Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic

Abstract

The coronavirus disease (COVID-19) pandemic has posed a challenge for healthcare systems, and healthcare workers (HCWs) are at high risk of exposure. Protecting HCWs is of paramount importance to maintain continuous patient care and keep healthcare systems functioning. Used alongside administrative and engineering control measures, personal protective equipment (PPE) is the last line of defense and the core component of protection. Current data suggest that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is mainly transmitted through respiratory droplets and close contact. Airborne transmission may occur during aerosol-generating procedures. However, the modes of transmission still remain uncertain, especially regarding the possibility of airborne transmission when aerosolgenerating procedures are not performed. Thus, there are some inconsistencies in the respiratory protective equipment recommended by international and national organizations. In Korea, there have been several modifications to PPE recommendations offering options in choosing PPE for respiratory and body protection, which confuses HCWs; they are often unsure what to wear and when to wear it. The choice of PPE is based on the risk of exposure and possible modes of transmission. The level of protection provided by PPE differs based on standards and test methods. Thus, understanding them is the key in selecting the proper PPE. This article reviews evidence on the mode of SARS-CoV-2 transmission, compares the current PPE recommendations of the World Health Organization with those in Korea, and discusses standard requirements and the proper selection of PPE.

SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles

“…In the absence of clinical trials on SARS-CoV-2, trials on other viruses with similar infection patterns (i.e., documented droplet and suspected airborne transmission) are the best available alternatives. Recent systematic and narrative reviews comparing the effectiveness of respirators versus masks against common viral respiratory infections (including coronaviruses and influenza viruses such as H1N1) come to similar conclusions: both devices offer comparable protection in health care settings (23)(24)(25)(26)(27)(28)(29)(30)(31).…”

“…1B). For the current pandemic and future ones, our priority should therefore be elimination strategies (e.g., decreasing bed occupancy rates, source control), engineering controls (e.g., segregated red zones and proper ventilation), and administrative controls (e.g., dedicated staff, adequate training, and strict enforcement of IPC regulations), ending with PPE (29). Unfortunately, we have seen, around the globe, many health care systems fail to meet the structural, human, and material challenges brought on by COVID-19, and some HCWs have paid the price for our collective unpreparedness.…”

Recomendações quanto ao uso de máscaras/ respiradores de proteção por profissionais de saúde em risco de exposição ao sars-cov-2: scoping review

“…Uma vantagem apresentada por esses tipos de EPIé sua reutilização, principalmente em momentos de escassez de respiradores descartáveis, como vivenciados nesta pandemia. Entretanto, seu uso, assim como para outros respiradores, precede de treinamento e programas de manutenção robustos para garantir bom uso, e consequentemente, sua eficácia (Park, 2020).…”

Beurteilung des Infektionsrisikos durch SARS-CoV-2 für medizinisches Personal – Erkenntnisse aus der Praxis

“…RKI und die Arbeitsausschüsse beim BMAS empfehlen für medizinisches Personal beim direkten Kontakt mit an COVID-19 Erkrankten das Tragen von filtrierenden Halbmasken (FFP2 oder vergleichbar; [ 13 , 23 ]). Die WHO empfiehlt das Tragen von filtrierenden Masken, wenn Aerosole generiert werden (Übersicht bei [ 24 ]). Ebenso ist in der Literatur zu finden: „In conclusion, PPE, when available and properly used, confers protection and lowers infection rates of COVID-19 among health care workers when compared with reported infection rates in the general public“ [ 19 ].…”