Types of PPE
The ‘level’ of PPE is matched to the clinical environment and the procedures being undertaken. Generally the levels are categorised as standard, or those that are designed to mitigate against contact, droplet or airborne pathogensa and enhanced PPE (full-body) for highly infectious or ‘high-consequence’ pathogens. A Cochrane review evaluated the effect of full-body PPE used by HCWs exposed to highly infectious diseases, defined as causing such as Ebola Virus Disease, COVID-19 and severe acute respiratory syndrome (SARS).3 The review highlighted eight studies comparing types of whole-body PPE. Key to efficacy was a better fitting gown around the neck, wrists and hands (relative risk, RR 0.08, 95% confidence interval, CI 0.01-0.55), a better cover of the gown‐wrist interface (RR 0.45, 95% CI 0.26-0.78). Covering more parts of the body could provide a better protection. For example, a powered, air-purifying respirator with coverall may protect better than an N95 mask with a gown (RR 0.27, 95% CI 0.17- 0.43). However, these conclusions were based on simulation studies with small sample sizes.3