The COVID-19 pandemic, personal protective equipment and respirator: A narrative review

Int J Clin Pract. 2020 Jun 8;e13578. doi: 10.1111/ijcp.13578. Online ahead of print.

Abstract

Introduction: The coronavirus disease 2019 pandemic has touched almost every continent. Personal protective equipment (PPE) is the final line of protection of healthcare workers (HCW). There is variation as well as controversy of infection control recommendation with regards to the use of PPE for HCW between institutions. The aim of this narrative review is to of examine and summarise the available evidence to guide recommendation for the safety of HCW.

Method: A literature search was conducted on the PubMed, MedLine and Embase databases with the keywords "personal protective equipment," "COVID 19," "n95," "health care worker" and "mortality."

Results: SARS-nCoV-2 is highly contagious. About 3.5%-20% of HCW has been reported to be infected. The mortality ranges from 0.53% to 1.94%. PPE is part of the measure within a package of prevention and control of pandemic, rather than a replacement of. Respirators are more effective than masks in preventing aerosol transmission to HCWs. Extended use may be considered if guidelines are adhered. Powered air-purifying respirators if available should be used in high-risk procedures.

Conclusion: Transmission of viruses is multimodal and in the setting of a novel pathogen with high case fatality with no proven effective interventions, PPE that affords the best protection should be available to HCWs.