Thursday, June 8, 2023
Physicians - maximum of 0.25 AMA PRA Category 1 Credit(s)™
ABIM Diplomates - maximum of 0.25 ABIM MOC points
Nurses - 0.25 ANCC Contact Hour(s) (0 contact hours are in the area of pharmacology)
Pharmacists - 0.25 Knowledge-based ACPE (0.025 CEUs)
Physician Assistant - 0.25 AAPA hour(s) of Category I credit
IPCE: 0.25 Interprofessional Continuing Education (IPCE) credit
This activity is intended for infectious disease clinicians, internists, family medicine/primary care clinicians, nurses/nurse practitioners, pharmacists, physician assistants and other members of the health care team involved in protection from COVID-19.
The goal of this activity is for the healthcare team to be better able to describe whether medical masks are noninferior to N95 respirators to prevent COVID-19 in health care workers providing routine care, based on a multicenter, randomized, noninferiority trial at 29 health care facilities in Canada, Israel, Pakistan, and Egypt from May 4, 2020, to March 29, 2022.
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Awarded 0.25 contact hour(s) of nursing continuing professional development for RNs and APNs; 0.00 contact hours are in the area of pharmacology.
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CME / ABIM MOC / CE Released: 1/20/2023
Valid for credit through: 1/20/2024
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Note: The information on the coronavirus outbreak is continually evolving. The content within this activity serves as a historical reference to the information that was available at the time of this publication. We continue to add to the collection of activities on this subject as new information becomes available. It is the policy of Medscape Education to avoid the mention of brand names or specific manufacturers in accredited educational activities. However, manufacturer names related to the approved COVID-19 vaccines are provided in this activity in an effort to promote clarity. The use of manufacturer names should not be viewed as an endorsement by Medscape of any specific product or manufacturer.
It is uncertain whether medical masks offer similar protection against COVID-19 compared with N95 respirators. Systematic reviews of randomized trials and observational studies of other respiratory viruses suggest similar protection.
However, medical masks may offer less protection because of their looser fit and less effective filtration compared with N95 respirators. During the pandemic, supplies of N95 respirators were insufficient globally, and currently the high costs reduce access in low- and middle-income countries.
Regular medical masks might provide protection similar to that of N95 respirators in preventing SARS-CoV-2 infection among healthcare workers, according to the first randomized trial that tested the 2 types of masks head to head in the COVID-19 era.
Owing to limitations in the study, however, the authors were only formally able to conclude that healthcare workers who wore medical masks while treating patients with COVID-19 were not twice as likely to contract the virus as workers wearing N95 respirators.
“Nonetheless, this trial provides the best evidence to date on comparative effectiveness of mask types in preventing SARS-CoV-2 infection in health care workers providing routine patient care,” writes Roger Chou, MD, in an editorial published with the study.[1]
In summarizing, Dr Chou said that “the results indicate that medical masks may be similar to N95 respirators in Omicron-era settings with high COVID-19” rates, but the researchers set a low bar for establishing whether one is more effective than the other.
“Therefore, the results are not definitive,” Dr Chou writes.
In the study, published Tuesday in the Annals of Internal Medicine, the authors evaluated 1009 healthcare workers in Canada, Israel, Pakistan, and Egypt who had not been vaccinated against SARS-CoV-2 and had not previously been infected by the virus.[2] Participants were randomly assigned to wear either a medical mask or an N95 respirator for 10 consecutive weeks. The study period was from May 2020 to March 2022.
Reverse transcriptase polymerase chain reaction (RT-PCR) tests confirmed that COVID occurred in 52 (10.46%) of 497 participants in the medical mask group vs 47 (9.27%) of 507 in the N95 respirator group (hazard ratio [HR], 1.14; 95% CI, 0.77-1.69).
The World Health Organization recommends medical masks (sometimes called surgical masks) for routine care, whereas the Centers for Disease Control and Prevention recommends that N95s be used while caring for patients with COVID-19. Before the pandemic, research showed that N95s and medical masks carried similar risks while caring for patients with influenza-like illnesses.
Dr Chou said that decision-makers should keep in mind the uncertainty of whether one mask type is more effective than the other and should take worker preferences, N95 respirator availability, and resource constraints into consideration.
Ann Intern Med. Published online November 29, 2022.
