By A.U. Bankaitis Smith, PhD

Editor’s note: Dr Bankaitis Smith has also provided a YouTube video on this topic which can be viewed below.

As preparations are made to reopen clinical practices, many may be experiencing a new source of anxiety about workplace safety due to delayed access to key infection control supplies. With critical shortages of face masks, disinfectants, and alcohol-based hand sanitizers, here are acceptable alternatives per the Centers for Disease Control and Prevention (CDC)1

Cloth/Clear Masks

Face-shield-for-infection-control
Face shield for infection control.

In a recent communication to federal, state, and local public health officials—including leaders responsible for developing and implementing policies and procedures for preventing pathogen transmission in healthcare settings—the CDC outlined specific strategies for optimizing the supply of face masks based on evidence provided by the Division of Viral Diseases within the National Center for Immunization and Respiratory Disease (NCIRD).  When no face masks are available, the use of a face shield that covers the entire front (extending to the chin or below) and sides of the face with no face mask is an option.1

For audiologists and other hearing care professionals waiting for either cloth or clear masks, face shields have been easier to source, are more readily available, and more likely to be in stock for immediate purchase. In addition, face shields are more comfortable to wear than cloth or clear masks. They may be reused indefinitely (if the material is not torn or worn out, creating gaps between the shield and the forehead headpiece2) and easily cleaned and disinfected. Unlike some masks, face shields offer the ability to more effectively communicate with patients because the clear shield allows patients to see lips and full facial expressions without the need for face shield removal. 

Disinfectants

The Environmental Protection Agency (EPA) recently released a list of disinfectants qualified for use against SARS-CoV-2, the specific coronavirus that causes COVID-19, referred to as “List N”.3 In addition, the agency outlined other criteria to help identify qualified, EPA-registered disinfectants that do not appear on List N.4  Many products commonly used in audiology clinics have been deemed qualified but not all; for your convenience, a list of disinfectants sold by Oaktree Products meeting EPA’s criteria is available to assist audiologists in making informed product purchase decisions quickly and confidently. 

general-disinfectants-Oaktree
General disinfectants and size/application options.

For audiologists waiting for delivery of product, keep in mind that qualified disinfectants are available in different forms ranging from individually wrapped single wipes to sprays and gallon solutions. If the preferred form of disinfectant (eg, canister of wipes) is not available, make the switch to something that is available. For instance, if the canister of disinfectant towelettes typically used in your office is not available, consider switching to a spray disinfectant, even if it means switching to another brand. Also, as suppliers try to source product, new brands are being identified so be sure to ask if there are any new brands available qualified against SARS-CoV-2. Per the CDC, one major step in getting your clinic ready to reopen is to stock up on necessary supplies now and on a regular basis.5  Ask your supplier what is currently in stock and buy when you can. 

Alcohol-based Hand Sanitizers

Antibacterial or regular hand soap.

Supply disruptions in alcohol-based hand sanitizers have resulted in the Food and Drug Administration (FDA) to provide flexibility to manufacturers and other designated professionals to increase the supply of sanitizersnone of which endorse home-made solutions.6,7 While the use of alcohol-based hand sanitizers is the preferred method of hand hygiene in healthcare settings,8 the use of soap and water meets infection control standards and represents an acceptable form of hand hygiene. For audiologists waiting for alcohol-based hand sanitizers, plain or anti-microbial soap is acceptable.9

Summary

  1. When no face masks are available, the use of a face shield that covers the entire front (extending to the chin or below) and sides of the face with no face mask is an option1;
  2. Refer to List N3 and other EPA-established criteria4 to identify disinfectants qualified effective against SARS-CoV-2;
  3. Consider different brand and/or form of disinfectant (eg, spray instead of canister of towelette) to acquire needed supplies more readily in stock, and
  4. Plain or anti-microbial soap is an effective alternative to alcohol-based hand-sanitizers.9

Author’s note: This information is based on current CDC recommendations which are supported by evidence and science. It is critical for audiologists and other hearing care professionals to follow state, county, and local mandates, including the direction provided by the public health department of your individual state. Be sure you know how contact the health department of your individual state and stay connected with them along with other state, county and local authorities to keep informed about COVID-19 in your community. 

Acknowledgement

This article originally appeared on AU Bankaitis’s Audiology Blog on May 4, 2020 and appears here with permission of the author.

References

  1. CDC. Strategies for optimizing the supply of facemasks. March 17, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html
  2. Perencevich EN, Diekema DJ, Edmond MB. Moving personal protective equipment into the community: Face shields and containment of COVID-19. April 29, 2020. Available at: https://jamanetwork.com/journals/jama/fullarticle/2765525
  3. US Environmental Protection Agency (EPA). List N: Disinfectants for use against SARS-CoV-2. Updated April 30, 2020. Available: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
  4. Bankaitis, AU. Qualified disinfectants against COVID-19. April 14, 2020. Available at: http://aubankaitis.com/qualified-disinfectants-for-covid-19/
  5. US Centers for Disease Control (CDC). Get your clinic ready for coronavirus Disease 2019 (COVID-19). Updated March 11, 2020. Available at: https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinic-preparedness.html
  6. US Food and Drug Administration (FDA). Guidance for industry: Temporary policy for preparation of certain alcohol-based hand sanitizer products during the public health emergency (COVID-19). March 2020. Available at: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/guidance-industry-temporary-policy-preparation-certain-alcohol-based-hand-sanitizer-products-during
  7. FDA. Policy for temporary compounding of certain alcohol-based hand sanitizer products curing the public health emergency. March 2020. Available at: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/policy-temporary-compounding-certain-alcohol-based-hand-sanitizer-products-during-public-health
  8. CDC. Hand hygiene guidance. Updated January 20, 2020. Available: https://www.cdc.gov/handhygiene/providers/guideline.html
  9. CDC. Hand hygiene. March 1, 2016. Available: https://www.cdc.gov/oralhealth/infectioncontrol/faqs/hand-hygiene.html
A.U. Bankaitis Smith, PhD

About the author: A.U. Bankaitis Smith, PhD, is Vice President of Oaktree Products, Chesterfield, Mo, and is well-known in the hearing care field for her work in infection control principles, as well as helping hearing care professionals identify communication solutions for their patients.

Correspondence to Dr Bankaitis Smith at: au@oaktreeproducts.com