Masks, face shields, eye protection

Q: Are facilities able to ask visitors to wear masks now that the governor let the state mask mandate expire (in April 2021)? Are there resources to help us with that?

A: Yes, masks are still required for residents and their visitors during visits of all kinds. Refer to Reopening Guidance for Long-term Care Facilities (LTCFs) (note this is a historical document, this guidance no longer in effect as of 5/6/21) from the NH Bureau of Infectious Disease Control, specifically, the guidance on pp. 9-16 and chart on p. 10, which note masks are required for visitation at all levels of opening (for current guidance see: Reopening). The CDC also provides guidance on mask wearing in their Interim Public Health Recommendations for Fully Vaccinated People.

We’ve put together a one page communication guide about mask wearing to help you.

Here is a brief public service announcement (PSA), “Wear a Mask,” from the Alliance for Aging Research.

Q: Are most facilities masking all employees and residents even if there are no confirmed positive cases? (note, this question is from early in the pandemic)

A: Yes, facilities should implement universal masking for source control. See the CDC’s recommendations as well as their scientific brief, Community Use of Cloth Masks to Control the Spread of SARS-CoV-2 , the NH DHHS COVID-19 Universal Mask Recommendation for Long-term Care and Assisted Living Facilities.

See also CDC’s Improve How Your Mask Protects You which addresses fit, nose wires, layers, etc.

Q: Do N95 masks need to be fitted? How and by whom?

A: Yes. See this article for an overview of fitting and using N95 masks. The CDC also notes in Strategies for Optimizing the Supply of N95 Respirators that OSHA guidance suspends the requirement for annual fit testing by employers during “contingency capacity” and also notes “just in time” fit testing is appropriate during a pandemic. OSHA explains how to fit test and who can do fit testing in regulation 1910.134. Appendix A, Part I, section B1 and C1.

Q: Do cloth masks such as those donated by volunteers provide adequate protection?

A: The ANA, CDC, NH DHHS and WHO all note that cloth masks are NOT considered PPE for health care workers, and recommend the use of face shields with cloth masks.

For more on cloth masks in healthcare settings, see NH DHHS Health Alert #11 as well as their COVID-19 Universal Mask Recommendation for Long-term Care and Assisted Living Facilities. For general information on cloth face masks and COVID-19, see the CDC’s Considerations for Wearing Cloth Face Coverings as well as CDC’s Improve How Your Mask Protects You which addresses fit, nose wires, layers, etc.

Q: Should I change my mask between patients/residents?

A: While the CDC has issued Strategies for Optimizing the Supply of Facemasks, ideally CDC and WHO recommend that single use masks be changed between patients/residents.

AMDA (The Society for Post-Acute and Long Term Care Medicine) has extensive advice on shortages of masks, gloves, and other PPE on pp. 28-31 of this document.

Q: We heard there are counterfeit N95 masks, which ones?

A: There have been some counterfeit Makrite masks; The Foundation for Healthy Communities reports that they had “not for medical use” printed under the lot number, but that Makrite masks distributed by NH DHHS were checked and were legitimate. This does not account for any sold by private vendors. Makrite lists scams on its website. Note that there may be other companies selling counterfeit PPE. See the Procuring PPE and other supplies page for contact information for the NH U.S. Attorney’s office, where PPE fraud should be reported.

Q: What are the recommendations on face shields and eye protection?

A: In December 2020, NH DHHS updated their recommendations on eye protection in Coronavirus Disease 2019 (COVID-19) Guidance for Long-term Care Facilities (LTCF) – by stating that this is recommended wherever there is substantial community transmission.

CDC recommendations on face shields and eye protection such as goggles for staff (including those cleaning as well as caring for residents) can be found in the Healthcare Infection Prevention and Control FAQs for COVID-19 and in Interim Infection Prevention and Control Recommendations for Healthcare Personnel During the Coronavirus Disease 2019 (COVID-19) Pandemic. Basically, CDC says “HCP working in facilities located in areas with moderate to substantial community transmission” should use eye protection. See the NH DHHS HAN #22 for the NH Division of Public Health’s guidance affirming this recommendation.

NH DHHS tracks community transmission levels in their interactive maps on the schools dashboard. See also CDC’s definition of community transmission levels.

Q: What is the procedure for cleaning face shields?

A: See the manufacturer’s instructions for cleaning and disinfecting, or consult these instructions from the CDC (scroll down to Selected Options for Reprocessing Eye Protection).

and Q: What should we know about cleaning and reusing masks?

A: NYC Health Department issued Strategies for Reuse and Extended Use of Personal Protective Equipment (PPE) During COVID-19 Outbreak which has information about cleaning and reusing PPE, including masks.

Q: Who should be wearing a mask at our facility?

A: NH DHHS issued COVID-19 Universal Mask Recommendation for Long-term Care and Assisted Living Facilities on April 14, 2020 that details mask recommendations for facilities with and without suspected or confirmed cases.

See also: Donning & Doffing PPE, Procuring PPE

This page updated 5/10/21

Information is changing rapidly as the COVID-19 outbreak evolves. Please take the links on these pages, especially the NH DHHS, which coordinates the COVID-19 response in our state, and other public health resources such as your local public health department, the CDC and WHO to find the latest guidance and recommendations.

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