minute semi-structured interviews were conducted with all 14 individuals involved in the Design Sprint. With the exception of one interview, the interviews were audio-recorded, transcribed, and inductively coded to identify themes. CONCLUSION: Our experience suggests that HCD can: enhance community engagement; expedite the timeframe for challenge identification, program design, and implementation; and create innovative programs that address complex challenges.