The need of health policy perspective to protect Healthcare Workers during COVID-19 pandemic. A GRADE rapid review on the N95 respirators effectiveness.

Primiano Iannone; Greta Castellini; Daniela Coclite; Antonello Napoletano; Alice Fauci; Laura Iacorossi; Daniela D'Angelo; Cristina Renzi; Giuseppe La Torre; Claudio Mastroianni; Silvia Gianola

The favourable (albeit not significant) trend of N95 for laboratory confirmed respiratory infections and ILI deserves some comment. In fact, these findings could be viewed as evidence against the benefit of respirators. Instead, given the blurred distinction between airborne and droplet diffusion of respiratory virues [35] it could also be considered as indirect evidence of the opportunistic airborne route of transmission of respiratory viruses in the healthcare environment, where prolonged exposures, high viral loads, asymptomatic carriers, overcrowding and poor ventilation could enhance the opportunistic airborne diffusion among HCWs of viruses such as SARS-CoV-2. Regarding the lack of apparent benefit of N95 for influenza in the only trial where this outcome was assessed, both the outpatient setting (with lower viral exposure loads) [36] and the droplet route of transmission believed to be operative for influenza are worth of consideration. Finally, we suggest to integrate the perspective and the findings of this review into the . CC-BY-ND 4.0 International license It is made available under a author/funder, who has granted medRxiv a license to display the preprint in perpetuity.