OBJECTIVES: To assess the risk of coronavirus transmission to healthcare workers performing aerosol-generating procedures and the potential benefits of personal protective equipment during these procedures. DATA SOURCES: MEDLINE, EMBASE, and Cochrane CENTRAL were searched using a combination of related MeSH terms and keywords. STUDY SELECTION: Cohort studies and case controls investigating common anesthetic and critical care aerosol-generating procedures and transmission of severe acute respiratory syndrome coronavirus 1, Middle East respiratory syndrome coronavirus, and severe acute respiratory syndrome coronavirus 2 to healthcare workers were included for quantitative analysis. DATA EXTRACTION: Qualitative and quantitative data on the transmission of severe acute respiratory syndrome coronavirus 1, severe acute respiratory syndrome coronavirus 2, and Middle East respiratory syndrome coronavirus to healthcare workers via aerosol-generating procedures in anesthesia and critical care were collected independently. The Risk Of Bias In Non-randomized Studies - of Interventions tool was used to assess the risk of bias of included studies. DATA SYNTHESIS: Seventeen studies out of 2,676 yielded records were included for meta-analyses. Endotracheal intubation (odds ratio, 6.69, 95% CI, 3.81–11.72; p < 0.001), noninvasive ventilation (odds ratio, 3.65; 95% CI, 1.86–7.19; p < 0.001), and administration of nebulized medications (odds ratio, 10.03; 95% CI, 1.98–50.69; p = 0.005) were found to increase the odds of healthcare workers contracting severe acute respiratory syndrome coronavirus 1 or severe acute respiratory syndrome coronavirus 2. The use of N95 masks (odds ratio, 0.11; 95% CI, 0.03–0.39; p < 0.001), gowns (odds ratio, 0.59; 95% CI, 0.48–0.73; p < 0.001), and gloves (odds ratio, 0.39; 95% CI, 0.29–0.53; p < 0.001) were found to be significantly protective of healthcare workers from contracting severe acute respiratory syndrome coronavirus 1 or severe acute respiratory syndrome coronavirus 2. CONCLUSIONS: Specific aerosol-generating procedures are high risk for the transmission of severe acute respiratory syndrome coronavirus 1 and severe acute respiratory syndrome coronavirus 2 from patients to healthcare workers. Personal protective equipment reduce the odds of contracting severe acute respiratory syndrome coronavirus 1 and severe acute respiratory syndrome coronavirus 2.

BACKGROUND The 2019 coronavirus pandemic (COVID-19) has led to increase in global awareness of related public health preventive measures. The public awareness can be reflected by online searching trends of major search engines, namely Google Trends. OBJECTIVE This study aims to interpret online searches of COVID-19 related public health preventive measures and to identify possible correlations between early search trends and progression of the pandemic. METHODS Search data from five queries “Mask”, “Hand Washing”, “Social Distancing”, “Hand Sanitizer”, and “Disinfectant” were extracted from Google Trends (GT) in the form of Relative Search Volumes (RSV). Global incidence data of COVID-19 was obtained from January 1st to June 30th 2020. Subsequently, the data were analyzed and illustrated in forms of a global temporal RSV trend diagram, a geographical RSV distribution chart, scatter graphs comparing regional RSV with average daily cases; and heat-maps comparing temporal trend of RSV with average daily cases. RESULTS Global temporal trend revealed multiple surges in RSV, which were temporally associated with certain COVID news events. Geographical distribution showed differences of query interests among regions. Although scatter graphs failed to illustrate strong correlations between regional RSV and average daily cases, the heat-maps were able to demonstrate patterns of early RSV peaks in countries with lower average daily cases, for queries “Mask”, “Hand Sanitizer”, and “Disinfectant”, upon incorporating with the temporal element into analysis. CONCLUSIONS Early public awareness of multiple preventive measures was observed in countries with lower daily average cases. Public health authorities may look into early public awareness as an effective measure for future disease control.