Since the start of the Covid-19 outbreak, frontline healthcare providers (HCPs) have consistently been forced to deal with dwindling, limited, or non-existent PPE, especially N95-filtering facepiece respirators. Indeed, 66% of HCPs report that N95 respirators are still in short supply, according to a Washington Post-Ipsos poll.

But behind the scenes, another narrative is taking place: counterfeit respirators are flooding the market, increasing the risk of SARS-CoV-2 acquisition and transmission. The saga reads as if it were taken from the pages of a crime thriller. It began in March with the discovery of a shipment of fake N95 respirators at Los Angeles International Airport. Subsequently, the National Institute for Occupational Safety and Health (NIOSH) voiced its concerns, issuing an alert on imported N95-style respirators that are falsely marketed and sold as NIOSH-approved. Shortly after, the Food and Drug Administration issued a letter highlighting numerous products failing to meet NIOSH’s 95 percent minimum particulate filtration efficiency.

At last count, more than 65 companies have been caught up in the enforcement sweep, and the numbers are increasing, according to The Washington Post. Filtering facepiece respirators and other fraudulent Covid-19 products have also caught the eye of the US Immigration and Customs Enforcement’s (ICE) Homeland Security Investigations (HSI) unit, prompting the launch of Operation Stolen Promise. ‍

How to Tell if Your N95 Respirator is Real

Several news outlets report that counterfeit N95 respirators had been circulated to numerous hospitals and clinics across the country as of early March. Even more troubling is that some remain in use by unsuspecting providers. That is why it is essential to distinguish the real from the fake.

According to the latest guidance from The National Personal Protective Technology Laboratory (NPPTL):

• The biggest ‘tell’ is the use of ear loops vs. headbands. NIOSH-approved respirators have headbands, which provide a tighter fit and greater protection against Covid-19 air particles.  

• All NIOSH-approved respirators carry an approval label on the packaging and/or within user instructions. If you can’t access the original box, check for an abbreviated approval sign on the respirator itself. Administrators can also check the label’s integrity on the NIOSH Certified Equipment List or the NIOSH Trusted-Source page. 

• Counterfeit respirators commonly have no facepiece markings (including NIOSH) and/or approval (i.e., TC) numbers on either the facepiece or headband.

• “NIOSH” is often misspelled on counterfeit equipment.

• NIOSH-approved products do not contain decorative fabrics or add-ons, such as sequins.

• NIOSH products are never approved for use by children.

Healthcare professionals and administrators are strongly encouraged to check equipment using visuals contained in the NPPTL guidance and other examples and tips.

As long as the Covid-19 outbreak continues, it is safe to assume that counterfeits will continue to flood the marketplace. The bottom line? Err on the side of caution and practice due diligence.