Dear member / clinic,

Please note Ministry of Health advice below on the removal of N95/P2 mask exemptions outside Auckland.
Although they refer to ‘Pharmacy and General Practice’, we’ve confirmed this applies to urgent care clinics too.
Please also refer to our earlier CDC-based advice on double masking (which almost doubles the mask effectiveness) and mask reuse in the event of N95 /P2 unavailability, copied below.

Failure of DHB supply of N95s
If this occurs for whatever reason, we have three suggestions:


1. Private sector supplier
We will maintain a list of other N95 suppliers. We’d suggest ordering early. If you have a supplier, please share with the College, via alex@rnzcuc.org.nz. Make sure the masks you buy are truly N95 or equivalent; please contact RNZCUC if you have any doubts.


2. Mask re-use
We issued CDC guidelines on mask reuse last year, copied below. While this is not ideal, it is better than no mask. We suggest storing used N95s in a breathable paper bag, labelled with the staff member’s name, rather than throwing them out, in case there is a shortage.


3. Double masking
CDC advice on double masking effectiveness and technique is linked.
Double masking, as with a surgical mask under a cloth mask, reduces air leak. CDC research indicates that up to 95% of aerosol particles are excluded by this technique, considerably better than a surgical mask or cloth mask alone.
This diagram compares the level of effectiveness of double masking, vs surgical masking, a well-fitting N95, and a poorly fitting one, with references.
The CDC recommends ‘knotting’ the underlying surgical mask; this video from NZ GP Sandhya Ramanathan demonstrates how.
We repeat that the size of the inoculum is related to both likelihood of infection and severity of infection, and that any reduction in viral exposure is very worthwhile.


With thanks,


David Gollogly, Jasmine Mackay, Richard Chen, Kelvin Ward
Pandemic Response Subcommittee

rnzcuc-mail-logo

MoH advice on P2/N95 supply

Exemption Cessation P2/N95’s in Alert level 2
This email is to confirm that effective 11:59pm today (14 September 2021), the Ministry of Health will remove the exemptions put in place for use of N95/P2 use by Pharmacy and General Practice outside of the Auckland region. From 15 September 2021, N95/P2’s will only be supplied to those Pharmacy and General Practice outside of the Auckland region undertaking swabbing, who have provided the Ministry of Health with a fit test declaration.

Use of P2/N95 Particulate Respirators: COVID-19 Vaccine
Please also note that as per the COVID-19 Vaccine Operating Guidelines (pg. 76) for Infection Prevention and Control requirements – specifically mask wearing across Alert settings – does not require the use of an N95/P2 particulate respirator. The Ministry of Health’s centralised supply of PPE will not provide N95/P2 particulate respirators for use in Vaccine Centres. DHBs are further asked to not provide N95/P2 respirators from their supply to Vaccine Centres. The supply of N95/P2 particulate respirators is specifically selected for use across a range of sectors.

We ask that all Vaccine Centres as per the request in the Vaccine Operating Guidelines (pg. 46), contact the COVID-19 Health Supply Chain team to access PPE through HealthCare Logistics or Onelink.
Please note that there are no exceptions unless approved on an individual case by case basis by the Ministry of Health directly. The Principles of Supply clearly articulate PPE across Alert Levels and settings. If you are unsure in the first instance, please refer to Covid-19: Personal Protective Equipment Central Supply.

Ngā mihi,

COVID-19 Health Supply Chain
COVID-19 Health System Response, Ministry of Health l www.moh.govt.nz

Reuse of PPE

The CDC has released a statement on reusing masks in case supplies run low, which may be useful for facilities that wish to prepare for a mask shortage.
The United States is at a different stage of the pandemic, and emphasises that reuse is not the ‘standard of care’.
Key points:
  • “ultraviolet germicidal irradiation, vaporous hydrogen peroxide, and moist heat showed the most promise as potential methods to decontaminate FFRs (filtering facepiece respirators).”
  • Strategies for FFR extended use and reuse (without decontamination of the respirator) are currently available from CDC’s National Institute for Occupational Safety and Health (NIOSH)
  • It references a paper on SARS-COV-2 survival in the environment on different materials, where the figure for near-extinction on cardboard is given as two days.
  • It suggests healthcare workers store their masks in a breathable paper bag at the end of each shift and re-use after five days.