Scenarios to Manage the Demand for N95 Respirators for Healthcare Workers During the COVID-19 Pandemic

Abstract

Background

By estimating N95 respirator demand based on simulated epidemics, we aim to assist planning efforts requiring estimations of respirator demand for the healthcare system to continue operating safely in the coming months.

Methods

We assess respiratory needs over the course of mild, moderate and severe epidemic scenarios within Singapore as a case study using a transmission dynamic model. The number of respirators required within the respiratory isolation wards and intensive care units was estimated over the course of the epidemic. We also considered single-use, extended-use and prolonged-use strategies for N95 respirators for use by healthcare workers treating suspected but negative (misclassified) or confirmed COVID-19 patients.

Results

Depending on the confirmed to misclassified case ratio, from 1:0 to 1:10, a range of 117.1 million to 1.1 billion masks are required for single-use. This decreases to 71.6–784.4 million for extended-use and 12.8–148.2 million for prolonged-use, representing a 31.8–38.9% and 86.5–89.1% reduction, respectively.

Conclusion

An extended-use policy should be considered when short-term supply chains are strained but planning measures are in place to ensure long-term availability. With severe shortage expectations from a severe epidemic, as some European countries have experienced, prolonged use is necessary to prolong supply.

Keywords:

• COVID-19 pandemic
• mathematical modelling
• policy
• healthcare resources
• N95 respirators

Acknowledgments

This research is supported by the Singapore’s National Medical Research Council under the Centre Grant Programme – Singapore Population Health Improvement Centre (NMRC/CG/C026/2017_NUHS) and COVID-19 Research Fund (COVID19RF-004); and by the JSPS KAKENHI Grant Number 19K24250, and Leading Young Researcher Overseas Visit Program under Ministry of Education, Culture, Sports, Science and Technology, Japan.

Abbreviations

PPE, personal protective equipment; HCW, healthcare worker; WHO, World Health Organisation; SEIR model, Susceptible-Exposed-Infectious-Recovered model; ICU, intensive care unit.

Disclosure

The authors declare that they have no competing interests. These authors contributed equally to this manuscript: Hirono Otomaru and Borame L Dickens.