scholarly journals The Urologist, Personal Protective Equipment (PPE) and COVID-19

2020 ◽  
Vol 3 (4) ◽  
pp. e1-e14
Author(s):  
Subhabrata Mukherjee ◽  
Vasileios Bonatsos ◽  
Asif Raza
Keyword(s):  
Personal Protective Equipment ◽  
Elective Surgery ◽  
Cochrane Review ◽  
Virus Transmission ◽  
Digital Rectal Examination ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Surgical Equipment ◽  
Prostate Biopsies ◽  
Regulatory Bodies

Background and ObjectiveTo review the literature from a urologist’s perspective regarding the use of Personal Protective Equipment (PPE), associated challenges, and other potential measures that can be taken to reduce the risk of nosocomial COVID-19 transmission. Material and MethodsA literature review using PubMed, Cochrane Review, and Google Scholar database search was performed using the keyword terms “COVID-19”, “Coronavirus”, “Personal Protective Equipment” (PPE), “healthcare workers” (HCW), “protection”, “masks”, and “urology”. Non-English articles were excluded. We present a summary of key guidance provided by regulatory bodies as well as some of the key articles published to date relating to PPE. DiscussionSARS-CoV-2 virus is found mainly in the respiratory system but is also in blood, feces, semen, and urine. Both standard infection control precautions (SICPs) and transmission-based precautions (TBPs) are nec-essary to reduce nosocomial transmission of COVID-19 infection. PPE includes gowns, gloves, masks or respirators, goggles, and face shields; however, wearing PPE is only part of many precautionary measures that are necessary to prevent viral transmission. When used appropriately PPE not only protects HCWs from patients but also protects patients from HCWs who may be asymptomatic carriers of COVID-19 infection. Attention should also be paid to fit testing and fit checking, donning and doffing, and ever-evolving guide-lines on PPE. Wearing PPE for a long time is also technically challenging and may adversely affect surgical outcomes. Shortages of PPE in the supply chain during the peak of the pandemic as well as concerns about substandard PPE should be considered for a possible second wave of COVID-19. Other key measures to minimize nosocomial SARS-CoV-2 virus transmission are a symptom and temperature screening of patients and staff; controlling the flow of patients, staff, and relatives in hospitals; self-isolation by patients before elective surgery; a robust testing protocol for both patients and staff; patient and staff cohorting; physical distancing; good hand hygiene; respiratory etiquette including face coverings for patients, staff and visitors; proper disposal of waste and enhanced cleaning; thorough cleaning and sterilization of surgical equipment performed post-operatively; choosing suitable anesthetic methods to minimize aerosolization of the virus; and if possible ensuring a negative-pressure theatre environment while dealing with COVID-19 positive patients. As scientific and regulatory bodies continue to issue updated guidance as more data is collected and a better knowledge base is developed regarding COVID-19 employers and staff need to keep up to date with guidance also. ConclusionCOVID-19 will be around for the foreseeable future and infection rates may fluctuate as restrictions are eased. HCWs including urologists should take appropriate PPE measures not only in theatres, clinics, and endoscopy suits but also when performing simple tasks such as urine dipsticks, catheter, nephrostomy management, digital rectal examination (DRE), prostate biopsies, etc. as SARS-CoV-2 can be detected in feces, urine, and semen. Both employers and HCWs should adhere strictly to current guidelines and work together to minimize nosocomial transmission of COVID-19 infection.

Respiratory protection ‒ new challenges

2021 ◽  
Vol 70 (1) ◽  
pp. 129-153
Author(s):  
Władysław Harmata ◽  
Dorota Kamionek
Keyword(s):  
Air Pollution ◽  
Particulate Matter ◽  
Personal Protective Equipment ◽  
Virus Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Protection Measures ◽  
Normative Requirements ◽  
New Challenges

The paper characterizes the problem of air pollution with smog. The possibility of SARS-CoV-2 virus transmission on particulate matter and the possibility of infection was analyzed. Individual respiratory protection measures available on the market were analyzed in terms of mass use, taking into account legal and normative requirements. Keywords: personal protective equipment, respiratory protection

scholarly journals COVID-19 infections among Healthcare Workers and Transmission within Households

2020 ◽  
Author(s):  
Kevin L. Schwartz ◽  
Camille Achonu ◽  
Sarah A. Buchan ◽  
Kevin A. Brown ◽  
Brenda Lee ◽  
...  
Keyword(s):  
General Population ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Population Based ◽  
Cross Sectional Study ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Sectional Study ◽  
Cross Sectional ◽  
Testing Bias

