Reusable Elastomeric Respirators as An Alternative During the Covid-19 Pandemic: Hospital-Based Health Technology Assessment

Abstract
Author Affiliations 1Instituto Global de Excelencia Clínica Keralty, Centro de Evaluación de Tecnologías en salud, Departamento de gestión de dispositivos médicos, Bogotá-Colombia. 2Instituto Global de Excelencia Clínica Keralty, Centro de Evaluación de Tecnologías en salud, Departamento de estudios económicos, Bogotá-Colombia. 3Agencia de Calidad y seguridad Keralty, Bogotá- Colombia. 4Instituto Global de Excelencia Clínica Keralty, Centro Iberoamericano de investigación en Salutogénesis y bienestar, Bogotá-Colombia. 5Instituto Global de Excelencia Clínica Keralty, Centro de Medicina basada e informada en la evidencia, Bogotá-Colombia. 6Instituto Global de Excelencia Clínica Keralty, Centro de Evaluación de Tecnologías en salud, Bogotá-Colombia. 7Instituto Global de Excelencia Clínica Keralty, Bogotá-Colombia. 8Grupo de Investigación Translacional-Fundación Universitaria Sanitas 9Keralty 10Purchasing department Keralty, Bogotá-Colombia Received: August 19, 2020 | Published: September 09, 2020 Corresponding author: Claudia Guevara Pérez, Instituto Global de Excelencia Clínica Keralty, Centro de Evaluación de Tecnologías en salud, Departamento de gestión de dispositivos médicos, Av. Calle 127 # 20 – 56 6th floor, Colombia DOI: 10.26717/BJSTR.2020.30.004910 Introduction: The pandemic caused by the novel coronavirus SARS-CoV-2 has increased the demand for health services and thereby created a shortage of personal protective equipment for health workers. In a real scenario of a shortage of N95 filtering facepiece respirators, organizations such as the Centers for Disease Control and Prevention recommend the alternative use of reusable elastomeric respirators. Objective: To perform a hospital-based health technology assessment of reusable half-face and full-face elastomeric respirators for use in intensive care units focused on patients with a confirmed or suspected diagnosis of COVID-19. Method: The process was carried out with a multicriterion decision approach to assess six domains according to the recommendations of the European Network for Health Technology Assessment. Results: The available evidence on reusable elastomeric respirators in healthcare settings is scarce. The studies found allow us to recommend the use of elastomeric respirators in a conditional context of a shortage of N95 respirators in specific areas, and our analysis shows that they are less expensive. These respirators are the first-line alternative to scarce N95 respirators and have cost advantages in the simulation scenario. A training, monitoring, and assessment strategy must be in place for the implementation of reusable elastomeric respirators. At the organizational level, the use of these respirators is perceived as safe and comfortable. Conclusions: This hospital-based health technology assessment shows that reusable elastomeric respirators can be used in intensive care units as a rational alternative to disposable N95 respirators whose shortage is caused by a pandemic. Keywords: Technology Assessment; Hospital-Based; Pandemics; Personal Protective Equipment; Respiratory Protective Devices; Mask Abbreviations: PPE:Personal Protection Equipment; CDC: Centers for Disease Control; WHO: World Health Organization; RERs: Reusable Elastomeric Respirators; HTA: Health Technology Assessment; ICU: Intensive Care Unit; OSHA: Occupational Safety and Health Administration; NIOSH: National Institute for Occupational Safety and Health