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What exactly is considered PPE?
According to the Food and Drug Administration (FDA), PPE works as a barrier between an individual’s skin, mouth, nose, or eyes and viral and bacterial infections. In order to be used in a medical setting, most PPE—medical gloves, gowns, and N95 respirators—is regulated by the government agency and must meet their regulations.
“When used properly and with other infection control practices such as hand-washing, using alcohol-based hand sanitizers, and covering coughs and sneezes, [PPE] minimizes the spread of infection from one person to another,” the FDA explains on its website.
PPE also varies situationally, per the World Health Organization (WHO). For example, the sufficient gear needed to treat patients with the flu varies from that which is crucial when dealing with those infected with Ebola. In the context of COVID-19—which is spread primarily between people through close contact and droplets, not by airborne transmission—PPE includes the following, but can vary between medical professionals, hospital cleaners, and patient visitors:
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Gloves
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Medical masks
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Respirators (N95 or FFP2 standard, or equivalent)
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Eye protection
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Gowns
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Aprons
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Boots or closed-toe work shoes
Certain procedures also necessitate a greater need for PPE, says Dr. Pischel, pointing to intubation (the process of inserting a tube through a patient's mouth and into their airway) and nebulizer treatments (a machine that delivers medicated mist to the lungs). "These procedures create a large amount of virus in the air so anyone around would need to wear PPE." But really, Dr. Pischel points out that “anyone who is entering into a patient’s room with known COVID-19,” is in need of the recommended protective gear.
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Can PPE be reused or shared?
The issue with most PPE items stems from the first word of the acronym: personal. With few exceptions, “in general, most PPE is designed to be used only one time and by one person prior to disposal,” explains the FDA. Therefore, washing and reusing or sharing equipment with other users is not intended.
However, new medical research published by MedRxiv (a database for preprints of studies that have not yet been peer reviewed) on March 27, 2020 may be game-changing in regards to N95 masks. Yale Medicine doctors found that many N95 masks can be reprocessed, using vaporized hydrogen peroxide to sterilize them for reuse. In short, they were able to clean a room full of N95s all at once using a system used to fumigate hospital rooms after patients with the hospital infection C. Diff are discharged. The results were replicated three times.
“There is data showing that you can do this to N95 respirators without damaging their ability to act as a high efficiency filter, but there has never been any showing that this is effective for viruses on a respirator,” Patrick Kenney, MD, medical director of the supply chain for Yale Medicine and Yale New Haven Health, explains to Health. “We inoculated N95s with three different viruses that are a reasonable proxy for SARS-CoV-2 and then reprocessed them. A highly sensitive test showed no evidence of residual virus.”
While the CDC is expected to recommend that Americans begin wearing cloth masks or face coverings to prevent the spread of COVID-19, surgical masks and N95 masks are definitely not recommended for the general public, a message that Dr. Pischel echoes. This is incredibly important in regards to the shortage, because for every civilian who is hoarding one of these much-needed masks, there is a healthcare worker whose own health is being compromised.
While various companies that don't usually produce PPE are working hard to make supplies for medical professionals, and government leaders are trying to supply hospitals with shipments of PPE, it's still not enough—yet. If you're currently in possession of extra masks, or know a company that is, you can donate them to various initiatives including PPE Link and the website #FindtheMasks, among others.
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