scholarly journals Cost of Personal Protective Equipment During the First Wave of COVID-19

2021 ◽  
Vol 1 (S1) ◽  
pp. s49-s49
Author(s):  
Alfredo Mena Lora ◽  
Mirza Ali ◽  
Sherrie Spencer ◽  
Eden Takhsh ◽  
Candice Krill ◽  
...  
Keyword(s):  
Supply Chains ◽  
Personal Protective Equipment ◽  
Face Mask ◽  
Protective Equipment ◽  
Market Prices ◽  
Maximum Cost ◽  
Pandemic Response ◽  
The Difference ◽  
N95 Respirators ◽  
The Impact

Background: As the world prepared for and responded to the COVID-19 pandemic in early 2020, a rapid increase in demand for personal protective equipment (PPE) led to severe shortages worldwide. Acquisition of PPE in the general market was an integral part of pandemic response, along with the safeguarding of hospital supplies. We seek to quantify the difference in cost per unit (CPU) of PPE during the first wave of COVID-19 compared to prepandemic prices. Methods: We performed a retrospective review of market prices for PPE during the first surge of the pandemic in Chicago. Cost of PPE was tabulated and compared with prepandemic prices. The maximum cost per unit (CPU) of PPE was tabulated for each week, and the average cost throughout the pandemic was calculated. Disposable gowns, washable gowns, N95 respirators, face masks, and gloves were included in our analysis. Results: PPE prices were significantly higher during the pandemic compared to prepandemic prices (Figure 1). Disposable gown CPU peaked at $12 during the first week of March, 13.7 times higher than prepandemic prices, and the average gown CPU was 7.5 times higher than prepandemic prices. N95 respirators had a peak CPU of $12, and average CPU was 8 times higher than prepandemic prices. Face-mask CPU peaked at $0.55, 11 times higher, and averaged 9 times higher the regular price. Gloves averaged 2.5 times higher than the prepandemic CPU. Conclusions: Market prices for PPE were significantly elevated during the first weeks of the pandemic and remained high throughout the first wave of COVID-19. Multiple factors likely contributed to high prices, including demand shock, disrupted supply chains, and a rush to acquisition by healthcare systems and the general population alike. The impact of COVID-19 on prices highlights the importance of supply chains and national stockpiles for pandemic preparedness.Funding: NoDisclosures: None

scholarly journals Impact of an e-learning module on personal protective equipment knowledge in student paramedics: a randomized controlled trial

2020 ◽  
Vol 9 (1) ◽  
Author(s):  
Laurent Suppan ◽  
Loric Stuby ◽  
Birgit Gartner ◽  
Robert Larribau ◽  
Anne Iten ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Controlled Trial ◽  
Ambulance Service ◽  
Protective Equipment ◽  
Post Intervention ◽  
Learning Group ◽  
Learning Module ◽  
E Learning ◽  
The Difference ◽  
The Impact

Abstract Background Prehospital professionals such as emergency physicians or paramedics must be able to choose and adequately don and doff personal protective equipment (PPE) in order to avoid COVID-19 infection. Our aim was to evaluate the impact of a gamified e-learning module on adequacy of PPE in student paramedics. Methods This was a web-based, randomized 1:1, parallel-group, triple-blind controlled trial. Student paramedics from three Swiss schools were invited to participate. They were informed they would be presented with both an e-learning module and an abridged version of the current regional prehospital COVID-19 guidelines, albeit not in which order. After a set of 22 questions designed to assess baseline knowledge, the control group was shown the guidelines before answering a set of 14 post-intervention questions. The e-learning group was shown the gamified e-learning module right after the guidelines, and before answering post-intervention questions. The primary outcome was the difference in the percentage of adequate choices of PPE before and after the intervention. Results The participation rate was of 71% (98/138). A total of 90 answer sets was analyzed. Adequate choice of PPE increased significantly both in the control (50% [33;83] vs 25% [25;50], P = .013) and in the e-learning group (67% [50;83] vs 25% [25;50], P = .001) following the intervention. Though the median of the difference was higher in the e-learning group, there was no statistically significant superiority over the control (33% [0;58] vs 17% [− 17;42], P = .087). The e-learning module was of greatest benefit in the subgroup of student paramedics who were actively working in an ambulance company (42% [8;58] vs 25% [− 17;42], P = 0.021). There was no significant effect in student paramedics who were not actively working in an ambulance service (0% [− 25;33] vs 17% [− 8;50], P = .584). Conclusions The use of a gamified e-learning module increases the rate of adequate choice of PPE only among student paramedics actively working in an ambulance service. In this subgroup, combining this teaching modality with other interventions might help spare PPE and efficiently protect against COVID-19 infection.

