Nhu Quyen Dau, PharmD

N95 respirators should be required for all workers caring for COVID-19 inpatients — and not only during aerosol-generating procedures, according to an opinion piece published in the Annals of Internal Medicine.

Current guidelines for mask-wearing differ and are based on unreliable data analyses, wrote Nhu Quyen Dau, PharmD, from Marshall B. Ketchum University College of Pharmacy, California. The conclusion that medical masks are equivalent to N95 respirators in reducing infection risk is unsupported, Dau and colleagues wrote.

But the data do show that aerosol transmission is possible, they argue. If the risk for healthcare worker infection is tied to the duration and magnitude of exposure, multiple patients coughing and breathing in an inpatient unit will expose them to droplets, resuspended droplets and aerosols, they explain.

“N95 respirators achieve better filtration of airborne particles than medical masks if used properly and continuously. [The authors of] guideline recommendations that do not support N95 use for all inpatient COVID-19 management should consider reevaluating the existing data or at least acknowledge the issues raised,” the investigators concluded.