ST. PAUL — St. Paul hospitals have begun implementing ways to decontaminate and reuse N95 masks for frontline health care workers in the fight against coronavirus. It’s a way to stave off shortages of personal protective equipment needed against the respiratory illness.

Mark Sannes, an infection prevention doctor at HealthPartners, outlined the threat they’ve seen in three colors: red is for crisis, yellow for caution and green is good to go.

“We bordered at times on yellow going on red, where we were down to seven to 10 days left of N95,” Sannes said in an interview Friday. “With strategies like this one, and with some of the acquisition (of more masks), I think we are very much on the other end of that yellow perspective, perhaps even yellow going on green at times right now.”

HeathPartners, which runs Regions Hospital, discovered last week that treating the masks with ultraviolet light can create opportunities to reuse them up to 10 times. Regions and Methodist Hospital in St. Louis Park will be pilot sites for the decontamination process.

M Health Fairview, which runs Bethesda Hospital, said Thursday, April 16, their separate UV treatments can create up to six reuses of masks. M Health will use its facility on the University of Minnesota’s West Bank camps to decontaminate masks and deliver them back to Bethesda.

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“That is a game changer,” said Dr. Abraham Jacob, M Health Fairview’s chief quality officer.

Decontamination in lab settings has helped create a “good” supply of the respirator masks at M Heath Fairview, but the M Health Fairview and HealthPartners’ type of treatment and amount of reuse gained is different from what the National Institutes of Health has recommended.

The NIH said Wednesday a study at its Rocky Mountain Laboratories in Montana showed the most-effective method of decontaminating N95 respirators is vaporized hydrogen peroxide (VHP), while UV light was deemed OK. The NIH pegged the masks functional integrity at up to three total uses.

Jacob said VHP takes longer to disinfect fewer masks and requires tight packaging to execute, while M Health Fairview has partnered with Clorox to provide its UV capabilities in a quicker process. M Health Fairview, which also worked with 3M on the project, said safety guidelines are in place to watch over the masks' integrity for two to six uses.

The Minnesota Nurses Association, however, questioned the safety of all decontamination efforts on Thursday, citing the National Nurses United statement from April 6:

“There is no validated, scientific evidence that multiple re-use or decontamination of N95 respiratory masks is safe and will protect a health care worker from being infected when exposed to a patient with the virus.”

Jacob said in a best-case scenario N95 masks would be used once as recommended, but the pandemic has forced change.

“We are in an unprecedented time,” added Sannes, “where we need to be flexible to how we try to extend the limited resource of personal protective equipment.

“I think the practical matter is we have far from what we anticipate will be a peak of COVID-19 patients in our hospitals, and we want to ensure that we have strategies to have adequate equipment on hand for when this comes for our nurses, doctors and everybody else that is working with these patients.”

HealthParters wants to further implement the decontamination before they get closer to a peak patient load. “You want to be comfortable with anything like this,” Sannes said.

Sannes said employees also are asked to rotate N95 masks by putting recently used ones in paper bags for days.

“It’s another way to reuse those masks is an attempt to cycle them over a period of several days,” Sannes said. “… Our goal is to protect our staff and these are other means in which we can do it.”