Addressing Personal Protective Equipment (PPE) Decontamination: Methylene Blue and Light Inactivates SARS-CoV-2 on N95 Respirators and Medical Masks with Maintenance of Integrity and Fit.
Lendvay TS., Chen J., Harcourt BH., Scholte FE., Lin YL., Kilinc-Balci FS., Lamb MM., Homdayjanakul K., Cui Y., Price A., Heyne B., Sahni J., Kabra KB., Lin Y-C., Evans D., Mores CN., Page K., Chu LF., Haubruge E., Thiry E., Ludwig-Begall LF., Wielick C., Clark T., Wagner T., Timm E., Gallagher T., Faris P., Macia N., Mackie CJ., Simmons SM., Reader S., Malott R., Hope K., Davies JM., Tritsch SR., Dams L., Nauwynck H., Willaert J-F., De Jaeger S., Liao L., Zhao M., Laperre J., Jolois O., Smit SJ., Patel AN., Mayo M., Parker R., Molloy-Simard V., Lemyre J-L., Chu S., Conly JM., Chu MC.
OBJECTIVE: The coronavirus disease 2019 (COVID-19) pandemic has resulted in shortages of personal protective equipment (PPE) underscoring the urgent need for simple, efficient, and inexpensive methods to decontaminate SARS-CoV-2-exposed masks and respirators. We hypothesized that methylene blue (MB) photochemical treatment, which has various clinical applications, could decontaminate PPE contaminated with coronavirus. DESIGN: The two arms of the study included: 1) PPE inoculation with coronaviruses followed by MB with light (MBL) decontamination treatment, and 2) PPE treatment with MBL for 5 cycles of decontamination (5CD) to determine maintenance of PPE performance. METHODS: MBL treatment was used to inactivate coronaviruses on three N95 filtering facepiece respirator (FFR) and two medical mask (MM) models. We inoculated FFR and MM materials with three coronaviruses, including SARS-CoV-2, and treated with 10 µM MB and exposed to 50,000 lux of white light or 12,500 lux of red light for 30 minutes. In parallel, integrity was assessed after 5CD using multiple US and international test methods and compared to the FDA-authorized vaporized hydrogen peroxide plus ozone (VHP+O3) decontamination method. RESULTS: Overall, MBL robustly and consistently inactivated all three coronaviruses with 99.8 - to >99.9% virus inactivation across all FFRs and MMs tested. FFR and MM integrity was maintained after 5 cycles of MBL treatment, whereas one FFR model failed after 5 cycles of VHP+O3. CONCLUSIONS: MBL treatment decontaminated respirators and masks by inactivating three tested coronaviruses without compromising integrity through 5CD. MBL decontamination is effective, low-cost and does not require specialized equipment, making it applicable in all-resource settings.