Personal protective gear – Attaining a fine balance!

Novel coronavirus (SARS-COV-2) is a new strain of coronavirus, causing COVID-19, first identified in Wuhan city, China. Other coronavirus infections include common cold (HCoV 229E, NL63, OC43, and HKU1), Middle East respiratory syndrome (MERS-CoV), and severe acute respiratory syndrome (SARS-CoV). The virus appears to have originated in Hubei province in China toward the end of 2019. Since then, it has spread across the world.
Most cases of COVID-19 globally have evidence of human-to-human transmission. This virus can be readily isolated from respiratory secretions, faces, and fomites. The latest guidelines from Chinese health authorities have described three main transmission routes for COVID-19 – droplet transmission, contact transmission, and aerosol transmission.

Droplet transmission was reported to occur when respiratory droplets (as produced when an infected person coughs or sneezes) are ingested or inhaled by individuals nearby in close proximity; contact transmission may occur when a subject touches a surface or object contaminated with the virus and subsequently touch their mouth, nose, or eyes; and aerosol transmission may occur when respiratory droplets mix into the air, forming aerosols and may cause infection when high doses of aerosols are inhaled into the lungs in a relatively closed environment. In addition to these three routes, one study also indicated the digestive system as a potential transmission route for COVID-19 infection.

Donning personal protective gear, especially by the healthcare workers, is a very important step in not only protecting themselves but also in helping stop the spread of the virus. Because of the nature of the disease, and the way it is spreading, it has induced a lot of panic amongst people. There is increased demand, sometimes going overboard, in procuring and holding personal protective gear. It is important to understand about the nature of the work, exposure risk, and the recommended personal protective gear that is required. A judicious use of the gear is one of the ways to make sure we do not run out of them.
The Ministry of Health and Family Welfare of India has published a detailed list of personal protective gear that is needed to be used in the hospitals in various settings. We all need to follow these protocols so as promote appropriate use of the gear and help conserve them for those who need it the most and help attain a fine balance.

Various methods are being tried to sterilize and reuse the gear, but we need more data to ensure it is safe to reuse without affecting their efficacy. There are guidelines published by CDC.gov on how to reprocess and reuse some of the gears without affecting their integrity; these methods can be used to help prolong the use of these gears. People are also innovating and creating their own personal protective gear, which is good and indeed the need of the hour. But as far as N95 masks are concerned for healthcare workers, who are in the frontline, we should use only good-quality mask.
The production of these gears has been ramped up several times, and now the partial lifting of the lockdown will help in easing the supply chain as well, which will bridge the gap in the demand and supply.

The coronavirus infection is here to stay for at least the next couple of months. Therefore, it is the responsibility of each one of us to use the personal protective gear appropriately and effectively. Do not forget the basics of maintaining social distancing, washing hands, and using regular masks when not actively taking care of patients in the hospital setting.