Cost-effectiveness analysis of surgical masks, N95 masks compared to wearing no mask for the prevention of COVID-19 among health care workers: Evidence from the public health care setting in India.

BACKGROUND: Nonpharmacological interventions, such as personal protective equipment for example, surgical masks and respirators, and maintenance of hand hygiene along with COVID-19 vaccines have been recommended to reduce viral transmission in the community and health care settings. There is evidence from the literature that surgical and N95 masks may reduce the initial degree of exposure to the virus. A limited research that has studied the cost-effective analysis of surgical masks and N95 masks among health care workers in the prevention of COVID-19 in India. The objective of this study was to estimate the cost-effectiveness of N95 and surgical mask compared to wearing no mask in public hospital settings for preventing COVID-19 infection among Health care workers (HCWs) from the health care provider's perspective. METHODS: A deterministic baseline model, without any mask use, based on Eikenberry et al was used to form the foundation for parameter estimation and to estimate transmission rates among HCWs. Information on mask efficacy, including the overall filtering efficiency of a mask and clinical efficiency, in terms of either inward efficiency(ei) or outward efficiency(e0), was obtained from published literature. Hospitalized HCWs were assumed to be in one of the disease states i.e., mild, moderate, severe, or critical. A total of 10,000 HCWs was considered as representative of the size of a tertiary care institution HCW population. The utility values for the mild, moderate and severe model health states were sourced from the primary data collection on quality-of-life of HCWs COVID-19 survivors. The utility scores for mild, moderate, and severe COVID-19 conditions were 0.88, 0.738 and 0.58, respectively. The cost of treatment for mild sickness (6,500 INR per day), moderate sickness (10,000 INR per day), severe (require ICU facility without ventilation, 15,000 INR per day), and critical (require ICU facility with ventilation per day, 18,000 INR) per day as per government and private COVID-19 treatment costs and capping were considered. One way sensitivity analyses were performed to identify the model inputs which had the largest impact on model results. RESULTS: The use of N95 masks compared to using no mask is cost-saving of $1,454,632 (INR 0.106 billion) per 10,000 HCWs in a year. The use of N95 masks compared to using surgical masks is cost-saving of $63,919 (INR 0.005 billion) per 10,000 HCWs in a year. the use of surgical masks compared to using no mask is cost-saving of $1,390,713 (INR 0.102 billion) per 10,000 HCWs in a year. The uncertainty analysis showed that considering fixed transmission rate (1.7), adoption of mask efficiency as 20%, 50% and 80% reduces the cumulative relative mortality to 41%, 79% and 94% respectively. On considering ei = e0 (99%) for N95 and surgical mask with ei = e0 (90%) the cumulative relative mortality was reduced by 97% and the use of N95 masks compared to using surgical masks is cost-saving of $24,361 (INR 0.002 billion) per 10,000 HCWs in a year. DISCUSSION: Both considered interventions were dominant compared to no mask based on the model estimates. N95 masks were also dominant compared to surgical masks.

Cost-effectiveness of mask mandates on subways to prevent SARS-CoV-2 transmission in the United States.

BACKGROUND: Community-based mask wearing has been shown to reduce the transmission of SARS-CoV-2. However, few studies have conducted an economic evaluation of mask mandates, specifically in public transportation settings. This study evaluated the cost-effectiveness of implementing mask mandates for subway passengers in the United States by evaluating its potential to reduce COVID-19 transmission during subway travel. MATERIALS AND METHODS: We assessed the health impacts and costs of subway mask mandates compared to mask recommendations based on the number of infections that would occur during subway travel in the U.S. Using a combined box and Wells-Riley infection model, we estimated monthly infections, hospitalizations, and deaths averted under a mask mandate scenario as compared to a mask recommendation scenario. The analysis included costs of implementing mask mandates and COVID-19 treatment from a limited societal perspective. The cost-effectiveness (net cost per averted death) of mandates was estimated for three different periods based on dominant SARS-CoV-2 variants: Alpha, Beta, and Gamma (November 2020 to February 2021); Delta (July to October 2021); and early Omicron (January to March 2022). RESULTS: Compared with mask recommendations only, mask mandates were cost-effective across all periods, with costs per averted death less than a threshold of $11.4 million (ranging from cost-saving to $3 million per averted death). Additionally, mask mandates were more cost-effective during the early Omicron period than the other two periods and were cost saving in January 2022. Our findings showed that mandates remained cost-effective when accounting for uncertainties in input parameters (e.g., even if mandates only resulted in small increases in mask usage by subway ridership). CONCLUSIONS: The findings highlight the economic value of mask mandates on subways, particularly during high virus transmissibility periods, during the COVID-19 pandemic. This study may inform stakeholders on mask mandate decisions during future outbreaks of novel viral respiratory diseases.

