National Center for Occupational Health and Infection Control, Office of Public Health and Environmental Hazards, Veterans Health Administration, 1601 SW Archer Rd (151B), Gainesville, FL 32608, USA.
Disaster Med Public Health Prep. 2009 Dec;3 Suppl 2:S203-10. doi: 10.1097/DMP.0b013e3181be830c.
The respiratory protective equipment necessary to protect health care workers from the novel swine-origin influenza A (H1N1) virus is not known. The knowledge gap created by this unanswered question has caused substantial debate and controversy on a global scale, leading public health organizations to feel pressured into issuing decisive recommendations despite a lack of supportive data. Changes in clinical practice caused by public health guidance during such high-profile events can be expected to establish a new standard of care. Also possible is an unforeseen gradual transition to widespread N95 respirator use, driven by public health pressures instead of science, for all outbreaks of influenza or influenza-like illness. Therefore, public health organizations and other influential institutions should take care to avoid making changes to established practice standards, if possible, unless these changes are bolstered by sound scientific evidence. Until definitive comparative effectiveness clinical trials are conducted, the answer to this question will continue to remain elusive. In the meantime, relying on ethical principles that have been substantiated over time may help guide public health and clinical decisions.
目前尚不清楚用于保护医护人员免受新型猪源甲型 H1N1 流感病毒侵害的呼吸防护设备。这一悬而未决的问题造成了全球范围内大量的争论和争议，导致公共卫生组织在缺乏支持性数据的情况下，感到有压力必须做出果断的建议。在这种备受瞩目的事件中，公共卫生指导下的临床实践变化预计将确立新的护理标准。也有可能会出现不可预见的、逐渐向广泛使用 N95 呼吸器过渡的情况，这是由公共卫生压力而非科学驱动的，适用于所有流感或流感样疾病的爆发。因此，如果可能的话，公共卫生组织和其他有影响力的机构应注意避免对既定的实践标准进行更改，除非这些更改有合理的科学证据支持。在进行明确的比较有效性临床试验之前，这个问题的答案将继续难以捉摸。在此期间，依靠经过时间验证的伦理原则可能有助于指导公共卫生和临床决策。
