Face masks and face shields over the masks are now required in enclosed workplaces as well as other enclosed commercial establishments in Metro Manila and elsewhere. What used to be hospital protocol for the use of Personal Protective Equipment or PPE are now becoming more common even in workplaces such as service industries like salons and barbershops.
The difficult situation now for many businesses and households is the shortage in reasonably priced PPEs such as masks, face shields, and gloves. It took me numerous trips to the stores to finally get a box of gloves, settling for whatever size was available. There was also a prolonged search for retailers of suitable masks, both N95 and surgical types, and acceptable face shields. At some point, our household actually resorted to making our own cloth masks that make use of napkins as filters.
Lack of PPE supply, and increasing prices, make it difficult particularly for smaller businesses to continue operating. A firm with even just 10 employees will spend a significant amount of money daily for face masks and face shields as minimum requirements to remain compliant with present health and safety protocols set by the government. This is not to mention other requirements that must be met if one intends to remain open for business.
Then there are necessary disinfection protocols for businesses as well as households. As a matter of practice, all things coming from outside are best “disinfected” prior to bringing them into one’s residence. If feasible, the same should be done even for workplaces, especially those with workers who “commute” or travel with others in company shuttles.
Masks, the minimum safety standard, are usually disposable. But masks are now in short supply. Considering that this particular requirement applies to all who opt to leave the residence for whatever reason, there is significant cost involved in making masks available to all who need them. Then, there is the significant amount of possibly contaminated garbage generated daily from disposable masks.
For hospitals and workplaces, or even residences, that make use of a large volume of masks daily, the government should consider offering assistance in making available technologies and facilities that can allow the reuse particularly of the sturdier N95 and KN95 masks. There have been studies that show such masks — in times of crisis — may be reused, provided they are properly disinfected. But there are limited technologies for disinfecting what should be disposable masks.
There is a risk to reusing masks, of course. There are no guarantees that a mask can be 100% disinfected and at the same time retain its integrity. However, considering the situation now with supply and cost, as well as the demand, I believe that cost-effective disinfection technologies should be looked into urgently, and support should be extended to those offering such solutions.
UV technology or the use of medical-grade disinfecting ultraviolet light can be an option. This technology does not entail the use of chemicals; involve little to no “consumables” that escalate operating cost; and, is a mature technology that can be made readily available and has long been used to disinfect drinking water, waste water, air, pharmaceutical products, and surfaces against human pathogens in the last 40 years.
We refer here to Ultraviolet C or UVC ultraviolet radiation with wavelengths between 200 and 290 nm. From its natural source, the sun, studies indicate this type of radiation is filtered out by the ozone layer so that none reaches the earth’s surface. However, it can be produced for use in disinfection. Available literature indicates “Ultraviolet C is germicidal and is also used in ultraviolet phototherapy; and has been proved effective in disinfection processes.”
I concede that when it comes to COVID-19, there is nothing “tried and tested” or “proven effective” for the long-term. Thus, any intervention, when it comes to COVID-19, requires a leap of faith. However, the International Ultraviolet Association (IUVA) notes that “UV light, specifically between 200-280 nm (UVC or the germicidal range), inactivates (a.k.a., ‘kills’) at least two other coronaviruses that are near-relatives of the COVID-19 virus: 1) SARS-CoV-1 and 2) MERS-CoV.”
But it also notes that such “inactivation has been demonstrated under controlled conditions in the laboratory. The effectiveness of UV light in practice depends on factors such as the exposure time and the ability of the UV light to reach the viruses in water, air, and in the folds and crevices of materials and surfaces.”
The Centers for Disease Control and Prevention (CDC) in the US, meanwhile, came out with a recent study on disinfecting face masks, and it noted that “disposable filtering facepiece respirators (FFRs) are not approved for routine decontamination and reuse as standard of care. However, FFR decontamination and reuse may need to be considered as a crisis capacity strategy to ensure continued availability. Based on the limited research available, ultraviolet germicidal irradiation [or UVGI], vaporous hydrogen peroxide, and moist heat showed the most promise as potential methods to decontaminate FFRs.”
The CDC added that “researchers, decontamination companies, healthcare systems, or individual hospitals should focus current efforts on these technologies.” As for UV germicidal irradiation, it also said that “disinfection efficacy is dependent on dose,” noting that “not all UV lamps provide the same intensity thus treatment times would have to be adjusted accordingly.” It also noted that use of UVGI requires precautions to avoid “exposure to skin or the eyes.”
We find ourselves in a crisis now, and I believe that disinfecting and reusing masks may no longer be a matter of choice soon enough. If things get any worse, disinfection and reuse may be necessary just to ensure sufficient supply of masks to all those who need them. I prefer UVGI for this primarily because it does not use disinfecting chemicals. The crude method of disinfecting N95 masks at home is through heat by placing N95 masks in an old rice cooker for at least 50 minutes. Between UVC and an old rice cooker, what would you rather trust?
Disinfecting masks is not just for hospitals, where the risk of exposure is probably higher than other work environments. Hospitals also have the risk of higher “viral load” — quantity of virus in a given volume of fluid like sputum or plasma. In short, I reckon people tend to get sick more from exposure in a hospital environment rather than in an open work environment.
If so, and UVGI disinfection may be deemed too risky for N95 masks used in hospitals, perhaps the method can be considered an option for disinfecting masks used in regular work environments. Perhaps in places like restaurants, or even hotels as well as casinos, where not only masks but other items like cellphones, playing cards, playing chips, etc. may be disinfected using UVC technology.
Larger work environments spend a hefty sum for masks for their workers. Being able to reuse an N95 mask maybe even for just five to eight times, rather than disposing of them immediately after a single use, by letting UV light shine upon them may go a long way in saving on mask supply for where they are needed most; in lowering business operating costs; and, minimizing the amount of garbage generated daily because of disposable PPEs.
Marvin Tort is a former managing editor of BusinessWorld, and a former chairman of the Philippines Press Council