Personal Protective Equipment (PPE) for COVID-19
Why Personal Protective Equipment (PPE) is Important during COVID-19 Pandemic
Although social (physical) distancing and performing hand hygiene remain top priorities in reducing COVID-19 virus transmission, those are not always possible, and in particular for frontline health workers who require additional precautions to protect themselves while providing healthcare. It is important to remember that use of PPE is only one component of comprehensive infection prevention and control strategies. PPE should be used based on the risk of exposure based on the clinical activity, the transmission of the pathogen (contact, droplet, aerosol), and the stocks of PPE available to the health workers. The overuse of PPE will have a further impact on supply shortages.
PPE includes: medical masks, respirators, gowns, gloves, and eye protection (goggles or face shields)
Types of Personal Protective Equipment (PPE)
Medical Masks (Surgical Masks) are loose-fitting disposable masks that protect the mouth and nose from contact with droplets or splashes or sprays that may contain germs. These protect others by reducing exposure to saliva and respiratory secretions of person wearing the mask, and filter out large particles
Respirator Masks. Respirator masks offer more protection than a surgical mask because they filter out both large and small particles. Also called “respirator” masks They keep out at least 95% of airborne pathogens (FFP2- 94%) and mold to the wearer’s face, which makes them effective particularly for healthcare workers in direct care or exposure to COVID-19 patients. Some have valves for added protection. These types of masks are important especially for aerosol-generating clinical procedures. KN95, N95, and FFP2 (94%) are essentially the same mask, but are named differently based on where they are manufactured, the KN95 is the Chinese model, N95 is the American model, and FFP2 is European model.
Disposable Isolation Gowns
Non-sterile disposable isolations suits protect against liquids and other particulates from entering the body by covering the ears, hair, and full body. It has an elastic hood brim, zipper closure and is dust and splash proof and anti-static. This should be reserved for healthcare workers directly involved in the care of confirmed or suspected COVID-19 patients.
Protective clothing can reduce spread of droplets or other body fluids to the health care workers’ skin and clothing and thereby reduce the risk of secondary spread to hands and mucous membranes. Long-sleeve gowns, rather than aprons, are recommended for both aerosol-generating procedures and non-aerosol generating procedures except for initial triage. For contact and droplet precautions, the recommendation is “a clean, non-sterile, long-sleeved gown” (as well as gloves and eye/face protection). Although disposable aprons can provide an additional layer of protection if they are fluid-resistant, alone they are insufficient to protect health care workers’ risk of exposure during COVID-19 patient care.
The two types of eye-protection recommended by WHO are single use face-shields and wrap-around protective goggles with a soft frame and indirect vent (to prevent fogging)
Gloves should be examination, nitrile, powder-free, large, medium, small, non-sterile, and single use. When providing direct care for a COVID 19 case, gloves must be removed, followed by hand hygiene between COVID-19 patients. Using the same gloves for multiple COVID-19 cases is not acceptable. Double gloving is not recommended, except for surgical procedures that carry a high risk of rupture.
Key Considerations when Selecting PPE
Each facility is likely to have their own guidance about the utilization and conservation of PPE; this Buyers Guide provides basic information about different types.
- Who is using the PPE? PPE, including medical masks, respirators, gloves, gowns, and eye protection, must be prioritized for health care workers and others caring for COVID-19 patients.
- What is the clinical use of PPE? When performing aerosol-generating procedures and treatments such as tracheal intubation, non-invasive ventilation, tracheotomy, cardiopulmonary resuscitation, and manual ventilation before intubation, and bronchoscopy, healthcare workers should use respirators, eye protection, gloves and gowns, (or aprons if gowns are not fluid-resistant)
- Conservation Strategies for PPE. Guidelines for conservation of PPE may vary and may change frequently depending on global and local supply chains.
VIA Global Health is committed to supporting health systems access affordable and appropriate medical products to improve the health in their communities. Products included in our Buyers Guides are available for purchase at VIA Global Health.
References and Acknowledgments
(1) World Health Organization: Clinical management of severe acute respiratory infection (SARI) when COVID-19 disease is suspected: Interim guidance, March 2020. Accessed here)
(2) Dondorp, A., Hayat M. et al. Review Article. Respiratory Support in Novel Coronavirus Disease (COVID-19) Patients, with a Focus on Resource-Limited Settings. Am. J. Trop. Med. Hyg., 00(0), 2020, pp. 1–7doi:10.4269/ajtmh.20-028. Accessed herecessed here