Horizon to provide KN95 masks to public as province revises mask guidelines

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Horizon patients and visitors will be able to get a KN95 mask now, rather than the non-medical masks normally handed out. (CBC - image credit)
Horizon patients and visitors will be able to get a KN95 mask now, rather than the non-medical masks normally handed out. (CBC - image credit)

Horizon Health Network hospitals will now provide KN95 masks to members of the public who wish to receive one upon entry.

In addition, if patients and visitors wear their own N95 or KN95 mask, they won't be required to change it.

Until now, people have been required to remove whatever mask they were wearing and replace it with a hospital-issued non-medical mask.

Margaret Melanson, Horizon's vice-president of quality and patient-centred care, confirmed the changes to CBC News Tuesday.

They come as the COVID-19 Omicron variant continues to tear across New Brunswick, with record-high hospitalizations and new cases, including hundreds of health-care workers.

N95 and KN95 masks are respirators and considered the highest level of mask protection. They filter out more particles and provide a better fit, with fewer gaps for tiny airborne particles, or aerosol, to get through.

"We would note – as it relates to the PPE [personal protective equipment] we provide to our staff – KN95s are not suitable for medical care," said Melanson.

"Horizon staff have access to fit-tested N95s in their units and departments. They are asked to perform a point of care risk assessment and if it is determined an N95 is needed, they can wear one."

It's all part of revised COVID-19 enhanced precautionary guidance for use of personal protective equipment, issued by the province on Jan. 11.

CBC
CBC

The updated guidance "introduces the use of N95 and/or KN95 respirators as an option for clinical and non-clinical staff across the health system as well as for visitors, patients and designated support persons," said Department of Health spokesperson Bruce Macfarlane.

The regional health authorities and other health partners are in the process of implementing this new guidance and ensuring availability of these new masks in all appropriate settings, he said.

Vitalité Health Network officials were too busy to respond to a request for comment Tuesday.

Although N95s and KN95s have been hard to come by in stores, Macfarlane said there are no "significant concerns" about the province's PPE inventory.

The department, in collaboration with partners, will continue to monitor available PPE and "replenish the pandemic stockpile as needed to respond to the new guidance," he said.

All outpatients, designated support persons for patients and visitors should wear either a well-fitting medical-grade face mask or a Public Health Agency of Canada-approved and authorized KN95 respirator or equivalent alternate mask on entry into the health-care facility, according to the revised guidelines, obtained by CBC News.

Fit-tested, seal–checked N95 respirators are now "strongly recommended" for all clinical and non-clinical health-care workers while caring for a confirmed or suspected COVID-19 patient "if they determine there is a significant risk of transmission when all elements of controls have been addressed as best as possible."

"Caring" is defined broadly and includes entering the room or bed space of the patient or being within two metres of them, according to the Jan. 11 memo, signed by Dr. Jennifer Russell, chief medical officer of health.

The revised guidance also applies to other employees within "health-care settings" who provide services in the community, acute care and long-term care sectors.

These health-care settings include, among others, long-term care facilities, home care services, temporary shelters, family doctors' offices and specialists practices.

Niagara Regional Police Service
Niagara Regional Police Service

The province updated its Dec. 23 guidance the same day it released projections that showed about 5,500 New Brunswickers could test positive for COVID-19 daily by the end of January and hospitalizations could reach nearly 220 if current trends held and no changes were made.

Last Friday, the province moved to Level 3 of the COVID-19 winter plan to help slow the spread and allow time for more people to get vaccinated and their booster shot.

On Tuesday, Public Health announced three more COVID-related deaths and 113 people hospitalized with the virus, including 15 in intensive care. Four of them are on ventilators.

A total of 347 health-care workers who have tested positive for COVID-19 are off, isolating.

There were 330 new COVID cases confirmed through PCR (polymerase chain reaction) testing, putting the active caseload at 4,568. An additional 1,623 people tested positive on rapid tests and registered their results online.

The [revised] masking recommendations should be followed until otherwise indicated. - Dr. Jennifer Russell, chief medical officer of health

"Well-fitted medical grade face masks remain an appropriate level of PPE for the care of a suspect/confirmed COVID-19 patient," the memo states.

"However, as a precautionary measure, the [revised] masking recommendations should be followed until otherwise indicated."

A fit-tested seal–checked N95 respirator is required for all health-care workers who are providing care for or must enter the room of a confirmed or suspected COVID-19 patient when an aerosol generating medical procedure is performed.

When supplies of N95 are "constrained," equivalent respirators approved under standards used in other countries, such as medical KN95 respirators and FFP2 respirators, are also acceptable as long as they are authorized under Health Canada's interim order for the importation and sale of medical devices, according to the memo.

"This is an interim measure, until such time that all health-care workers who provide direct patient care or support services in the patient/resident/client-care environment, have had an opportunity to be fit-tested," it notes.

Government of New Brunswick
Government of New Brunswick

Earlier this month, the government posted mask guidance for the public on social media.

"Wearing a well-fitted mask is an important added layer of protection. Think about your risk when choosing what kind of mask to wear."

The tweet described non-medical masks, including three-layer cloth masks, two-layer cloth masks with a filter, and disposable masks, as "good."

Medical masks, including surgical masks, KN95s and N95s, are "best," it said.

"Ensure your mask is well-fitted with no gaps and worn properly over your nose and mouth."

Asked at a recent COVID-19 news conference whether N95 or KN95 masks should be made available to the general public for free to help prevent spread of the virus, or whether it should be mandated that employees in public-facing jobs, such as grocery stores, be provided with them by their employers, Russell replied, "Great question."

"We can only recommend what we know in terms of evidence-based information, and we are not saying that exclusively a person who's not in the health-care system should wear an N95," she said.

"And again, there's different types of N95. So there's the fitted ones, which again are very specifically used in the health-care settings, where there is risk. Then there's the unfitted N95, which is similar to a KN95.

"And if you look at the data on that, it's really the equivalent of a surgical Level 1 mask. … So they're interchangeable with the KN95 if it's fitted properly.

"And if a person wants to continue to wear a fabric mask, they can put a filter in it if they want. … So it's about having options and it's about having the right protection based on risk."

She did not respond about whether the province will provide the pricey masks for free, particularly for those who can't afford them, or whether it will mandate employers to.

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