21 (49% of 43 members) Both adult and pediatric 22 (34% of 65 members) Region: New England 54 (55% of 98 members) 288 (52% of 549 members)

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1 9 December 01 Infectious Diseases Society of America Emerging Infections Network Report for Query: Use of Respiratory Protective Devices for Influenza Overall response rate: 686/1,7 (7%) physicians responded from /0/1 to 1/0/1. Note: The denominator includes only members who have ever responded to an EIN survey; 9 members who joined the EIN but have not yet responded to any surveys so far are excluded. Note: Not all respondents answered all questions, so totals for individual questions vary. Responders as percent of overall members in each category: Practice: Adult 08* (6% of 1 members) Pediatric 16 (% of 91 members) Both adult and pediatric (% of 6 members) Region: New England (% of 98 members) Mid Atlantic 9 (% of 0 members) East North Central 9 (7% of 0 members) West North Central 66 ( of 1 members) South Atlantic 1 (6% of 71 members) East South Central (7% of 7 members) West South Central 6 (7% of 98 members) Mountain 1 (% of 9 members) Pacific 11 (% of 6 members) Puerto Rico 1 ( of members) Canada 10 (8% of 6 members) Years experience since ID fellowship: < years * (% of 60 members) -1 06* (1% of 97 members) 1-17 (9% of members) 191 (% of 9 members) Employment: Hospital/clinic 18 (% of 1 members) Private/group practice 16* ( of 0 members) University/medical school 9 (% of 60 members) VA and military 8 (8% of 79 members) State gov t 6 (6% of 1 members) Primary hospital type: Community 1* (8% of 7 members) Non-university teaching 189 (6% of 09 members) University 88 (% of 9 members) VA hospital or DOD 1 (8% of 8 members) City/county 1 (9% of members) Other (0 % of 10 members) *Non-respondents were significantly more likely than respondents to have fewer than 1 years of ID experience (p=0.006), be adult ID practitioners (p=0.00), work in a private/group practice (p=0.00) and in a community hospital (p=0.0017). Page 1

2 9 December 01 Question 1. How often do you believe seasonal influenza is transmitted by small-particle aerosols? 67 (1%) [defined as transmission at a distance of >6 feet] 178 (%) (6%) Never (%) (8%) Question. How often do you believe seasonal influenza is transmitted by droplets? 08 (9%) [defined as transmission at a distance of <6 feet] (6%) 8 (1%) Never 0 (0.%) Combined answers to Questions 1 and shown in graph below Aerosol transmission [9 respondents answered both questions] 7 Droplet Transmission Never Number of respondents Question. Are you involved in your facility s decisions about respiratory protection for influenza? No 97 (8%) -These respondents are excluded from all remaining data shown Yes 89 (%) All further data shown is for the 89 respondents who answered Yes to Q 8% of the 89 respondents are hospital epidemiologists, are on an institution s infection control committee, or have indicated interest in infection prevention/control. Page

3 9 December 01 Question. Your personally preferred form of respiratory protection during the care of patients with the following types of influenza (regardless of your hospital s policy) for the following activities: SURG = Surgical mask N-9 = N-9 respirator Other a. Entry into patient room (no patient contact and >6 feet from patient) Seasonal influenza SURG = 89% N-9 = % Other = 6% to moderate severity pandemic (mortality similar to 009) or severe seasonal influenza SURG = 79% N-9 = 18% Other = % Severe pandemic disease (mortality 1%) SURG = N-9 = 8% Other = % b. Routine patient care without aerosol generating procedures (e.g. examining patient) c. Provision of patient care involving aerosol generation SURG = 9% N-9 = 7% Other = 1% SURG = 8% N-9 = Other = % SURG = 7% N-9 = 7% Other = 1% SURG = % N-9 = 7% Other = % SURG = 1% N-9 = 67% Other = % SURG = 8% N-9 = 87% Other = % Question. Which of the following devices does your facility generally have a. available (with training and/or fit testing) for routine patient care? b. stockpiled? No Yes 10 Stockpiled Available Stockpiled Available Stockpiled Available Stockpiled Surgical MASKs N-9s ELASTOMERIC PAPRs 6 Page

4 9 December 01 Question 6. Please rate your level of concern for each of the following possible barriers to expanded use: [89 respondents provided a level of concern for each form of respiratory protection] Disposable N-9 Respirators Elastomeric Respirators Powered Air Purifying Respirators (PAPRs) Page

5 9 December 01 Question 7. If N-9 respirators are recommended and there is a shortage of these devices, which of the following strategies would you be most likely to endorse if the predominant circulating influenza strain during a future influenza pandemic is associated with a high mortality and there is no vaccine available? Extended use of N-9s. Re-use of N-9s Use of PAPRs.7 Median Mean Use of surgical masks.6 Use of elastomeric respirators. 0 1 Other strategies recommended in open-text field: --Cohorting and/or limitation on number of caregivers (mentioned by ) --Hand hygiene, or protective double handwashing & high touch surface (mentioned by ) --Put surgical mask on patient (mentioned by ) --Airborne isolation if possible --Combination of surgical mask & N-9 as used during SARS epidemic in 00-0 to extend life of N-9 --Portable HEPA, increase room ACH, open windows --Screening visitors --Pandemic prevention strategies in place at hospital system level --Maintain stockpile Page