BOSTON — It was a rapidly disappearing commodity at Brigham and Women's Hospital. And so, when a box of 50,000 donated N-95 face masks arrived a few weeks ago, doctors and nurses were relieved.
“We were very, very treacherously low on the small N-95s,” said James Rathmell, MD, an anesthesiologist at the hospital. “It was a really, really stressful time in saying how can we keep our people safe and still take care of our patients.”
But disappointment set in once the box was opened. The elastic straps on the masks had degraded to the point they came apart when the mask was put on. For doctors and nurses caring for COVID-19 patients, this was no small problem.
"It's very different from a standard surgical mask where there's like openings on the side," said Jeff Karp, PhD, a professor of medicine at Harvard Medical School. "With N-95, you need a perfect air-tight seal."
Anything less when working around patients with an infectious disease can be dangerous.
“Fundamentally, the mask itself is a safety device,” said Anthony Samir, MD, MPH, a radiologist at Massachusetts General Hospital. “If there’s any sort of problem and you lose that airtight seal you could inadvertently expose people to COVID-19 and they might not really know this because they’re busy, they’re working, the virus is incredibly tiny.”
"They were ready to go in a dumpster, we were pretty close," said Dr. Rathmell. But he knew that the donor, a church, had gone to a lot of trouble to send the N-95s -- and everything else about the face masks seemed fine. "And I just felt... there's got to be an answer. These are very recent vintage, already-tested masks."
And they were of a smaller face size the hospital desperately needed. “We’re 50% women in the department and they happen to have small faces and so many of those people have no protection or very limited protection.”
It turns out that Partners, the parent company of Brigham and Women’s, Massachusetts General and several other hospitals, had recently been helping New Balance, the running shoe company, come up with a face mask design of its own.
“They helped us out quite a bit from learning what we knew really well, which was footwear, into how do you make a really great mask,” said Dave Wheeler executive vice-president of New Balance. “We had a lot of interactions on testing not only the fabric itself but fit-testing.”
New Balance, of course, had expertise Partners did not: mass manufacturing know-how.
And so a quick partnership was formed -- one in which speed was of the essence.
"You have a fairly challenging task," said Dr. Samir. "Not only do you have to repair the mask but you have to repair it in such a way that it's durable, you have confidence it will work as intended and you've got to do it 50,000 times."
Partners provided input on the fix -- which was crucial, given the masks are such a critical piece of equipment when caring for COVID-19 patients. “We created prototypes for the team at Partners to evaluate,” Wheeler said. “So that when we started the repairs they were correct, they fit correctly, they felt okay.”
For New Balance, helping with the repairs was a bit like returning a favor. But Dave Wheeler says it was actually more than that. "And so everybody just rallied together you know for the greater cause. And it was super inspirational and extremely fast at the same time."
So fast, that the first batch of repaired masks made it to the floors within days after a prototype was settled on. And, apparently, it was not a moment too soon.
"It brought down the whole anxiety level for being out there on the front lines to the point where it's very calm now," said Dr. Rathmell.
Partners praised New Balance for getting a production line going so fast -- but Wheeler redirected their gracious words. “The team is not only proud but super humbled to be working with world-class institutions,” he said. “And they’re the real heroes fighting out there on the front line.”
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