Triboelectric Nanogenerator from Used Surgical Face Mask and Waste Mylar Materials Aiding the Circular Economy.

Apart from claiming the lives of more than 3.2 million people, the COVID-19 pandemic is worsening the global plastic pollution every day, mainly with the overflux of single-use polypropylene (PP) face masks. In this scenario, as an innovative solution to mitigate plastic pollution as well as to meet the rising electrical energy demand, we are introducing an all-flexible and facile waste material-based triboelectric nanogenerator (WM-TENG), aiding toward the circular economy. The WM-TENG operating in contact separation mode is fabricated using the PP from a used face mask in combination with recovered Mylar sheets from solid wastes as triboelectric contact layers and a flexible supporting structure. After detailed investigation and trials to study the effect of various disinfection mechanisms of PP materials on the energy output of WM-TENG, UV-C radiation is selected for disinfecting the used masks owing to the retention of electrical energy output. Under a tapping force of 3 N, the WM-TENG having an active area of 6 cm2 delivers an open-circuit voltage of 200 V and a short-circuit current density of 0.29 mA/m2, respectively. The WM-TENG also delivered a maximum power density of 71.16 mW/m2 under 108 Ω load. Additionally, the WM-TENG is demonstrated for powering electronic gadgets such as a calculator, digital thermometer, and LCD clock. This flexible and low-cost nanogenerator without any complex fabrication steps is a sustainable solution for the alarming plastic pollution as well as the rising energy demands.

The cost-effectiveness of common strategies for the prevention of transmission of SARS-CoV-2 in universities.

BACKGROUND: Most universities that re-open in the United States (US) for in-person instruction have implemented the Centers for Disease Prevention and Control (CDC) guidelines. The value of additional interventions to prevent the transmission of SARS-CoV-2 is unclear. We calculated the cost-effectiveness and cases averted of each intervention in combination with implementing the CDC guidelines. METHODS: We built a decision-analytic model to examine the cost-effectiveness of interventions to re-open universities. The interventions included implementing the CDC guidelines alone and in combination with 1) a symptom-checking mobile application, 2) university-provided standardized, high filtration masks, 3) thermal cameras for temperature screening, 4) one-time entry ('gateway') polymerase chain reaction (PCR) testing, and 5) weekly PCR testing. We also modeled a package of interventions ('package intervention') that combines the CDC guidelines with using the symptom-checking mobile application, standardized masks, gateway PCR testing, and weekly PCR testing. The direct and indirect costs were calculated in 2020 US dollars. We also provided an online interface that allows the user to change model parameters. RESULTS: All interventions averted cases of COVID-19. When the prevalence of actively infectious cases reached 0.1%, providing standardized, high filtration masks saved money and improved health relative to implementing the CDC guidelines alone and in combination with using the symptom-checking mobile application, thermal cameras, and gateway testing. Compared with standardized masks, weekly PCR testing cost $9.27 million (95% Credible Interval [CrI]: cost-saving-$77.36 million)/QALY gained. Compared with weekly PCR testing, the 'package' intervention cost $137,877 (95% CrI: $3,108-$19.11 million)/QALY gained. At both a prevalence of 1% and 2%, the 'package' intervention saved money and improved health compared to all the other interventions. CONCLUSIONS: All interventions were effective at averting infection from COVID-19. However, when the prevalence of actively infectious cases in the community was low, only standardized, high filtration masks clearly provided value.

A life cycle assessment of reprocessing face masks during the Covid-19 pandemic.

