COVID-19 pandemic and personal protective equipment shortage: protective efficacy comparing masks and scientific methods for respirator reuse

Abstract

Background and Aims: The abrupt outbreak of the novel coronavirus disease 2019 and its rapid spread over many healthcare systems throughout the world has led to a shortage in personal protective equipment (PPE), which cannot be solved by reducing their use or by increasing production. It is thus necessary to promote PPE rational use, highlighting possible differences in terms of efficacy and promoting an effective technique to reuse them.Methods: A literature search was performed on PubMed, Scopus, Cochrane database, and Google Scholar, and from the 25 top cited articles, 15 were selected for relevance and impact.Results: Most studies on previous respiratory virus epidemics to date suggest surgical masks are not inferior compared with N95 respirators in terms of protective efficacy among healthcare workers. Therefore, the use of N95 respirators should be limited to high-risk situations. Concerning respirator reuse, highly energetic, shortwave, ultraviolet germicidal irradiation (UVGI) at 254 nm was determined to decontaminate N95 respirators from viral respiratory agents, but UVGI requires careful consideration of the type of respirator and of the biologic target.Conclusions: Rational use and successful reuse of respirators can help in the shortage of PPE during a pandemic. Further studies testing UVGI and other decontamination techniques are an unmet need. The definitive answer to pandemic issues can be found in artificial intelligence and deep learning. These groundbreaking modalities could help in identifying high-risk patients and in suggesting appropriate types and use of PPE. (Gastrointest Endosc 2020;92:519-23.)

Biosafety Measures at the Dental Office After the Appearance of COVID-19: A Systematic Review

“…On the other hand, an alternative to disinfection is the use of ultraviolet light, the use of which, however, is limited due to its high cost. 9,15,[30][31][32] Surfaces and objects used after care must be constantly disinfected to reduce the risk of cross-contamination. A large number of studies have shown that sodium hypochlorite at 0.1%-0.5%, 62-71% ethanol, and 2% glutaraldehyde are able to disinfect surfaces by decreasing virus load.…”

“…[24][25][26]33 Direct contact with disinfectants, such as alcohol and hypochlorite, may cause skin reactions, such as peeling, cracking, stinging, bleeding, and dermatitis; therefore, the use of protection is recommended for surface disinfection. 31 In addition, it is important to follow adequate waste management after dental consultation, categorizing the different types of waste into the corresponding packaging, providing better management by the staff responsible for waste disposal. 18,23,27,28 Moreover, because the appearance of COVID-19 is a recent phenomenon, more research is necessary to clarify the doubts remaining in relation to biosafety for dental offices and procedures and to establish definitive protocols.…”

Recommendations for the Operation of Endoscopy Centers in the setting of the COVID‐19 pandemic – World Endoscopy Organization guidance document

“…Data regarding efficacy as compared to N95 respirator are conflicting. 16,36,37 Combining with a face shield and eye protection maximizes protection. There are other respirator masks available but not all of them are equally efficacious, and many including the N95 require fit testing to ensure an adequate seal.…”

“…If viral testing is readily available, it is recommended that all patients undergo rapid nucleic acid based Real Time Reverse Transcriptase Polymerase Chain Reaction (RT-PCR)/antigen testing. 16 Ideally, these tests should be performed within 72 h of the procedure. 17 18 .…”

Innovative application of ultraviolet rays and hydrogen peroxide vapor for decontamination of respirators during COVID-19 pandemic- An experience from a tertiary eye care hospital

“…Moreover, this has also resulted in acute shortage of PPE. [ 1 ] The need of the hour is to minimize this shortage by decontaminating these respirators, so that they can be optimally reused. We already have evidence for Ultraviolet light and Hydrogen Peroxide (H 2 O 2 ) as a good source for decontamination of PPE.…”