Impact of COVID-19 on Nuclear Medicine in Germany, Austria and Switzerland: An International Survey in April 2020

2020 ◽  
Vol 59 (04) ◽  
pp. 294-299 ◽  
Author(s):  
Lutz S. Freudenberg ◽  
Ulf Dittmer ◽  
Ken Herrmann
Keyword(s):  
Nuclear Medicine ◽  
Health Systems ◽  
Personal Protective Equipment ◽  
Large Scale ◽  
Diagnostic Procedures ◽  
Protective Equipment ◽  
Current Crisis ◽  
Web Based ◽  
Public Versus Private ◽  
The Impact

Abstract Introduction Preparations of health systems to accommodate large number of severely ill COVID-19 patients in March/April 2020 has a significant impact on nuclear medicine departments. Materials and Methods A web-based questionnaire was designed to differentiate the impact of the pandemic on inpatient and outpatient nuclear medicine operations and on public versus private health systems, respectively. Questions were addressing the following issues: impact on nuclear medicine diagnostics and therapy, use of recommendations, personal protective equipment, and organizational adaptations. The survey was available for 6 days and closed on April 20, 2020. Results 113 complete responses were recorded. Nearly all participants (97 %) report a decline of nuclear medicine diagnostic procedures. The mean reduction in the last three weeks for PET/CT, scintigraphies of bone, myocardium, lung thyroid, sentinel lymph-node are –14.4 %, –47.2 %, –47.5 %, –40.7 %, –58.4 %, and –25.2 % respectively. Furthermore, 76 % of the participants report a reduction in therapies especially for benign thyroid disease (-41.8 %) and radiosynoviorthesis (–53.8 %) while tumor therapies remained mainly stable. 48 % of the participants report a shortage of personal protective equipment. Conclusions Nuclear medicine services are notably reduced 3 weeks after the SARS-CoV-2 pandemic reached Germany, Austria and Switzerland on a large scale. We must be aware that the current crisis will also have a significant economic impact on the healthcare system. As the survey cannot adapt to daily dynamic changes in priorities, it serves as a first snapshot requiring follow-up studies and comparisons with other countries and regions.

scholarly journals COVID-19 global pandemic planning: Dry heat incubation and ambient temperature fail to consistently inactivate SARS-CoV-2 on N95 respirators

2020 ◽  
pp. 153537022097781
Author(s):  
Douglas J Perkins ◽  
Robert A Nofchissey ◽  
Chunyan Ye ◽  
Nathan Donart ◽  
Alison Kell ◽  
...  
Keyword(s):  
Ambient Temperature ◽  
Personal Protective Equipment ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Experimental Conditions ◽  
Dry Heat ◽  
Global Pandemic ◽  
Individual Site ◽  
Pandemic Planning ◽  
N95 Respirators

