scholarly journals COVID-19 Global Pandemic Planning: Decontamination and Reuse Processes for N95 Respirators

2020 ◽  
Author(s):  
Douglas J Perkins ◽  
Steven Villescas ◽  
Terry H. Wu ◽  
Timothy Muller ◽  
Steven Bradfute ◽  
...  
Keyword(s):  
Operating Room ◽  
Healthcare Providers ◽  
Respiratory Illness ◽  
Lessons Learned ◽  
Healthcare Personnel ◽  
Environmental Controls ◽  
Global Pandemic ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
N95 Respirators

ABSTRACTCoronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified as a cluster of respiratory illness in Wuhan City, Hubei Province, China in December 2019, and has rapidly spread across the globe to greater than 200 countries. Healthcare providers are at an increased risk for contracting the disease due to occupational exposure and require appropriate personal protective equipment (PPE), including N95 respirators. The rapid worldwide spread of high numbers of COVID-19 cases has facilitated the need for a substantial supply of PPE that is largely unavailable in many settings, thereby creating critical shortages. Creative solutions for the decontamination and safe reuse of PPE to protect our frontline healthcare personnel are essential. Here, we describe the development of a process that began in late February 2020 for selecting and implementing the use of hydrogen peroxide vapor (HPV) as viable method to reprocess N95 respirators. Since pre-existing HPV decontamination chambers were not available, we optimized the sterilization process in an operating room after experiencing initial challenges in other environments. Details are provided about the prioritization and implementation of processes for collection and storage, pre-processing, HPV decontamination, and post-processing of filtering facepiece respirators (FFRs). Important lessons learned from this experience include, developing an adequate reserve of PPE for effective reprocessing and distribution, and identifying a suitable location with optimal environmental controls (i.e., operating room). Collectively, information presented here provides a framework for other institutions considering decontamination procedures for N95 respirators.

scholarly journals COVID-19 global pandemic planning: Decontamination and reuse processes for N95 respirators

2020 ◽  
Vol 245 (11) ◽  
pp. 933-939 ◽  
Author(s):  
Douglas J Perkins ◽  
Steven Villescas ◽  
Terry H Wu ◽  
Timothy Muller ◽  
Steven Bradfute ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Operating Room ◽  
Personal Protective Equipment ◽  
Healthcare Personnel ◽  
Protective Equipment ◽  
Environmental Controls ◽  
Creative Solutions ◽  
Increased Risk ◽  
N95 Respirators ◽  
Hydrogen Peroxide Vapor

Coronavirus disease 2019 (COVID-19) is an illness caused by a novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The disease was first identified as a cluster of respiratory illness in Wuhan City, Hubei Province, China, in December 2019, and has rapidly spread across the globe to greater than 200 countries. Healthcare providers are at an increased risk for contracting the disease due to occupational exposure and require appropriate personal protective equipment (PPE), including N95 respirators. The rapid worldwide spread of high numbers of COVID-19 cases has facilitated the need for a substantial supply of PPE that is largely unavailable in many settings, thereby creating critical shortages. Creative solutions for the decontamination and safe reuse of PPE to protect our frontline healthcare personnel are essential. Here, we describe the development of a process that began in late February 2020 for selecting and implementing the use of hydrogen peroxide vapor (HPV) as viable method to reprocess N95 respirators. Since pre-existing HPV decontamination chambers were not available, we optimized the sterilization process in an operating room after experiencing initial challenges in other environments. Details are provided about the prioritization and implementation of processes for collection and storage, pre-processing, HPV decontamination, and post-processing of filtering facepiece respirators. Important lessons learned from this experience include, developing an adequate reserve of PPE for effective reprocessing and distribution, and identifying a suitable location with optimal environmental controls (i.e. operating room). Collectively, information presented here provides a framework for other institutions considering decontamination procedures for N95 respirators. Impact statement There is a critical shortage of personal protective equipment (PPE) around the globe. This article describes the safe collection, storage, and decontamination of N95 respirators using hydrogen peroxide vapor (HPV). This article is unique because it describes the HPV process in an operating room, and is therefore, a deployable method for many healthcare settings. Results presented here offer creative solutions to the current PPE shortage.