The Covid-19 pandemic led to threatening shortages in healthcare of medical products such as face masks. Due to this major impact on our healthcare society an initiative was conducted between March and July 2020 for reprocessing of face masks from 19 different hospitals. This exceptional opportunity was used to study the costs impact and the carbon footprint of reprocessed face masks relative to new disposable face masks. The aim of this study is to conduct a Life Cycle Assessment (LCA) to assess and compare the climate change impact of disposed versus reprocessed face masks. In total 18.166 high quality medical FFP2 face masks were reprocessed through steam sterilization between March and July 2020. Greenhouse gas emissions during production, transport, sterilization and end-of-life processes were assessed. The background life cycle inventory data were retrieved from the ecoinvent database. The life cycle impact assessment method ReCiPe was used to translate emissions into climate change impact. The cost analysis is based on actual sterilization as well as associated costs compared to the prices of new disposable face masks. A Monte Carlo sampling was used to propagate the uncertainty of different inputs to the LCA results. The carbon footprint appears to be 58% lower for face masks which were reused for five times compared to new face masks which were used for one time only. The sensitivity analysis indicated that the loading capacity of the autoclave and rejection rate of face masks has a large influence on the carbon footprint. The estimated cost price of a reprocessed mask was €1.40 against €1.55. The Life Cycle Assessment demonstrates that reprocessed FFP2 face masks from a circular economy perspective have a lower climate change impact on the carbon footprint than new face masks. For policymakers it is important to realize that the carbon footprint of medical products such as face masks may be reduced by means of circular economy strategies. This study demonstrated a lower climate change impact and lower costs when reprocessing and reusing disposable face masks for five times. Therefore, this study may serve as an inspiration for investigating reprocessing of other medical products that may become scarce. Finally, this study advocates that circular design engineering principles should be taken into account when designing medical devices. This will lead to more sustainable products that have a lower carbon footprint and may be manufactured at lower costs.

Exceptional Prices of Medical and Other Supplies during the COVID-19 Pandemic in Ecuador.

Shortages of essential supplies used to prevent, diagnose, and treat COVID-19 have been a global concern, and price speculation and hikes may have negatively influenced access. This study identifies variability in prices of products acquired through government-driven contracts in Ecuador during the early pandemic response, when the highest mortality rates were registered in a single day. Data were obtained from the National Public Procurement Service (SERCOP) database between March 1 and July 31, 2020. A statistical descriptive analysis was conducted to extract relevant measures for commonly purchased products, medical devices, pharmaceutical drugs, and other goods. Among the most frequently purchased products, the greatest amounts were spent on face masks (US$4.5 million), acetaminophen (US$2.2 million), and reverse transcriptase quantitative polymerase chain reaction assay kits (US$1.8 million). Prices varied greatly, depending on each individual contract and on the number of units purchased; some were exceptionally higher than their market value. Compared with 2019, the mean price of medical examination gloves increased up to 1,307%, acetaminophen 500 mg pills, up to 796%, and oxygen flasks, 30.8%. In a context of budgetary constraints that actually required an effective use of available funds, speculative price hikes may have limited patient access to health care and the protection of the general population and health care workers. COVID-19 vaccine allocations to privileged individuals have also been widely reported. Price caps and other forms of regulation, as well as greater scrutiny and transparency of government-driven purchases, and investment in local production, are warranted in Ecuador for improved infectious disease prevention.

Facemask and social distancing, pillars of opening up economies.

The COVID-19 pandemic has caused severe health and economic impacts globally. Strategies to safely reopen economies, travel and trade are a high priority. Until a reliable vaccine is available, non-pharmaceutical techniques are the only available means of disease control. In this paper, we aim to evaluate the extent to which social distancing (SD) and facemask (FM) use can mitigate the transmission of COVID-19 when restrictions are lifted. We used a microsimulation activity-based model for Sydney Greater Metropolitan Area, to evaluate the power of SD and FM in controlling the pandemic under numerous scenarios. The hypothetical scenarios are designed to picture feasible futures under different assumptions. Assuming that the isolation of infected cases and the quarantining of close contacts are in place, different numerical tests are conducted and a full factorial two-way MANOVA test is used to evaluate the effectiveness of the FM and SD control strategies. The main and interactive effects of the containment strategies are evaluated by the total number of infections, percentage of infections reduction, the time it takes to get the pandemic under control, and the intensity of active cases.

Will COVID-19-related economic worries superimpose health worries, reducing nonpharmaceutical intervention acceptance in Germany? A prospective pre-registered study.

Nonpharmaceutical interventions (NPI) such as stay-at-home orders aim at curbing the spread of the novel coronavirus, SARS-COV-2. In March 2020, a large proportion of the German population supported such interventions. In this article, we analyse whether the support for NPI dwindle with economic worries superimposing virus-related worries in the months to follow. We test seven pre-registered1 hypotheses using data from the German COSMO survey (Betsch, Wieler, Habersaat, et al. 2020), which regularly monitors behavioural and psychological factors related to the pandemic. The present article covers the period from March 24, 2020 to July 7, 2020 (Ntotal  = 13,094), and, in addition, includes a validation study providing evidence for the reliability and validity of the corresponding COSMO measures (N = 612). Results revealed that virus-related worries decreased over time, whereas economic worries remained largely constant. Moreover, the acceptance of NPIs considerably decreased over time. Virus-related worries were positively associated with acceptance of NPIs, whereas this relationship was negative regarding economic worries (albeit smaller and less consistent). Unexpectedly, no interactions between virus-related worries and economic worries were found. We conclude that individual differences in virus-related and economic threat perceptions related to COVID-19 play an important role in the acceptance of NPIs.