The ongoing pandemic of the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has placed a substantial strain on the supply of personal protective equipment, particularly the availability of N95 respirators for frontline healthcare personnel. These shortages have led to the creation of protocols to disinfect and reuse potentially contaminated personal protective equipment. A simple and inexpensive decontamination procedure that does not rely on the use of consumable supplies is dry heat incubation. Although reprocessing with this method has been shown to maintain the integrity of N95 respirators after multiple decontamination procedures, information on the ability of dry heat incubation to inactivate SARS-CoV-2 is largely unreported. Here, we show that dry heat incubation does not consistently inactivate SARS-CoV-2-contaminated N95 respirators, and that variation in experimental conditions can dramatically affect viability of the virus. Furthermore, we show that SARS-CoV-2 can survive on N95 respirators that remain at room temperature for at least five days. Collectively, our findings demonstrate that dry heat incubation procedures and ambient temperature for five days are not viable methods for inactivating SARS-CoV-2 on N95 respirators for potential reuse. We recommend that decontamination procedures being considered for the reuse of N95 respirators be validated at each individual site and that validation of the process must be thoroughly conducted using a defined protocol.

scholarly journals The COVID-19 Pandemic and nursing challenges: A review of the early literature

Work ◽  
2021 ◽  
pp. 1-14
Author(s):  
Mojtaba K. Danesh ◽  
Ehsan Garosi ◽  
Hamedeh Golmohamadpour
Keyword(s):  
Health Systems ◽  
Personal Protective Equipment ◽  
Qualitative Studies ◽  
Systematic Search ◽  
Current Paper ◽  
Protective Equipment ◽  
Early Literature ◽  
The Face ◽  
Physical Distress ◽  
The Impact

BACKGROUND: The COVID-19 pandemic has put health systems under unprecedented pressure, challenging their workforce, especially nurses. OBJECTIVE: The current paper presented a review of the early literature concerning emerging nursing challenges during the early stages of the COVID-19 pandemic. METHODS: A systematic search of the published literature between January and May 2020 was carried out in Medline, Science Direct, and Google Scholar to identify relevant quantitative and qualitative studies. RESULTS: Twenty-two original articles were retrieved, the majority of which were survey studies from China. Synthesis of the evidence resulted in four overarching themes including “being physically and mentally drained in the face of fear and uncertainty,” “shortage of personal protective equipment and usability issues,” “psychosomatic disturbances among nurses,” and “moderators to mitigate nurses’ challenges.” CONCLUSIONS: Providing care for demanding COVID-19 patients, nurses experienced a gruelling situation, during which a significant amount of psychological and physical distress was inflicted to them. However, receiving proper support from their organization and society could improve the condition substantially. Further research is required to explore the impact of the COVID-19 pandemic on nurses, especially from Western countries.

scholarly journals Retrospective Study on Personal Protective Equipment During Pandemic Link to Outbreak of Carbpenem-Resistant Enterobacteriace

2021 ◽  
Vol 1 (S1) ◽  
pp. s9-s10
Author(s):  
Kenisha Evans ◽  
Jennifer LeRose ◽  
Angela Beatriz Cruz ◽  
Lavina Jabbo ◽  
Teena Chopra
Keyword(s):  
Retrospective Study ◽  
Infection Control ◽  
Personal Protective Equipment ◽  
Horizontal Transmission ◽  
Control Measures ◽  
Protective Equipment ◽  
Local Health ◽  
Infection Rates ◽  
Infection Control Measures ◽  
The Impact

