Guidance on the use of surgical masks when healthcare is being provided in the context of the COVID-19 pandemic

Changes to the guidance issued on April 22nd 2020

  1. Clarification of the basis for the guidance on use of surgical masks published on April 22.04.2020.
  2. Clarification on the application of the 15-minute rule.
  3. Clarification on safe use of surgical masks.
  4. Clarification on disposal of surgical masks in settings where there is no direct access to a healthcare risk waste stream.

Introduction
On April 21 2020, National Public Health Emergency Team (NPHET) decided that HPSC guidance should be updated in accordance with a NPHET decision on the use of surgical masks. This guidance reflects that NPHET decision and replaces previous HPSC guidance on the use of surgical masks in the context of providing healthcare during the COVID-19 pandemic. The content of this guidance will be incorporated into other Infection Prevention and Control guidance documents as they are updated.

Use of surgical masks by healthcare workers in the context of viral respiratory tract infection has two objectives:

  1. To reduce the risk of droplet transmission of infection to the wearer.
  2. To reduce the risk of droplet transmission of infection to others.


Use of surgical masks for these purposes is in addition to and is not intended as a replacement for other measures to reduce the risk of transmission of infection. These measures include hand hygiene and maintaining a distance of 2 m between people whenever possible. Surgical masks must be donned correctly and should remain in place covering the nose and mouth throughout the period of use.  Masks should not be moved up and down over the nose and mouth.

Guidance

  • Surgical masks should be worn by healthcare workers when they are providing care to people and are within 2 m of a person, regardless of the COVID-19 status of the person.
  • Surgical masks should be worn by all healthcare workers for all encounters, of 15 minutes or more, with other healthcare workers in the workplace where a distance of 2 m cannot be maintained.

Note. This means that a healthcare worker should don a mask if they anticipate being within 2 m of one or more other healthcare workers for a continuous period of 15 minutes or longer. It is not intended that healthcare workers should attempt to estimate in the morning the total duration of a sequence of very brief encounters that may occur during the day.

Safe use of masks
Always change your mask:

  • When you answer the telephone or take a drink/break
  • When leaving a clinical area
  • If your mask is wet, dirty or damaged.
  • When leaving a person’s home.

Never fidget with your mask when it is on and never store your mask in your pocket.

Disposal
When a surgical mask is no longer required or if a fresh surgical mask is needed the surgical mask must be removed and disposed of safely.

  • If you have access to a healthcare risk waste stream discard the surgical masks in to that waste stream.
  • In settings where there is no access to a healthcare risk waste stream, for example in a person’s home, volumes of waste are generally low and in that context the following approach is acceptable.
    • Person with known/suspect COVID-19:  In this context the mask will be used in association with other elements of Personal Protective Equipment (PPE). The mask and all other items of PPE should be discarded into a plastic bag. The bag should never be filled more than three quarters full. This first bag should be securely tied and placed inside another waste bag (double bag). This bag should be stored securely for 72 hours before leaving it out for collection in the normal domestic waste stream.
    • Person who is not known or suspected to have COVID-19: In this context the mask may be used alone or in association with gloves or apron when required for Standard Precautions. In the absence of a specific know infectious disease risk (such as COVID-19) the mask and other items may be discarded as domestic waste.  

Version: 2.0

Published: 28 April 2020