COVID-19: Key Mask Updates for Audiologists

The CDC recently updated their consumer webpage (January 14, 2022 updates) to reflect new mask recommendations to prevent transmission of SARS-CoV-2. This update received a lot of press although it targets consumers and remains separate from mask guidance for healthcare personnel. Based on the most recent interim guidance for healthcare personnel issued by the Centers for Disease Control & Prevention (CDC) on September 10, 2021, the current mask options for audiologists employed in healthcare settings are as follows:

• NIOSH-approved N95 or equivalent respirator during aerosol-generating procedures (AGPs);
• Respirator approved under standards in other countries similar to NIOSH-approved N95 masks during non-AGPs; OR
• a well-fitting facemask.¹ 

While the referenced document does not specifically address what constitutes a “well-fitting facemask”, a report issued by MMWR on February 10, 2021 emphasized that the effectiveness of both cloth and medical procedure masks “can be improved by ensuring that they are well fitted to the contours of the face to prevent leakage of air around the mask‘s edges”.² While both cloth and medical procedure masks were mentioned in this MMWR report, the more recent CDC interim guidance specifically designates cloth masks for community use and not appropriate for use by healthcare personnel.¹ 

Another critical point outlined in the CDC’s September 2021 interim guidance document is the call for consideration for using NIOSH-approved N95 or equivalent respirators in clinical situations where multiple factors posing an increased risk of disease transmission may co-exist (e.g. unvaccinated patient, unable to wear mask, providing services in a poorly ventilated area).¹ This recommendation is very applicable to the audiology setting and something every clinical practice should taken into account when assessing current infection control protocols.

Footnote: Recognizing that the use of solid face masks may not be possible or appropriate when interacting with individuals with hearing and speech disorders, using a transparent mask is recommended.³

Final footnote: In early April, 2021, the CDC announced it was no longer necessary for health care facilities to implement NIOSH-approved crisis capacity strategies.^4-6 In the presence of increase availability and stabilized supply of NIOSH-approved respirators, the CDC recommended promptly resuming conventional use and disposal practices.

References:

1. CDC (2021). Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic. Available: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-control-recommendations.html
2. Brooks JT, Beezhold DH, Noti JD, et al. (2021). Maximizing Fit for Cloth and Medical Procedure Masks to Improve Performance and Reduce SARS-CoV-2 Transmission and Exposure. MMWR , 70:254–257. DOI: http://dx.doi.org/10.15585/mmwr.mm7007e1
3. CDC (2021). Strategies for optimizing the supply of facemasks.  Available: www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/face-masks.html.
4. FDA (2021). Considerations for Selecting Respirators for Your Health Care Facility. Available: https://www.fda.gov/medical-devices/coronavirus-covid-19-and-medical-devices/considerations-selecting-respirators-your-health-care-facility
5. CDC (2020). Strategies for Optimizing the Supply of N95 Respirators. Posted April 22, 2020. Available: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html
6. FDA. Non-NIOSH Approved Respiratory Emergency Use Authorization (EUA). Available: https://www.fda.gov/media/136664/download

For more information on audiology-related AGPs, see:

• Bankaitis AU. (2021) Infection-Control Hindsight from 2020: Lessons Learned from COVID-19. Audiology Today, 33(3): pp 12-21.
• ASHA (2021). Using masks for in-person service delivery during COVID-19 pandemic: what to consider. Available: https://www.asha.org/practice/using-masks-for-in-person-service-delivery-during-covid-19-what-to-consider/

NOTE: The information is based on current CDC recommendations which are supported by evidence and science. It is critical for audiologists 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.