Starr, Nichole

Weiser, Thomas G

English

eScholarship - University of California

UCSFUC San Francisco Previously Published WorksTitleComment on “COVID-19 Preparedness Within the Surgical, Obstetric, and Anesthetic Ecosystem in Sub Saharan Africa”Permalinkhttps://escholarship.org/uc/item/3m56x4g6JournalAnnals of Surgery, 274(6)ISSN0003-4932AuthorsStarr, NicholeWeiser, Thomas GPublication Date2021-12-01DOI10.1097/sla.0000000000004096Copyright InformationThis work is made available under the terms of a Creative Commons Attribution-NonCommercial-NoDerivatives License, availalbe at https://creativecommons.org/licenses/by-nc-nd/4.0/ Peer reviewedeScholarship.org Powered by the California Digital LibraryUniversity of CaliforniaANNALS OF SURGERY, Publish Ahead of Print DOI: 10.1097/SLA.0000000000004096  Comment on “COVID-19 preparedness within the surgical, obstetric and anesthetic ecosystem in Sub Saharan Africa”  Nichole Starr MD MPH Department of Surgery, University of California San Francisco, San Francisco, CA Safe Surgery Fellow, Lifebox Foundation, New York, NY  Thomas Weiser MD MPH* Department of Surgery, Stanford University, Stanford, Ca Consulting Medical Officer, Lifebox Foundation, New York, NY  On behalf of the authors.   *Corresponding Author: Stanford University School of Medicine, Department of Surgery  Division of General Surgery, Section of Trauma & Critical Care 300 Pasteur Drive, H3638 Stanford, CA 94305 tweiser@stanford.edu      Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.To the editor: In our article providing guidance on preparing the surgical ecosystem in Sub Saharan Africa for the COVID-19 pandemic1, we noted in the section regarding conserving PPE and consumables that N95 masks could potentially be decontaminated using dry heat at 70°C (160°F) for 30 minutes. The research community is moving quickly to build quality data around COVID-19 inactivation methods and knowledge in this regard is rapidly changing. The technique we put forward has proven to be inadequate for destroying SARS-CoV-19, the virus causing COVID-19.  Recent work by the N95decon group and others has demonstrated a number of promising methods for decontaminating filtering facepiece (FFP) respirators. Heating masks to 70°C (160°F) in a dry autoclave for 60 minutes (rather than 30 minutes as we had originally written) has been shown to destroy the virus under laboratory conditions.2,3 Other recent work reported virus inactivation using a steam autoclave cycle at 121°C for 15-30 minutes, although some N95 models were found to subsequently fail fit testing after more than a single cycle.4 Several other methods are also being tested, including vaporised hydrogen peroxide and UV-C sterilization3, but these are not widely available currently in many low-resource settings. The N95decon group has been providing rigorous and thoughtful strategies to decontaminate and reuse N95 masks as well as exploring other locally developed methods, particularly in resource-poor settings around the world. We urge providers and facility leads who are working to cope with limited supplies to seek updated information from this and other reputable groups.  Nichole Starr Department of Surgery, UCSF Safe Surgery Fellow, Lifebox Foundation Thomas Weiser   Department of Surgery, Stanford University Consulting Medical Officer, Lifebox Foundation  …on behalf of the authorship.  1 Ademuyiwa AO, Bekele A, Berhea AB, Borgstein E, Capo-Chichi N, et al. COVID-19 preparedness within the surgical, obstetric and anesthetic ecosystem in Sub Saharan Africa. Ann Surg 2020. [epublished ahead of print] 6 April 2020.  Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.2 N95decon: https://www.n95decon.org/publications, accessed 24 April 2020.  3 Fischer RJ, Morris DH, van Doremalen N, Sarchette S, Matson MJ, Bushmaker T, Yinda CK, Seifert SN, Gamble A, Williamson BN, Judson SD, de Wit E, Lloyd-Smith JO, Munster VJ. Assessment of N95 respirator decontamination and re-use for SARS-CoV-2. medRxiv. (2020). Advanced online publication [not peer reviewed] https://doi.org/10.1101/2020.04.11.20062018.  4 Kumar A, Kasloff SB, Leung A, Cutts T, Strong JE, Hills K, Vazquez-Grande G, Rush B, Lother S, Zarychanski R, Krishnan J. N95 Mask Decontamination using Standard Hospital Sterilization Technologies. medRxiv. (2020). Advance online publication [not peer reviewed] https://doi.org/10.1101/2020.04.05.20049346.   Copyright © 2020 Wolters Kluwer Health, Inc. Unauthorized reproduction of this article is prohibited.

Comment on “COVID-19 Preparedness Within the Surgical, Obstetric, and Anesthetic Ecosystem in Sub Saharan Africa”

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Comment on “COVID-19 Preparedness Within the Surgical, Obstetric, and Anesthetic Ecosystem in Sub Saharan Africa”

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