Facing COVID-19 pandemic: development of custom-made face mask with rapid prototyping system.

BACKGROUND: COVID-19 is a global pandemic. The virus spreads through respiratory droplets and close contact. Therefore, the availability of personal protective equipment (PPE) for healthcare professionals is essential. 3D printing technology could represent a valid option to ameliorate PPE shortages. METHODOLOGY: Custom-made face mask were designed on the basis of facial scan and then 3D-printed. The whole protocol is executed with freeware software and only required a 3D printer. Six healthcare workers wore the device weekly thus expressing a judgment regarding quality of work, respiratory and skin comfort. RESULTS: The estimated total cost of a single mask is approximately 5 USD. The virtual design of a complete mask lasted 68 minutes on average. Most healthcare workers rated comfort as very good. CONCLUSIONS: Based on the encouraging results obtained, we can confidently confirm that custom-made masks are novel and useful devices that may be used in the fight against COVID-19.

Evaluation of N95 respirators, modified snorkel masks and low-cost powered air-purifying respirators: a prospective observational cohort study in healthcare workers.

Disposable N95 respirator masks are the current standard for healthcare worker respiratory protection in the COVID-19 pandemic. In addition to shortages, qualitative fit testing can have low sensitivity for detecting poor fit, leading to inconsistent protection. Multiple groups have developed alternative solutions such as modified snorkel masks to overcome these limitations, but validation of these solutions has been lacking. We sought to determine if N95s and snorkel masks with attached high-efficiency filters provide consistent protection levels in healthcare workers and if the addition of positive pressure via an inexpensive powered-air purifying respirator to the snorkel mask would provide enhanced protection. Fifty-one healthcare workers who were qualitatively fitted with N95 masks underwent quantitative mask fit testing according to a simulated workplace exercise protocol. N95, snorkel masks with high-efficiency filters and snorkel masks with powered-air purifying respirators were tested. Respiratory filtration ratios were collected for each step and averaged to obtain an overall workplace protocol fit factor. Failure was defined as either an individual filtration ratio or an overall fit factor below 100. N95s and snorkel masks with high-efficiency filters failed one or more testing steps in 59% and 20% of participants, respectively, and 24% and 12% failed overall fit factors, respectively. The snorkel masks with powered-air purifying respirators had zero individual or overall failures. N95 and snorkel masks with high-efficiency filter respirators were found to provide inconsistent respiratory protection in healthcare workers.

MOF based flexible, low-cost chemiresistive device as a respiration sensor for sleep apnea diagnosis.

The monitoring of respiratory disorders requires breath sensors that are fast, robust, and convenient to use and can function under real time conditions. A MOF based flexible sensor is reported for the first time for breath sensing applications. The properties of a highly porous HKUST-1 MOF and a conducting MoS2 material have been combined to fabricate an electronic sensor on a flexible paper support for studying sleep apnea problems. Extensive breath sensing experiments have been performed and interestingly the fabricated sensor is efficient in detecting various kinds of breaths such as deep, fast, slow and hydrated breath. The MOF breath sensor shows a fast response time of just ∼0.38 s and excellent stability with no decline in its performance even after a month. A plausible mechanism has been proposed and a smartphone based prototype has been prepared to demonstrate the real time applications of the hybrid device. This work demonstrates great potential for the application of MOFs in healthcare with a special focus on breath sensing and sleep apnea diagnosis.

How to Produce Cheap and Easy Custom-Made Sterilizable Filtering Facepiece 2/3 Masks for Healthcare Providers During Pandemic COVID-19 Emergency.

On January 8, 2020, a novel coronavirus was officially announced as the causative pathogen of coronavirus disease (COVID-19) by the Chinese Center for Disease Control and Prevention.On February 26, COVID-19 has been recognized in 34 countries, with a total of 80,239 laboratory-confirmed patients and 2700 deaths.Protecting healthcare workers from infectious hazards is paramount to ensuring their safety in delivering health care.In addition, being able to protect healthcare workers, constituting the front-line response against high-threat respiratory pathogens, such as severe acute respiratory syndrome coronavirus 2, is important for reducing secondary transmission in healthcare-associated outbreaks.Authors present a simple, reliable, and cheap protocol to produce a custom-made sterilizable filtering facepiece 2/3 masks for healthcare providers during pandemic COVID-19 emergency.

