As it turns out, smeared makeup and lip balm might be the only things standing in the way of a 20-fold increase in the country’s supply of N95 masks.
Bartosz Koszowski is the site manager at the Federal Emergency Management Agency’s decontamination operation located inside the Adams County Fairgrounds’ Exhibit Hall. The operation is designed to clean used mask from health-care providers and get them back into service quickly.
Soiling and contamination of the masks is the main thing that will keep them from being reused. And while the contamination can be from dirt or bodily fluids, that’s not the most common.
“One of the main reasons for us to discard them is from soiling from makeup,” Koszowski said. “We actually work with the hospitals to encourage their workers to not wear makeup. People need to feel comfortable wearing the masks, even if they are decontaminated, and soiling makes that difficult. So we have to care not only that they are clean but also about how they look.”
The Adams County operation, one of 45 that FEMA has set up around the country with national logistics consultants Battelle, is just getting started, Koszowski said. The site has been open and in operation since May 4.
It’s a free service for hospitals, medical centers, doctors’ offices and first responders that meet the company’s criteria and fill out the form on the company’s website, battelle.org.
“Right now, the system is still ramping up,” he said. “The health-care providers, they need a little more time to get their procedures in place. But Battelle is working with them to make the process easier.”
The Exhibit Hall contains four of the decontamination chambers, and Koszowski said his crew works in 12-hour shifts, keeping the location open and operating all day, seven days a week. They can process up to 80,000 used N95 masks a day, converting discarded personal protective gear into reusable safety equipment.
That’s a crucial task, according it Lee dePalo, the regional administrator for FEMA.
“Being able to reuse what we have is incredibly important, because we are trying to increase production of the N95 mask,” dePalo said.
Supplies of the medically critical N95 masks remain tight during the COVID-19 pandemic, and FEMA had to withdraw a contract for $55 million worth of respirator masks May 14 when the Virginia company failed to deliver.
Reusing the equipment is a good alternative, he said.
“It’s a good system, and it’s good to see what we can do to help America fight this COVID,” dePalo said.
DePalo’s Region 8, covers Colorado, Utah, Wyoming, Montana and the Dakotas and he said it’s home to four of the decontamination sites: Adams County, a second Colorado site in Montrose, and one apiece in North Dakota and Montana.
The Adams County site is meant to bring in masks that have been used up and down the Front Range, especially from hospitals and medical centers in the Denver metro area.
It’s been a quick turnaround for the federal agency and the logistics company. Their process for decontaminating the masks got Food and Drug Administration approval on March 29. The company signed a $1,465-per-day contract with the county to use the Exhibit Hall on April 18 and began moving in their equipment five days later.
Hydrogen peroxide vapor
The decontamination chambers are heavily modified shipping containers enclosing racks, sealed doors and a ventilation system covered by multiple HEPA filters. Each can hold 10,000 masks, Koszowski said.
Once the mask are in and the doors closed, the chamber is pumped full of vaporized hydrogen peroxide, which is meant to kill any germs still on the masks. The masks sit in the chamber for four hours, at which point the vapor is pumped out and then the masks sit drying for another four hours.
Each mask, assuming it is free of soiling and other contaminants, can be run through Battelle’s process 20 times before it must be thrown away.
“When we inspect them, we are looking for soiling but also tears and other problems,” Koszowski said.
Once a hospital is registered with Battelle, it’s given an identification number. Hospital personnel mark each mask with that number after it’s been used and then put them inside a special bag. Once full, that bag is boxed up and shipped to the Adams County site. Shipping is free via FedEx or UPS, or the hospital can use its own courier service.
Each treated mask goes back to the hospital that sent it in, complete with a report detailing when it was treated and how many times it’s been treated.
“Our computer system is very important because the health-care providers are all pre-qualified,” he said. “Each provider has a code, and we can track each mask and each box as they go through the system.”
The boxes are only opened, unpacked and sorted once they are in the decontamination chamber. Battelle workers inspect each mask and then place them on a metal shelf for the hydrogen peroxide treatment. Koszowski said the Battelle process uses a 35% hydrogen peroxide solution, about seven to 10 times stronger than the solution you can purchase at the store.
“Compared on what you use on cuts, it’s a much higher percentage,” Koszowski said. “It’s pretty unstable, but the only byproducts for this are water and oxygen. That’s what hydrogen peroxide decomposes to. It’s considered a green chemical, so nothing nasty is going to get into the environment.”
The workers wear pressurized clean-room suits when they are loading the masks in the chambers and are sprayed with isopropyl alcohol as soon as they step out to kill any viruses trying to hitch a ride. And once they have changed out of the clean-room suit, they go to a shower trailer to clean up and put on a fresh set of clothes.
The entire operation is modular and portable, made up of the shower trailer and eight shipping containers — four containing the decontamination equipment and four others for storage, office work, supplies and equipment.
The operation is meant to be in place indefinitely, but Adams County’s contract renting the space lasts through Oct. 20.
FEMA has been given the authorization to set up 60 of the sites across the country and has launched 45 so far, dePalo said, and is also looking at what other types of medical equipment can be decontaminated with Battelle’s process.
“Right now, it’s only approved for N95 masks, but there is an effort to look at a new emergency use authorization through the FDA for other equipment,” he said.
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