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 Covid-19 and food security: Jeopardy management and posterity deliberations

2021 ◽  
Vol 10 (2) ◽  
pp. 01-05
Author(s):  
Augustine Owusu-Addo ◽  
Atianashie Miracle A ◽  
Chukwuma Chinaza Adaobi ◽  
Larissa Agbemelo-Tsomafo
Keyword(s):  
Food Processing ◽  
Respiratory Illness ◽  
The United States ◽  
The Novel ◽  
Food Handling ◽  
Global Pandemic ◽  
Food Borne ◽  
Novel Coronavirus ◽  
Food Borne Infections ◽  
Safety Guidelines

COVID-19, also known as the ‘novel coronavirus disease 2019’, is a respiratory illness and the causative pathogen is officially named as ‘SARS-CoV-2’. Infections with SARS-CoV-2 have now been amplified to a global pandemic – as of April 3, 2020, nearly 1,018,000 cases have been confirmed in more than 195 countries, including more than 300,000 cases within the United States. Public safety guidelines are followed worldwide to stop the spread of COVID-19 and stay healthy. Despite COVID-19 is a respiratory illness with mode of invasion through the respiratory tract, not the gastrointestinal tract, an average food consumer is anxious and concerned about the food safety. Could an individual catch the deadly contagious COVID-19 from groceries brought home from the supermarket – or from the next restaurant takeout order? This brief review elucidates the epidemiology and pathobiological mechanism(s) of SARS-CoV-2 and its implications in food-borne infections, transmission via food surfaces, food processing and food handling.

Teledentistry Platforms for Orthodontics

2021 ◽  
Vol 45 (1) ◽  
pp. 48-53
Author(s):  
Jae Hyun Park ◽  
Leah Rogowski ◽  
Janet H Kim ◽  
Sumayah Al Shami ◽  
Scott E I Howell
Keyword(s):  
Orthodontic Treatment ◽  
Healthcare Providers ◽  
The Novel ◽  
Interpersonal Interactions ◽  
Global Pandemic ◽  
Novel Coronavirus

Technology has transformed almost every aspect of our lives. Smartphones enable patients to request, receive, and transmit information irrespective of the time and place. The global pandemic has forced healthcare providers to employ technology to aid in ‘flattening the curve. The Novel Coronavirus, which is responsible for COVID-19, is transmitted primarily through person-to-person contact but may also be spread through aerosol generating procedures, so many clinics have severely limited interpersonal interactions. The purpose of this article is to provide helpful information for those orthodontists considering some form of remote practice. Various HIPAA-compliant telecommunication or teledentistry systems that can be used for orthodontic treatment are introduced and discussed. Detailed information about each platform that can potentially be used for orthodontics is provided in Figure 1. The authors do not endorse any of the products listed and the included software is not all inclusive but instead is a glimpse into the options available.

scholarly journals Operational considerations for peritoneal dialysis management during the COVID-19 pandemic

2020 ◽  
Vol 13 (3) ◽  
pp. 322-327 ◽  
Author(s):  
Zhikai Yang ◽  
Jie Dong
Keyword(s):  
Public Health ◽  
Peritoneal Dialysis ◽  
Healthcare Providers ◽  
Healthcare Personnel ◽  
Human Society ◽  
Public Health Response ◽  
Clinic Management ◽  
Precautionary Measures ◽  
Novel Coronavirus ◽  
Remote Patient

Abstract Background Coronavirus disease 2019 (COVID-19) is an infectious respiratory disease caused by a novel coronavirus—severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). It is spread from human to human and has resulted in a global pandemic, posing a disastrous public health risk worldwide. Patients with chronic kidney disease, especially those on dialysis, are considered to be at higher risk of developing severe COVID-19 due to their immunocompromised status and frail condition. The home treatment setting of peritoneal dialysis (PD) has advantages in terms of implementing self-care when routine hospital visits and social activities are restricted, thus greatly reducing exposure of PD patients to the virus. Methods and Results We outline general operational considerations in PD management during the COVID-19 pandemic, including precautionary measures for PD patients and healthcare staff. Precautionary measures for PD patients include education on prevention of, and screening for, COVID-19, preclinic screening, in-clinic management, meticulous remote patient management and special hospitalization arrangements. The diagnosis and treatment of PD patients with COVID-19 are discussed. Precautionary measures for PD staff include continuous education on, and training in, COVID-19, exposure history surveillance and self-monitoring for COVID-19 among healthcare personnel, appropriate personal protective equipment and hand hygiene, organization of medical activities and staffing, and adequate environment cleaning. Conclusions This is a battle of the entire human society against the novel coronavirus. Integrated teamwork among healthcare providers, supported by society as a whole, is needed as part of the ongoing public health response to try to slow the spread of COVID-19.