Produção de máscaras cirúrgicas: estratégia no combate à covid-19 / Producción de máscaras quirúrgicas: estrategia para combatir el covid-19 / Production of surgical masks: strategy to combat covid-19

Objetivo relatar a experiência de produção de máscaras cirúrgicas por uma comissão de produção de inovação tecnológica. Método estudo descritivo do tipo relato de experiência. O processo de produção envolveu seis costureiras, uma cortando o tecido-não-tecido hospitalar, uma na máquina Overlock para fazer o acabamento nas laterais e quatro, costurando na máquina Reta. Foi utilizado tecido-não-tecido gramatura de 60, linhas brancas e arame galvanizado encapado. Resultado a produção chegou a 1.300 máscaras cirúrgicas por dia. Todas passaram pelo teste de qualidade em uma central de distribuição antes de serem encaminhadas aos serviços de saúde. O processo foi gerenciado por duas enfermeiras. Conclusão a estratégia relatada representou a produção de 63 mil unidades de máscaras cirúrgicas e foi uma maneira alternativa de suprir a demanda de máscaras cirúrgicas nos serviços de saúde, contribuindo para melhorar a segurança dos profissionais de saúde no âmbito da COVID-19.

Objetivo informar la experiencia de producción de mascarillas quirúrgicas por una comisión de producción de innovación tecnológica. Método estudio descriptivo del tipo informe de experiencia. El proceso de producción implicó seis costureras, una cortando la tela no tejida hospitalaria, una en la máquina Sobrehilada para hacer el acabado en los lados y cuatro cosiendo en la máquina Recta. Se utilizó una tela no tejida de 60 gramos, hilos blancos y un alambre galvanizado camuflado. Resultado la producción alcanzó 1.300 máscaras quirúrgicas por día. El proceso fue gestionado por dos enfermeras. Conclusión la estrategia reportada representó la producción de 63.000 unidades de mascarillas quirúrgicas y fue una forma alternativa de satisfacer la demanda de mascarillas quirúrgicas en los servicios de salud, contribuyendo a mejorar la seguridad de los profesionales de la salud en el contexto da la COVID-19.

Objective to report the experience of production of surgical masks by a committee of technological innovation production. Method descriptive study of the experience-report type. The production process involved six seamstresses, one cutting the hospital nonwoven fabric, one at the Overlock stitch machine to make the finish of sides and four sewing with the Straight stitch machine. A 60-grammage nonwoven fabric, white thread and a cloaked galvanized wire were used. Result production reached 1,300 surgical masks per day. The process was managed by two nurses. Conclusion the strategy reported represented the production of 63,000 units of surgical masks and was an alternative to meet the demand for surgical masks in health services, contributing to improve the safety of health professionals within the scope of COVID-19.

Evaluation of Safety and Cost of an Open-Design Oxygen Mask in a Large Community Hospital.

BACKGROUND: In our large community hospital, we observed that traditional oxygen masks were sometimes set at an inappropriately low flow. We hoped to eliminate this safety concern through adoption of an open-design oxygen mask. We also hoped that more immediate flow changes would lead to a decrease in medical gas consumption. Finally, by standardizing to one mask, goals were to reduce the cost of oxygen delivery. METHODS: We conducted a retrospective analysis, 12 months before and 12 months after implementation of the open-design oxygen mask. Unusual occurrence reports related to supplemental oxygen delivery were reviewed. Oxygen device use and bulk oxygen consumption were recorded. The total number of patient days was obtained from the electronic medical record. RESULTS: There were no unusual occurrence reports or concerns involving an oxygen device in those areas that converted to the open-design oxygen mask. In fiscal year 2014, bulk oxygen use was 13,036,686 cubic feet, and there were 74,734 patient days. In fiscal year 2016, bulk oxygen use was 12,072,610 cubic feet and there were 99,428 patient days. The reduction in oxygen consumption was $3,670 despite the increase in patient days. In fiscal year 2014, 3,848 oxygen devices were used for a cost of $3,411, and in fiscal year 2016, 5,512 devices were used for a cost of $12,963. The net savings from open-design oxygen mask conversion was $23,487 annual and corrected for increased patient population. Oxygen consumption and supply cost per patient day resulted in $1.19 per patient day pre-implementation and $0.95 after implementation of the open-design oxygen mask (P = .003). CONCLUSIONS: The open-design oxygen mask may be a safe and less costly alternative to traditional oxygen delivery devices.

