Summary
The degree of protection required in looking after people with COVID-19
infection, is dependent on the particular environment to which the HCW
is exposed. Covering more of the body could provide better protection
for HCWs. However, the degree of protection required is dependent on the
particular environment. Of importance, it is not just the provision of
PPE but the skills in donning and doffing of PPE that are important,
this being a key time for potential transmission of pathogen to the HCW
and in due time from them to others.
As the first wave of the COVID-19 pandemic abates gradually, surely now
is the time for an urgent review of what PPE should be used to decrease
COVID-19 transmission, based on the evidence to date from health systems
that have dealt with the first wave of the pandemic.
1. The Lancet. COVID-19: protecting health-care workers. The
Lancet 2020;395(10228):922. doi:
https://doi.org/10.1016/S0140-6736(20)30644-9
2. O’Sullivan ED. PPE guidance for covid-19: be honest about resource
shortages. BMJ 2020;369:m1507. doi: 10.1136/bmj.m1507
3. Verbeek JH, Rajamaki B, Ijaz S, et al. Personal protective equipment
for preventing highly infectious diseases due to exposure to
contaminated body fluids in healthcare staff. Cochrane Database of
Systematic Reviews 2020(4) doi: 10.1002/14651858.CD011621.pub4
4. Osei-Bonsu K, Masroor N, Cooper K, et al. Alternative doffing
strategies of personal protective equipment to prevent
self-contamination in the health care setting. American journal of
infection control 2019;47(5):534-39. doi: 10.1016/j.ajic.2018.11.003
[published Online First: 2018/12/24]
5. Poller B, Hall S, Bailey C, et al. ‘VIOLET’: a fluorescence-based
simulation exercise for training healthcare workers in the use of
personal protective equipment. Journal of Hospital Infection2018;99(2):229-35. doi: https://doi.org/10.1016/j.jhin.2018.01.021
6. Ma H, Wang H, Fang L, et al. A case-control study on the risk factors
of severe acute respiratory syndromes among health care workers.Chinese Journal of Epidemiology 2004;25(9) [published Online
First: 20041130]
7. Ying W, Gao L, Lin w, et al. Effectiveness of personal protective
measures in prevention of nosocomfal transmission of severe acute
respiratory syndrome. Chinese Journal of Epidemiology 2004;25(1)
[published Online First: 20040430]
8. Zou Y, chen S, Gao Y, et al. Protective Measures to Medical Personnel
and Their Effectiveness in SARS Prevention During the SARS Outbreak in
Guangdong Province. Chinese Journal of Nosocomiology 2004;14(4)
[published Online First: 20040730]
9. Regulation WH. Strengthening health security by implementing the
International Health Regulations (2005).
10. Seto WH, Tsang D, Yung RW, et al. Effectiveness of precautions
against droplets and contact in prevention of nosocomial transmission of
severe acute respiratory syndrome (SARS). Lancet2003;361(9368):1519-20. doi: 10.1016/s0140-6736(03)13168-6 [published
Online First: 2003/05/10]
11. Wang B, Lu H, Shen Y, et al. Development of personal protection
techniques in China from SARS to Ebola virus disease epidemics.Chinese Journal of Clinical Infectious Diseases 2015;8(3)
[published Online First: 20160204]
12. Derrick JL, Gomersall CD. Protecting healthcare staff from severe
acute respiratory syndrome: filtration capacity of multiple surgical
masks. Journal of Hospital Infection 2005;59(4):365-68. doi:
https://doi.org/10.1016/j.jhin.2004.10.013
13. Wen Z, Yu L, Yang W, et al. Assessment the protection performance of
different level personal respiratory protection masks against viral
aerosol. Aerobiologia (Bologna) 2013;29(3):365-72. doi:
10.1007/s10453-012-9286-7 [published Online First: 2012/12/23]
14. Teleman MD, Boudville IC, Heng BH, et al. Factors associated with
transmission of severe acute respiratory syndrome among health-care
workers in Singapore. Epidemiol Infect 2004;132(5):797-803. doi:
10.1017/s0950268804002766
15. Casanova LM, Rutala WA, Weber DJ, et al. Effect of single- versus
double-gloving on virus transfer to health care workers’ skin and
clothing during removal of personal protective equipment. American
journal of infection control 2012;40(4):369-74. doi:
10.1016/j.ajic.2011.04.324 [published Online First: 2011/08/13]
16. Chen W-Q, Ling W-H, Lu C-Y, et al. Which preventive measures might
protect health care workers from SARS? BMC Public Health2009;9:81-81. doi: 10.1186/1471-2458-9-81
17. Jefferson T, Del Mar CB, Dooley L, et al. Physical interventions to
interrupt or reduce the spread of respiratory viruses. Cochrane
Database of Systematic Reviews 2011(7) doi:
10.1002/14651858.CD006207.pub4