As the coronavirus outbreak continues to evolve in the U.S., one thing has still not changed: A lack of personal protective equipment (PPE). Although state and local governments are attempting to respond to increased demands, reports detailing scarce supplies of face masks, respirators, gowns, aprons, gloves, eye protection and ventilators continue to spread across social platforms and media outlets. Most recently, the group #GetUsPPE distributed a survey to over 600 institutions to provide a snapshot of national need– and the results are dismal. Supplies are either quickly dwindling or depleted entirely.
Protection and Infection
This week, the Cochrane Collaboration released a systematic review to better define which protective gear is most effective against infection and offer advice for donning and doffing PPE. The researchers found:
- Respirators with coveralls may offer better protection than masks and gloves, but are more difficult to put on.
- Breathable PPE is more comfortable, but leads to contamination.
- Modifications to PPE design, such as tabs to grab, may decrease the risk of contamination.
- HCPs should follow CDC doffing guidance, using a one-step gown and glove removal, layered gloves and spoken instructions during doffing.
- Face‐to‐face training in PPE use may also reduce errors more than folder‐based training.
The authors ultimately concluded that better PPE designs, rigorous follow-up and data collection are sorely needed. Strategically, these results are useful for future outbreaks, but for now, healthcare providers need less advice and more immediate answers.
The Future of PPE is Now
Some designers, researchers and companies are stepping up to address gaps in protection for healthcare professionals and devise innovative solutions.
- An Israeli research team has designed a constant flow plastic canopy system that supports delivery of non-invasive ventilatory support for up to four patients simultaneously, while reducing risks of exposure for providers. Although limited by a physical barrier between patient and staff, the authors explain that the design offers an alternative for patients with mild-to-moderate disease, who would otherwise go untreated.
- At Duke University, researchers announced a novel method for decontaminating N95 masks, enabling them to be reused up to 30 times. The protocol, which relies on hydrogen peroxide vapor, is publicly available for institutional modifications. The FDA issued an emergency use authorization for this method on April 12, 2020.
- The San Antonio-based company Xenex is scaling up manufacturing of its LightStrike disinfection robots to free up resources for patient care. Launched almost a decade ago, the robots use a pulsed xenon lamp to shoot intense UV light that targets and hampers the spread of germs. Company Co-founder and Chief Scientific Officer Mark Stibich reports that LightStrike has been tested against MERS and canine parvoviruses, hence meeting current U.S. Environmental Protection Agency Disinfectant Standards for SARS-CoV-2.
- Finally, LabCorp, a healthcare diagnostics company, received FDA emergency use authorization for its Pixel by LabCorp™ COVID-19 home test kit. Access is currently limited to healthcare workers with potential exposure or symptoms. Eventually, kits may be available to consumers with the intention of reducing PPE demands.
- Personal protective equipment for preventing highly infectious diseases due to exposure to contaminated body fluids in healthcare staff, Cochrane Library.
- Covid19: Minimising risk to healthcare workers during aerosol producing respiratory therapy using an innovative constant flow canopy, European Respiratory Journal.
- Duke Health researchers find way to decontaminate N95 face masks for reuse, The Chronicle.