AbstractImportanceProtecting healthcare workers (HCWs) from COVID-19 is a priority to maintain a safe and functioning healthcare system. The risk of transmitting COVID-19 to family members is a source of stress for many.ObjectiveTo describe and compare HCW and non-HCW COVID-19 cases in Ontario, Canada, as well as the frequency of COVID-19 among HCWs’ household members.Design, Setting, and ParticipantsUsing reportable disease data at Public Health Ontario which captures all COVID-19 cases in Ontario, Canada, we conducted a population-based cross-sectional study comparing demographic, exposure, and clinical variables between HCWs and non-HCWs with COVID-19 as of 14 May 2020. We calculated rates of infections over time and determined the frequency of within household transmissions using natural language processing based on residential address.Exposures and OutcomesWe contrasted age, gender, comorbidities, clinical presentation (including asymptomatic and presymptomatic), exposure histories including nosocomial transmission, and clinical outcomes between HCWs and non-HCWs with confirmed COVID-19.ResultsThere were 4,230 (17.5%) HCW COVID-19 cases in Ontario, of whom 20.2% were nurses, 2.3% were physicians, and the remaining 77.4% other specialties. HCWs were more likely to be between 30-60 years of age and female. HCWs were more likely to present asymptomatically (8.1% versus 7.0%, p=0.010) or with atypical symptoms (17.8% versus 10.5%, p<0.001). The mortality among HCWs was 0.2% compared to 10.5% of non-HCWs. HCWs commonly had exposures to a confirmed case or outbreak (74.1%), however only 3.1% were confirmed to be nosocomial. The rate of new infections was 5.5 times higher in HCWs than non-HCWs, but mirrored the epidemic curve. We identified 391 (9.8%) probable secondary household transmissions and 143 (3.6%) acquisitions. Children < 19 years comprised 14.6% of secondary cases compared to only 4.2% of the primary cases.Conclusions and RelevanceHCWs represent a disproportionate number of COVID-19 cases in Ontario but with low confirmed numbers of nosocomial transmission. The data support substantial testing bias and under-ascertainment of general population cases. Protecting HCWs through appropriate personal protective equipment and physical distancing from colleagues is paramount.Key PointsQuestionWhat are the differences between healthcare workers and non-healthcare workers with COVID-19?FindingsIn this population-based cross-sectional study there were 4,230 healthcare workers comprising 17.5% of COVID-19 cases. Healthcare workers were diagnosed with COVID-19 at a rate 5.5 times higher than the general population with 0.8% of all healthcare workers, compared to 0.1% of non-healthcare workers.MeaningHigh healthcare worker COVID-19 burden highlights the importance of physical distancing from colleagues, appropriate personal protective equipment, as well as likely substantial testing bias and under-ascertainment of COVID-19 in the general population.

scholarly journals Compliance with personal protective equipment use among non-medical healthcare professionals during Covid-19 pandemic

2021 ◽  
pp. 258-266
Author(s):  
Estika Mei Diana ◽  
Anna Wahyuni Widayanti ◽  
Satibi
Keyword(s):  
Personal Protective Equipment ◽  
Work Experience ◽  
Healthcare Professionals ◽  
Univariate Analysis ◽  
Virus Transmission ◽  
Binary Logistic Regression ◽  
Protective Equipment ◽  
Chi Square ◽  
Chi Square Test ◽  
Medical Healthcare

Non-medical healthcare professionals, including pharmacists, pharmacy technicians, nutritionists, and radiographers, have a high risk of  COVID-19 infection during work. Personal protective equipment use has shown effective in preventing virus transmission. This study aimed to investigate the compliance with personal protective equipment use and identify the factors that may influence their compliance. The study was designed cross-sectionally, with a self-administered questionnaire. The respondents were non-medical healthcare professionals recruited from covid and non-covid ward at Saiful Anwar General Hospital. The data were collected in November 2020. The questionnaire consists of four questions to assess compliance and eighteen questions to explore the factors that may relate to their compliance. This study used the Chi-square test to differentiate the level of compliance between two groups and binary logistic regression to analyze factors that may influence the compliance. Most participants in this study were female (84.8%), with a median age of 33 (23 – 57) years. More than 80 % of participants worked in the non-covid ward. Only one-fifth of participants had work experience of more than 15 years. The compliance with personal protective equipment was 67.3%. In univariate analysis, factors that influenced the compliance were difficulty using, removing, and disposing of personal protective equipment, lack of training and regular monitoring, unsure about the effectiveness of personal protective equipment, uncomfortable in donning personal protective equipment. Co-workers never reminding themselves to use personal protective equipment also influence compliance. In the multivariate analysis, the difficulty of using, removing and disposing of personal protective equipment (OR 2.83 (0.730 – 3.478), p=0.025) significantly influenced compliance with personal protective equipment use.