Cost-effectiveness analysis of N95 respirators and medical masks to protect healthcare workers in China from respiratory infections.

BACKGROUND: There are substantial differences between the costs of medical masks and N95 respirators. Cost-effectiveness analysis is required to assist decision-makers evaluating alternative healthcare worker (HCW) mask/respirator strategies. This study aims to compare the cost-effectiveness of N95 respirators and medical masks for protecting HCWs in Beijing, China. METHODS: We developed a cost-effectiveness analysis model utilising efficacy and resource use data from two cluster randomised clinical trials assessing various mask/respirator strategies conducted in HCWs in Level 2 and 3 Beijing hospitals for the 2008-09 and 2009-10 influenza seasons. The main outcome measure was the incremental cost-effectiveness ratio (ICER) per clinical respiratory illness (CRI) case prevented. We used a societal perspective which included intervention costs, the healthcare costs of CRI in HCWs and absenteeism costs. RESULTS: The incremental cost to prevent a CRI case with continuous use of N95 respirators when compared to medical masks ranged from US $490-$1230 (approx. 3000-7600 RMB). One-way sensitivity analysis indicated that the CRI attack rate and intervention effectiveness had the greatest impact on cost-effectiveness. CONCLUSIONS: The determination of cost-effectiveness for mask/respirator strategies will depend on the willingness to pay to prevent a CRI case in a HCW, which will vary between countries. In the case of a highly pathogenic pandemic, respirator use in HCWs would likely be a cost-effective intervention.

Review of economic evaluations of mask and respirator use for protection against respiratory infection transmission.

BACKGROUND: There has been increasing debate surrounding mask and respirator interventions to control respiratory infection transmission in both healthcare and community settings. As decision makers are considering the recommendations they should evaluate how to provide the most efficient protection strategies with minimum costs. The aim of this review is to identify and evaluate the existing economic evaluation literature in this area and to offer advice on how future evaluations on this topic should be conducted. METHODS: We searched the Scopus database for all literature on economic evaluation of mask or respirator use to control respiratory infection transmission. Reference lists from the identified studies were also manually searched. Seven studies met our inclusion criteria from the initial 806 studies identified by the search strategy and our manual search. RESULTS: Five studies considered interventions for seasonal and/or pandemic influenza, with one also considering SARS (Severe Acute Respiratory Syndrome). The other two studies focussed on tuberculosis transmission control interventions. The settings and methodologies of the studies varied greatly. No low-middle income settings were identified. Only one of the reviewed studies cited clinical evidence to inform their mask/respirator intervention effectiveness parameters. Mask and respirator interventions were generally reported by the study authors to be cost saving or cost-effective when compared to no intervention or other control measures, however the evaluations had important limitations. CONCLUSIONS: Given the large cost differential between masks and respirators, there is a need for more comprehensive economic evaluations to compare the relative costs and benefits of these interventions in situations and settings where alternative options are potentially applicable. There are at present insufficient well conducted cost-effectiveness studies to inform decision-makers on the value for money of alternative mask/respirator options.

Burn Center Barrier Protocols During Dressing Change: A National Survey.

Infection control is a critical component of post-burn care with prevention of infection serving as a major cause of decreasing morbidity and mortality. One potential deterrent for infection is barrier protection during dressing changes; however, no evidence-based standard has been established among burn centers. The purpose of this study is to describe the current barrier techniques of American burn centers. A 24-question survey was sent to 121 burn center nurse managers within the United States. The survey was comprised of yes or no questions with comment sections available for further detail. Questions were constructed to gain insight into the variation and commonality that may exist between burn center barrier protocols. Forty-one out of 121 centers (34%) responded. Centers reported the use of head covers, masks, gowns, and gloves during admission of a new burn (71%, 82%, 95%, and 100% respectively); daily dressing changes (64%, 80%, 97%, and 100% respectively); postoperative dressing changes (64%, masks 80%, 97%, and 100% respectively); and dressing changes of a nonburn (66%, 82%, 97%, and 100% respectively). Burn centers reported their use of sterile gloves and gowns during typical burn dressing changes as occurring 20% and 10% of the time, respectively. Estimates for costs of these garments annually ranged from $0 to $250,000. A calculation performed for this study demonstrated that barrier garments used for dressing changes nationwide is approximately $2.43 million. We demonstrated the immense cost, to an institution and nationwide, of barrier garments used solely for dressing changes.