scholarly journals Dynamic Response Systems of Healthcare Mask Production to COVID-19: A Case Study of Korea

Systems ◽  
2020 ◽  
Vol 8 (2) ◽  
pp. 18 ◽  
Author(s):  
EunSu Lee ◽  
Yi-Yu Chen ◽  
Melanie McDonald ◽  
Erin O’Neill
Keyword(s):  
Dynamic Response ◽  
Distribution Systems ◽  
Lessons Learned ◽  
Public And Private ◽  
Democratic Leadership ◽  
The Public ◽  
Response System ◽  
Global Pandemic ◽  
Production And Distribution ◽  
Novel Coronavirus

Korea initiated a new experiment, called a dynamic response system for open democratic societies as a principle to respond to the novel coronavirus (COVID-19). The global pandemic of COVID-19 led to a surge in demand for healthcare medical masks and respirators, and strained the global supply chain of mask production and distribution systems. This study provides a systemic view of critical personal protective equipment for both healthcare staff and the public to stop the spread of COVID-19. This study investigates the dynamic response system of healthcare mask production to the coronavirus and discusses lessons learned in view of systems thinking. The study shows that it is critical to developing a quick and dynamic response system to the evolving market conditions with flexible and agile operations. Visibility with transparency with information sharing with the public is also critical under global pandemic. Due to the shortage of mask supply, smart consumption is required along with collaboration with public and private sectors, as well as global organizations. Democratic leadership and a well-prepared strategic plan for long-term period are essential to the open society to prepare the global pandemic in the future. This study serves as a benchmark for dynamic and timely responses to the global pandemic.

scholarly journals SARS-CoV-2, ACE2 expression, and systemic organ invasion

2020 ◽  
Author(s):  
Usman M Ashraf ◽  
Ahmed A Abokor ◽  
Jonnelle M. Edwards ◽  
Emily W. Waigi ◽  
Rachel S. Royfman ◽  
...  
Keyword(s):  
Respiratory Illness ◽  
Normal Function ◽  
Multiple Organ ◽  
Angiotensin Converting Enzyme 2 ◽  
Multiple Organs ◽  
Global Pandemic ◽  
Organ Systems ◽  
Novel Coronavirus ◽  
Severe Respiratory Illness ◽  
Organ Invasion

A novel coronavirus disease, COVID-19, has created a global pandemic in 2020, posing an enormous challenge to healthcare systems and affected communities. COVID-19 is caused by Severe Acute Respiratory Syndrome (SARS)-CoronaVirus-2 (CoV-2) that manifests as bronchitis, pneumonia, or a severe respiratory illness. SARS-CoV-2 infects human cells via binding a "spike" protein on its surface to angiotensin-converting enzyme 2 (ACE2) within the host. ACE2 is crucial for maintaining tissue homeostasis and negatively regulates the renin-angiotensin-aldosterone system (RAAS) in the humans. The RAAS is paramount for normal function in multiple organ systems including the lungs, heart, kidney, and vasculature. Given that SARS-CoV-2 internalizes via ACE2, the resultant disruption in ACE2 expression can lead to altered tissue function and exacerbate chronic diseases. The widespread distribution and expression of ACE2 across multiple organs is critical to our understanding of the varied clinical outcomes of COVID-19. This perspective review based on the current literature was prompted to show how disruption of ACE2 by SARS-CoV-2 can affect different organ systems.

Radiation risk amongst orthopaedic surgeons – Do we know the risk?

2018 ◽  
Vol 29 (5) ◽  
pp. 115-121 ◽  
Author(s):  
Sushmith R Gowda ◽  
Chris J Mitchell ◽  
Sherif Abouel-Enin ◽  
Charlotte Lewis
Keyword(s):  
Radiation Exposure ◽  
Operating Room ◽  
Radiation Risk ◽  
Healthcare Personnel ◽  
Orthopaedic Surgeons ◽  
Increased Risk ◽  
Medullary Nailing ◽  
Specific Safety ◽  
Effects Of Radiation ◽  
Harmful Effects

