Thread by @LazarusLong13

Here's a true CoVid story from the Chicoutimi Hospital in Quebec, Canada. From catastrophe to redemption.

Huge outbreak of 400 employees over 2.5 months, directly linked to nosocomial infections. 70 HAI patients.

To be frank, at first the employees were blamed.

Because of overtime due to CoVid - but the employees were blamed.

lequotidien.com/actualites/dur…

Was that the end of the story?

No. The workers did not want to catch CoVid. They were careful.

See the quote below from Anne who caught CoVid below.

And the outbreak continued, until someone decided to test the ventilation.

Right now, you just raised an eyebrow.

"Why test the ventilation? It's not airborne!"

But, as you can see above, Anne was wearing her droplet protection.

So, here were the ventilation results as measured in CO2 (a decent aerosol stand-in).

Up to 1611 ppm. In a hospital!

So, what did they do?

Spent $200,000 to improve the ventilation (bring in exterior air) and bring in negative pressure rooms.

The ventilation improved, as expected. But it wasn't quite enough.

Why? Ventilation/ filtration solve far-field aerosols, but cannot act quick enough to remediate aerosols that are up close (near-field aerosols).

Those can only be remediated by airborne PPE.

In February, N95's were mandated.

ici.radio-canada.ca/premiere/emiss…

N95's are great - but they can be expensive if replacing them all the time, right?

N100 Elastomeric respirators, though - a little more expensive up front - but within a few days much, much cheaper.

Have these been deployed anywhere? Yes- at the Alleghany Health Network.

13 hospitals, 250 locations, 21,000+ employees.

Here is Dr. Chalikondra, CMO of AHN (ahn.org/about/leadersh…), talking about that roll-out:


Or here is a study that was done on that roll-out:
journalacs.org/article/S1072-…

Here's a cost-save calculator from MSA for elastomeric respirators over N95's:
webapps.msasafety.com/apr-calculator/

But besides the cost-save that will make you the hero of your administration?

You will be the hero to the HCW's under your charge. Why?

After the AHN roll-out, guess how many wanted to go back to N95's? 0.

facs.org/media/press-re…

N100's medical grade silicone is much more comfortable than scratchy N95 material.

And safer since they protect against 99.97% of particles vs. 95%.

cdc.gov/niosh/npptl/to…

What about the patients? Like anything new - it's just a matter of education.



My DM's are open for any questions that you might have - not just HCW's! Regular people wear N100 elastomeric respirators, too:

https://twitter.com/LazarusLong13/status/1435870824255262721?s=20