COVID-19

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COVID-19 is a disease caused by the SARS-CoV-2 virus which is a type of coronavirus. COVID-19 is an abbreviation for "Coronavirus Disease 2019". [1]

PPE for Healthcare Workers When Caring for Patients with Confirmed or Suspected COVID-19

Healthcare workers should be supplied with the proper personal protective equipment (PPE):

  1. Eye Protection [2]
  2. Isolation Gowns [3]
  3. Facemasks [4]
  4. Respirators [5]

Donning and Doffing PPE

Donning

Use safe work practice to protect yourself and limit the spread of contamination by: 1.) keeping hands away from face, 2.) limiting surfaces touched, 3.) changing gloves when torn or heavily contaminated and 4.) performing hand hygiene.

  1. Gown
  2. Mask or respirator
  3. Goggles or face shield
  4. Gloves

Doffing - Example 1

Perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE.

  1. Gloves
  2. Goggles or face shield
  3. Gown
  4. Mask or respirator
  5. Wash Hands or use an alcohol-based hand sanitizer immediately after removing all PPE

Doffing - Example 2

Perform hand hygiene between steps if hands become contaminated and immediately after removing all PPE.

  1. Gown and gloves
  2. Goggles or face shield
  3. Mask or respirator
  4. Wash Hands or use an alcohol-based hand sanitizer immediately after removing all PPE

Source: Centers for Disease Control and Prevention. [6]

Strategies to Optimize the Supply of PPE and Equipment

  1. Eye Protection
    1. Conventional Capacity (During usual practice)
      1. Use eye protection according to product labeling and local, state, and federal requirements.
    2. Contingency Capacity (Expected eye protection shortages)
      1. Selectively cancel elective and non-urgent procedures and appointments for which eye protection is typically used by HCP.
      2. Shift eye protection supplies from disposable to re-usable devices (i.e., goggles and reusable face shields).
      3. Implement extended use of eye protection.
    3. Crisis Capacity (During known shortages)
      1. Cancel all elective and non-urgent procedures and appointments for which eye protection is typically used by HCP.
      2. Use eye protection devices beyond the manufacturer-designated shelf life during patient care activities.
      3. Prioritize eye protection for selected activities such as during care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures, or during activities where prolonged face-to-face or close contact with a potentially infectious patient is unavoidable.
      4. Consider using safety glasses (e.g., trauma glasses) that have extensions to cover the side of the eyes.
      5. Exclude HCP at higher risk for severe illness from COVID-19 from contact with known or suspected COVID-19 patients.
      6. Designate convalescent HCP for provision of care to known or suspected COVID-19 patients.
  2. Isolation Gowns
    1. Conventional Capacity (During usual practice)
      1. Use isolation gown alternatives that offer equivalent or higher protection.
    2. Contingency Capacity (During expected shortages)
      1. Selectively cancel elective and non-urgent procedures and appointments for which a gown is typically used by HCP.
      2. Shift gown use towards cloth isolation gowns.
      3. Consider the use of coveralls.
      4. Use of expired gowns beyond the manufacturer-designated shelf life for training.
      5. Use gowns or coveralls conforming to international standards.
    3. Crisis Capacity (During known shortages)
      1. Cancel all elective and non-urgent procedures and appointments for which a gown is typically used by HCP.
      2. Extended use of isolation gowns.
      3. Re-use of cloth isolation gowns.
      4. Prioritize gowns.
        1. During care activities where splashes and sprays are anticipated, which typically includes aerosol generating procedures
        2. During the following high-contact patient care activities that provide opportunities for transfer of pathogens to the hands and clothing of healthcare providers, such as: ◦Dressing, bathing/showering, transferring, providing hygiene, changing linens, changing briefs or assisting with toileting, device care or use, wound care
  3. Facemasks
    1. Conventional Capacity (During usual practice)
      1. Use facemasks according to product labeling and local, state, and federal requirements.
    2. Contingency Capacity (During expected shortages)
      1. Selectively cancel elective and non-urgent procedures and appointments for which a facemask is typically used by HCP.
      2. Remove facemasks for visitors in public areas.
      3. Implement extended use of facemasks.
      4. Restrict facemasks to use by HCP, rather than patients for source control.
    3. Crisis Capacity (During known shortages)
      1. Cancel all elective and non-urgent procedures and appointments for which a facemask is typically used by HCP.
      2. Use facemasks beyond the manufacturer-designated shelf life during patient care activities.
      3. Implement limited re-use of facemasks.
      4. Prioritize facemasks for selected activities such as:
        1. For provision of essential surgeries and procedures
        2. During care activities where splashes and sprays are anticipated
        3. During activities where prolonged face-to-face or close contact with a potentially infectious patient is unavoidable
        4. For performing aerosol generating procedures, if respirators are no longer available
  4. N95 Respirators
    1. Conventional Capacity (During usual practice)
      1. N95 respirators
      2. Use of alternatives to N95 respirators
    2. Contingency Capacity (During expected shortages)
      1. Use of N95 respirators beyond the manufacturer-designated shelf life for training and fit testing
      2. Extended use of N95 respirators
    3. Crisis Capacity (During known shortages)
      1. Use of respirators beyond the manufacturer-designated shelf life for healthcare delivery
      2. Use of respirators approved under standards used in other countries that are similar to NIOSH-approved respirators
      3. Limited re-use of N95 respirators
      4. Use of additional respirators beyond the manufacturer-designated shelf life for healthcare delivery that have not been evaluated by NIOSH
      5. Prioritize the use of N95 respirators and facemasks by activity type

Calculator: PPE Burn Rate Excel Spreadsheet [7]

Source: “COVID-19: Strategies for Optimizing the Supply of PPE.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, www.cdc.gov/coronavirus/2019-ncov/hcp/ppe-strategy/index.html.[8]

Guidelines for Everyone

According to the Centers for Disease Control (CDC)[9], everyone should:

  1. Clean your hands often
  2. Avoid close contact
  3. Stay home if you’re sick
  4. Cover coughs and sneezes
  5. Wear a facemask if you are sick
  6. Clean and disinfect

PPE for Members of the Public Not Under Investigation for COVID-19

Widespread mask-wearing might be an effective complement to hand-washing, social-distancing and other measures to mitigate the pandemic.[10][11][12]