A Primer “for You Know Who”: Face Masks in New York City: 10,000-300,000

It’s clear that the U.S. didn’t respond quickly enough to this epidemic. “You know who” thought it was a hoax that would disappear like a miracle.  He also had fired the staff and funding of the NSC group that was tasked with planning and preparing the country for such an epidemic and cut the CDC staff and funding, here and in China, tasked with following and reporting on epidemics elsewhere.  We are unprepared for the  rapid acceleration of cases and need for equipment.

As is his tendency to speak without serious analysis “you know who” recently raised the question as to whether physicians and nurses were hoarding or otherwise nefariously creating a face mask and ventilator shortage. He doesn’t understand why a city might need a hundred of thousand or more face masks each day and postulated that the professionals were purposely and illegally creating the nationwide shortages.

Because “you know who” is, to put it gently, data naive, lets analyze his accusation in regard to face masks.  Lets say you are New York City in the midst of a once in a century accelerating epidemic that has killed several hundred residents in the space of three weeks.  It’s very infectious from exposure in the air and on surfaces.

Lets also say for the sake of simplicity that each acute care hospital in the city (there are 62) has 1000 employees interacting with patients and the public, some hospitals will have many more and  some  may have fewer. But to keep it simple for “you know who” lets call it 1000/hospital.

Each staff member interacting with people and patients during the epidemic needs to wear a mask. (that is everyone on a hospital staff).  Lets say for the sake of simplicity again for “you know who”, that 400 employees of each hospital are not in direct patient care but interact with the public.  And that 600 are in direct contact with patients.

The first group  will change their mask on an average of twice a day.  Some may change more often, some less but for the sake of “you know who” lets estimate that they change twice daily.  Why?  breathe into a mask for 8 hours straight and it becomes moist and contaminated.

For this group of employees the usage  totals 400 employees X 62 hospitals X 2 =  49,600 masks/day. 

The other 600 will change their mask more frequently.  Best practice is that a new mask be used for each patient seen.  For an ER doctor that might be 20 patients in a shift.  While a ward nurse might be responsible for anywhere from 4-8 patients depending on the type patients they are caring for.     Lets say again for simplicity and “you know who” that each of these professionals changes a mask and average of 5 times a day.  Not ideal but this is an epidemic and there is a supply shortage.

For this group of employees usage totals 600 employees X 62 acute care hospitals X 5 = 186,000 masks a day.  

If they were to change after every patient seen, say an average of 10 times a day the totals would be 600 X 62 X 10 = 372,000 masks per day.

Medicynical note:  Mr. “you know who” your track record on this epidemic is abysmal when you make “off the cuff” assessments.  The epidemic is not a media hoax; the epidemic has not gone away like a miracle; It would have been better to have planners following the course of the epidemic in China but you fired them.  Your assessment of the shortage of face masks is obviously ridiculously uninformed.  Please stop it. 


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