Background: In 2019, according to the Centers for Disease Control and Prevention, carbapenem-resistant Enterobacteriaceae (CRE), had cost the lives of >35,000 patients, particularly the most virulent plasmid-mediated New Delhi metallo-β-lactamase (NDM). Although healthcare systems normally have strict surveillance and infection control measures for CRE, the rapid emergence of novel SAR-CoV-2 and COVID-19 led to a shortage of personal protective equipment (PPE) and medical supplies. As a result, routine infection practices, such as contact precautions, were violated. Studies have shown this depletion and shift in resources compromised the control of infections such CRE leading to rising horizontal transmission. Method: A retrospective study was conducted at a tertiary healthcare system in Detroit, Michigan, to determine the impact of PPE shortages during the COVID-19 pandemic on NDM infection rates. The following periods were established during 2020 based on PPE availability: (1) pre-PPE shortage (January–June), (2) PPE shortage (July–October), and (3) post-PPE shortage (November–December). Rates of NDM per 10,000 patient days were compared between periods using the Wilcoxon signed rank-sum test. Isolates were confirmed resistant by NDM by molecular typing performed by the Michigan State Health Department. Patient characteristics were gathered by medical chart review and patient interviews by telephone. Results: Overall, the average rate of NDM infections was 1.82 ±1.5 per 10,000 patient days. Rates during the PPE shortage were significantly higher, averaging 3.6 ±1.1 cases per 10,000 patient days (P = .02). During this time, several infections occurred within patients on the same unit and/or patients with same treating team, suggesting possible horizontal transmission. Once PPE stock was replenished and isolation practices were reinstated, NDM infection rates decreased to 0.77 ±1.1 per 10,000 patient days. Conclusion: Control of CRE requires strategic planning with active surveillance, antimicrobial constructs, and infection control measures. The study illustrates that in times of crisis, such as the COVID-19 pandemic, the burden of effective infection control requires much more multidisciplinary efforts to prevent unintentional lapses in patient safety. A swift response by the state and local health departments at a tertiary-care healthcare center conveyed a positive mitigation of the highest clinical threats and decreased horizontal transmission of disease.Funding: NoDisclosures: None

scholarly journals Decontamination methods of personal protective equipment for repeated utilization in medical/surgical settings

2020 ◽  
Vol 8 (34) ◽  
pp. 27-39
Author(s):  
Abdurrahman Kharbat ◽  
Adin Mizer ◽  
Mimi Zumwalt
Keyword(s):  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Protective Equipment ◽  
Pilot Studies ◽  
Medical Supplies ◽  
Policy Statements ◽  
Repeated Use ◽  
Meta Analyses ◽  
N95 Respirators ◽  
Made In

The COVID-19 pandemic has affected citizens and healthcare workers worldwide due to a number of important factors. The transmission of the SARS CoV-2 microorganism, the pathogen that causes COVID-19 infection, occurs through droplet and aerosol spread due to coughs and sneezes from infected patients. A panicked public began hoarding medical supplies and personal protective equipment (PPE), leaving healthcare workers to care for patients without adequate protection. A literature review was conducted to better understand the options available to hospital and healthcare system administrators as they develop necessary protocols for the conservation and possible reuse of PPE. This review is based upon the peer-reviewed studies of various scientific investigators, biotechnology researchers, governmental agency health officials, including meta-analyses, preliminary/pilot studies, and policy statements. Current findings indicate that extended usage of N95 respirators is practical since there are methods available for the decontamination/repeated use of N95 respirators. In evaluating the efficacy of such methods, the safety of healthcare workers is important in deciding which method to recommend. Available evidence supports the use of the Bioquell Hydrogen Peroxide Vapor (HPV) system for decontaminating N95 respirators. Information on other PPE will also be discussed about more specific items. Informed decisions regarding the policies of hospitals and healthcare systems must be considered, and with the safety of healthcare workers in mind, both factors influenced the recommendations made in this comprehensive review.

scholarly journals The Impact Of COVID-19 On Out-Of-Hours Adult Hospice Care: An Online Survey

2021 ◽  
Author(s):  
Felicity Hasson ◽  
Paul Slater ◽  
Anne Fee ◽  
Tracey McConnell ◽  
Sheila Payne ◽  
...  
Keyword(s):  
Palliative Care ◽  
United Kingdom ◽  
Personal Protective Equipment ◽  
Protective Equipment ◽  
Community Based ◽  
Out Of Hours ◽  
Care Services ◽  
The United Kingdom ◽  
Palliative Care Services ◽  
The Impact

