Doylestown Hospital has a sterile solution to the N95 mask shortage

Health care workers on the front lines of the COVID-19 crisis face a nationwide scarcity of N95 masks. Initially designed for one-time use, the protective respirators — named for their ability to filter 95% of airborne particles — are being used and reused because of the shortage, sparking concerns about worker safety and risk of coronavirus transmission.

Doylestown Hospital is working to make that process safer for its staff, using hydrogen peroxide vapor technology to decontaminate its limited supply of N95 face masks. Doylestown Health, which operates the hospital, is one of the first health systems in the country to do so.

The machine used by the Bucks County hospital was manufactured by Bioquell, a global company whose U.S. office is in Horsham, Montgomery County. Originally designed to sanitize hospital rooms and equipment, the hydrogen peroxide vapor technology used is similar to the N95-specific sterilization system approved in March by the Food and Drug Administration for Ohio-based company Battelle.

In fact, the original FDA report prepared by Battelle — released in 2016 to evaluate the treatment of N95 masks for reuse in a possible pandemic — used a Bioquell unit to test the efficacy of hydrogen peroxide vapor in the sanitization process, said Roman Blahoski, communications director for Ecolab, the parent company of Bioquell. (Minnesota-based Ecolab acquired Bioquell in 2019).

Doylestown Hospital purchased the new system March 28, according to the Bucks County Courier Times, and began using it April 1. It is currently running two decontamination “cycles” a day, cleaning between 50 and 100 masks in each cycle.

Since proper fit is a key part of N95 efficacy, each mask is marked with the name of the staffer it belongs to; every time it is processed using the Bioquell sanitization system, the mask is marked with a dot.

After decontamination, masks are subjected to close examination and a new fit test. Although research has indicated masks can be sterilized and reused up to 50 times, Doylestown Hospital isn’t taking any chances.

How’s the sterilization process going?

“So far, so good,” Watson said Wednesday. “We’re really at the very beginning of the process, we’re still learning  — the challenge is collecting and treating and then distributing them. It’s not a matter of ‘Let’s put them in here and it’ll take care of itself.’”

The sterilization process doesn’t erase the hospital’s continued need for masks and other personal protective equipment. Watson said Doylestown is still in need of N95 masks, especially smaller ones. But safer reuse procedures are helping the hospital conserve and extend the supply it does have.

In the future, as the staff grows more confident with the sterilization and reuse system, their hope is to expand potential mask-reuse capacity to additional medical units, including hospice, visiting nurses, and EMS.

“We’re already using it within the hospital for anybody who uses an N95 mask, no matter where you are, treating measles, flu, COVID or what have you,” said Watson. “If you have to wear an N95 mask for your work, we’re reusing them. Obviously not if they’re broken or soiled. But if it makes it through the workday intact, we’ll try and decontaminate it.”

The decontamination machine Doylestown is using is still listed as available on Bioquell’s website; the company’s systems are priced from $30,000 to $80,000.

“Doylestown actually purchased the last system we had in stock,” Bioquell’s Chris Roberts, central account manager at the Horsham office, wrote in an email to WHYY.  “We are currently working on a 4-6 week lead time for any new system purchases.”

The hospital’s early acquisition of the decontamination system is due in large part, Watson said, to staffers’ forethought and preparation for the coronavirus spread.

“We started a task force in February,” he said. “Two weeks before the [coronavirus] problem hit Washington, we were working on it here.”