Fraser Health to patients: ‘No evidence’ N95s are safer

As Omicron continues to put a strain on BC’s healthcare system, patients and visitors in the Fraser Health region are being told they will not be allowed to enter hospitals while wearing their own N95 masks and must instead wear a surgical mask provided by staff—because there’s “no evidence” that N95s are safer.

The Beacon has reviewed copies of a memo sent to staff at Peace Arch Hospital in White Rock with guidance from Ruth Dueckman, executive director for infection prevention and control at Fraser Health, that says visitors must use medical masks.

The memo, shared by a Fraser Health employee who the Beacon has agreed to keep anonymous, details messaging that healthcare staff should share with patients or visitors who have complaints about the mask policy.

“We understand that people have heard that N95 is safer and there is no evidence to support that. N95 masks require fit testing and we also have no idea were [sic] the visitor has acquired their mask and whether it meets safety standards or fits them as expected. Our medical masks, when worn appropriately, provide protection from COVID,” the memo reads.

The employee told the Beacon their facility has been getting a lot of complaints from patients about the policy and that patients are being turned away if they do not change their N95s to a surgical mask. Patients are also not allowed to wear a surgical mask on top of their own N95.

The Beacon was also shown a memo including messaging sent to a patient who planned on cancelling their surgery at Peace Arch Hospital if they weren’t allowed to wear their N95 mask.

“I can certainly understand being anxious about protection against COVID-19, especially as you are preparing for surgery. At this time, the government mandate and the Fraser Health mandate has not changed—the hospitals are requesting that patients use the specific surgical masks provided at the hospital. In this way they can ensure they are fresh and used only once, are intact and are medical grade,” the patient was told.

“The concern about double masking is related to the actual fit of the mask as it is difficult to ensure one or both have proper fit together. I am aware that there is a variety of conflicting views and reports in the media and public discussion at this time revolving around the use of the N95 mask, however at this time we are following the current requirements. I am sorry but at this time, I am not able to ensure you will be able to wear your N95 mask or double mask at PAH hospital.”

It’s not clear whether the patient actually proceeded with cancelling their surgery. Fraser Health told the Beacon in a statement that it was not aware of any patients cancelling their surgery or procedure if they were not permitted to wear an N95.

We asked UBC mechanical engineer and aerosol expert Steven Rogak for his insight on the guidance, particularly that “there is no evidence to support” the theory that N95s are safer than medical masks.

“I can’t think of what science would support [the guidance],” Rogak said.

“I think there could be an argument for putting one of their masks over top of an N95. I think that if they’re concerned about having a minimum protection, in the very strange situation that somebody has a completely inadequate N95, then they could put another mask on top.”

As we’ve previously reported, Rogak agrees fit is a very important factor in a mask’s effectiveness—if there are large gaps at the side of your face, particles carrying the SARS-CoV-2 virus can likely get through no matter what kind of mask it is.

He said a properly fitted N95 will block out about 99.9% of those particles.

“Whereas the disposable blue pleated masks are pretty good—while the worst are the cloth masks that many people are wearing, that would probably filter out less than half of the viruses.”

But even if an N95 hasn’t undergone a stringent fit test, he said it’s likely that members of the public would be able to find a respirator that fits them relatively well—making them at least as useful as a surgical mask anyway.

Masks that don’t work as well as advertised, he said, are those that have an exhalation valve—usually in the form of a medium sized circle clearly visible on the mask. Those valves allow virus particles to escape from the wearer quite easily.

“That’s sort of a selfish mask. It doesn’t protect the people around you, it only protects yourself. So I could see an argument for not wanting those masks being worn by people coming into the hospitals, but those are very, very easy to spot,” Rogak said.

“And in most cases, you can just look at the mask somebody is wearing and decide, is it fitting reasonably well, and most N95s are going to fit better than the pleated medical masks.”

Fraser Health told the Beacon in an emailed statement that the provincial and Fraser Health requirement that visitors and patients must wear surgical masks remains in place, and is based on ensuring that masks are fresh, only used once, and of medical grade.

“When a visitor or patient presents to hospital with their own mask, such as an N95, we are unable to determine whether it meets safety standards or fits them as expected. Therefore, we provide everyone with a new surgical mask,” a spokesperson said.

“Surgical masks, when worn appropriately, provide sufficient protection against COVID-19.”