Abstract BackgroundGlobally COVID-19 has had a profound impact on the provision of healthcare, including palliative care. However, there is little evidence about the impact of COVID-19 on delivery of out-of-hours specialist palliative care services in the United Kingdom. The aim of the study is to investigate the impact of the COVID-19 pandemic on the delivery of out-of-hours community-based palliative care services.Methods A national online census survey of managers of adult hospices in the United Kingdom was undertaken. Survey were emailed to managers of adult hospices (n=150) who provided out-of-hours community palliative care services. Fifteen questions related specifically to the impact of COVID-19 and data were analysed thematically.ResultsEighty-one responses to the survey were returned (54% response rate); 59 were complete of which 47 contained COVID-19 data. Findings indicated that COVID-19 impacted on out-of-hours community-based palliative care. To meet increased patient need, hospices reconfigured services; redeployed staff; and introduced new policies and procedures to minimize virus transmission. Lack of integration between charitably and state funded palliative care providers was reported. The interconnected issues of the use and availability of Personal Protective Equipment (n=21) and infection control screening (n=12) resulted in changes in nursing practices due to fear of contagion for patients, carers and staff. Conclusions Survey findings suggest that due to increased demand for community palliative care services, hospices had to rapidly adapt and reconfigure services. Even though this response to the pandemic led to some service improvements, in the main, out-of-hours service reconfiguration resulted in challenges for hospices, including workforce issues, and availability of resources such as Personal Protective Equipment. These challenges were exacerbated by lack of integration with wider healthcare services. More research is required to fully understand the implications of such changes on the quality of care provided.

Feasibility study: Proposed alternative to N95 respirator during the personal protective equipment shortage from COVID-19 pandemic

2021 ◽  
Vol 19 (7) ◽  
pp. 192-202
Author(s):  
Ahel El Haj Chehade, MD ◽  
Jesintha Stephenson, MD ◽  
Evan Floyd, PhD ◽  
Jean Keddissi, MD, FCCP ◽  
Tony Abdo, MD ◽  
...  
Keyword(s):  
Pulse Oximetry ◽  
Feasibility Study ◽  
Personal Protective Equipment ◽  
Geometric Mean ◽  
Face Mask ◽  
The United States ◽  
Geometric Standard Deviation ◽  
Protective Equipment ◽  
Health Administration ◽  
Fit Testing

Introduction: Having an adequate supply of personal protective equipment during the COVID-19 pandemic has been a constant challenge for hospitals across the United States. In the event of shortages, our assembled mask might offer noninferior protection compared to an N95 respirator. Objective: To study the ability of an assembled mask to pass a quantitative fit testing.Methods: We conducted a feasibility study at the Oklahoma City Veteran Affairs Health Care System. Volunteers were fitted with an assembled mask made of either a Hans Rudolph half-face mask or a Respironics Performax full-face mask, attached to an Iso-Gard HEPA light Filter 28022 through a Performax SE elbow hinge. Quantitative fit testing was conducted using the Occupation Safety and Health Administration fit testing protocol. The primary outcome was the percentage of participants who pass the quantitative fit test. Secondary outcomes included the overall fit factor (FF), average FF for different exercises, changes in pulse oximetry and endtidal CO2 at 0 and 15 minutes, willingness to use the mask, and visibility assessment.Results: Twenty participants completed the study, and all (100 percent) passed the quantitative fit testing. The overall FF had a geometric mean of 2,317 (range: 208-16,613) and a geometric standard deviation of 3.8. The lowest FF was recorded while the subjects were talking. Between time 0 and 15 minutes, there was no clinically significant change in pulse oximetry and end-tidal CO2 levels. Most participants reported “very good” visibility and were “highly likely” to use the Hans Rudolph half-face mask in the case of shortage.Conclusion: Our assembled respirator offers noninferior protection to N95 respirators in the setting of hypothetical protective equipment shortage.

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