Radiation risk amongst orthopaedic surgeons and theatre personnel is increasing with increased use of fluoroscopy imaging. Increased radiation risk has been shown to be associated with an increased risk of malignancies, ocular and thyroid disorders. Very high exposures have been reported in spinal surgery and during intra-medullary nailing. With an increase in modern and percutaneous methods, the use of intra-operative fluoroscopy has increased as well. The aim of this article was to review the available evidence of radiation risk amongst healthcare personnel. A systematic search was carried out in PubMED, CINAHL and Cochrane on intra-operative radiation in trauma and orthopaedic operating room. Inclusion criteria were clinical studies and systematic reviews reporting on radiation exposure, fluoroscopy time and references to specific safety guidelines. This article highlights the safety aspects of radiation protection and harmful effects of radiation during orthopaedic procedures. The responsibility to minimise radiation exposure in operating theatre lies with the team within the operating room.

scholarly journals Coronavirus Pneumonia and Pulmonary Thromboembolism

2020 ◽  
Author(s):  
Mingkang Yao ◽  
Phei Er Saw ◽  
Shanping Jiang
Keyword(s):  
Pulmonary Thromboembolism ◽  
Respiratory Health ◽  
Healthcare Providers ◽  
Global Pandemic ◽  
Increased Risk ◽  
Clinical Relationship ◽  
Therapeutic Measures ◽  
Infectious Disease Specialists ◽  
Coronavirus Infection ◽  
The Common

In 2019, a novel pneumonia, called coronavirus disease 2019 (COVID-19), spread rapidly throughout the world. This novel global pandemic severely threatened public respiratory health and medical services. To date, except for the common respiratory symptoms, coagulation disorders, especially pulmonary thromboembolism (PTE), has been proven as an important complication in severe COVID-19 patients, and the incidence of PTE causes poor clinical outcome and increased fatality. Therefore, it is important that healthcare providers, including respiratory physicians, emergency medicine specialists, hematologists, cardiologists, infectious disease specialists, and other specialists, recognize that patients with COVID-19 are at increased risk of PTE, and ensure that appropriate prophylaxis is administered to the appropriate patients, and that they effectively manage PTE when it does occur. The mechanism of PTE in patients with coronavirus pneumonia consists of endothelial injury, activated platelet, cytokine storm, and a suppressed fibrinolytic system. Early prophylaxis, antiviral therapy, anticoagulation, and supportive treatment are beneficial to COVID-19 patients. In this review, we summarize the harm that coronavirus pneumonia wreaks and highlight the clinical relationship between PTE and coronavirus infection. The potential mechanism and the prophylaxis and therapeutic measures are also discussed to call for more effort and research to investigate the strategies for PTE in COVID-19.

scholarly journals Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) Position Statement and Advisory for the Practice of Neuroanesthesia during COVID-19 Pandemic

2020 ◽  
Vol 7 (03) ◽  
pp. 118-127 ◽  
Author(s):  
Kiran Jangra ◽  
Nitin Manohar ◽  
Prasanna U. Bidkar ◽  
Ponniah Vanamoorthy ◽  
Devendra Gupta ◽  
...  
Keyword(s):  
Critical Care ◽  
Healthcare Providers ◽  
Disease Status ◽  
Position Statement ◽  
Hospital Environment ◽  
World Health ◽  
Indian Society ◽  
Increased Risk ◽  
Novel Coronavirus ◽  
Health Organization

AbstractThe coronavirus disease 2019 (COVID-19) is a major health emergency in today’s time. In December 2019, a cluster of pneumonia cases in Wuhan, China was attributed to a novel coronavirus. The World Health Organization declared it as a pandemic. As the majority of the cases suffering from COVID-19 are mildly symptomatic or asymptomatic, it becomes a great challenge to identify the infected persons in the absence of extensive testing. In the hospital environment, it can infect several other vulnerable patients and healthcare providers, significantly impacting the hospital services. Anesthesiologists are at an increased risk of COVID-19 transmission from the patients, as they are frequently involved in several aerosol-generating procedures. It is not possible to identify asymptomatic COVID-19 patients solely based on history-taking during their first point of contact with the anesthesiologists at the preanesthetic checkup clinic.Most of the neurosurgical conditions are of urgent in nature and cannot be postponed for a longer duration. In view of this, the position statement and practice advisory from the Indian Society of Neuroanaesthesiology and Critical Care (ISNACC) provides guidance to the practice of neuroanesthesia in the present scenario. The advisory has been prepared considering the current disease status of the COVID-19 pandemic, available literature, and consensus from experts in the field of neuroanesthesiology. Since the pandemic is still progressing and the nature of the disease is dynamic, readers are advised to constantly look for updated literature from ISNACC and other neurology and neurosurgical societies.

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