scholarly journals Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

2020 ◽  
Author(s):  
Robert J. Fischer ◽  
Dylan H. Morris ◽  
Neeltje van Doremalen ◽  
Shanda Sarchette ◽  
M. Jeremiah Matson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Single Use ◽  
N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Here, we have analyzed four readily available and often used decontamination methods: UV, 70% ethanol, 70C heat and vaporized hydrogen peroxide for inactivation of SARS-CoV-2 on N95 respirators. Equally important we assessed the function of the N95 respirators after multiple wear and decontamination sessions.

scholarly journals Trait Mindful Nonreactivity and Nonjudgment Prospectively Predict of COVID-19 Health Protective Behaviors Across a Two-Month Interval in a USA Sample

2021 ◽  
Author(s):  
William H OBrien ◽  
Shan Wang ◽  
Aniko Viktoria Varga ◽  
Chung Xiann Lim ◽  
Huanzhen Xu ◽  
...  
Keyword(s):  
Longitudinal Study ◽  
Personal Protective Equipment ◽  
Virus Transmission ◽  
Protective Equipment ◽  
Protective Behaviors ◽  
Perceived Susceptibility ◽  
Social Distancing

The COVID-19 pandemic has prompted a growing recommendation for social distancing and using personal protective equipment (PPE) to help mitigate the virus transmission. Previous studies have shown promising relationships between perceived susceptibility to COVID-19, mindfulness-related variables, and COVID-19 health protective behaviors (social distancing and PPE use). In this longitudinal study, the variables were measured across a two-month interval during the earlier phase of the pandemic in June (Time 1) and August (Time 2), 2020. The results from 151 matched USA MTurk participants indicated that the perceived susceptibility to COVID-19 did not significantly predict the health protective behaviors. For mindfulness, nonreactivity was positively related to PPE use while nonjudgement was negatively related to PPE use. Accordingly, mindfulness promotion messages could be a way to increase the likelihood of people performing health protective behaviors to better constrain the COVID-19 outbreak.

scholarly journals Backlog to Surgery due to COVID-19 and Considerations to Address to Catch-up Safely

2020 ◽  
Vol 07 (03) ◽  
pp. 4-10
Author(s):  
Amy Lewis ◽  
Keyword(s):  
Acute Care ◽  
Personal Protective Equipment ◽  
Healthcare Professionals ◽  
Elective Surgery ◽  
Health And Safety ◽  
Protective Equipment ◽  
Healthcare Staff ◽  
Multifaceted Approach ◽  
Catch Up ◽  
Key Aspects

On March 11th 2020, COVID-19 met all criteria to be considered a pandemic. The resulting halt in surgery led to an estimated 28.4 million elective surgery cancellations around the globe. Figures suggest that the backlog to surgery may take years to clear, causing huge detrimental effects to both the economy and the health of patients. Addressing this surgical backlog, whilst ensuring the health and safety of healthcare professionals and patients during surgery, will require a multifaceted approach. Key aspects, such as providing a sufficient and stable supply of Personal Protective Equipment (PPE), adequate and efficient testing of healthcare staff and patients, and availability of post-acute care, need to be secured before surgery can recommence safely in this COVID-19 era.

scholarly journals Assessment of N95 respirator decontamination and re-use for SARS-CoV-2

2020 ◽  
Author(s):  
Robert J. Fischer ◽  
Dylan H. Morris ◽  
Neeltje van Doremalen ◽  
Shanda Sarchette ◽  
Jeremiah Matson ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
Uv Radiation ◽  
Personal Protective Equipment ◽  
Healthcare Workers ◽  
Nosocomial Transmission ◽  
Protective Equipment ◽  
Respiratory Protection ◽  
Single Use ◽  
N95 Respirators

The unprecedented pandemic of SARS-CoV-2 has created worldwide shortages of personal protective equipment, in particular respiratory protection such as N95 respirators. SARS-CoV-2 transmission is frequently occurring in hospital settings, with numerous reported cases of nosocomial transmission highlighting the vulnerability of healthcare workers. In general, N95 respirators are designed for single use prior to disposal. Several groups have addressed the potential for re-use of N95 respirators from a mechanical or from a decontamination perspective. Here, we analyzed four different decontamination methods – UV radiation (260 – 285 nm), 70ºC heat, 70% ethanol and vaporized hydrogen peroxide (VHP) – for their ability to reduce contamination with infectious SARS-CoV-2 and their effect on N95 respirator function.

scholarly journals The Global Impact of COVID-19 on Craniomaxillofacial Surgeons: A Follow-Up Survey After One Year

2022 ◽  
pp. 194338752110578
Author(s):  
Tevfik Cicek ◽  
Justin van der Tas ◽  
Thomas Dodson ◽  
Daniel Buchbinder ◽  
Stefano Fusetti ◽  
...  
Keyword(s):  
Personal Protective Equipment ◽  
Elective Surgery ◽  
Virus Disease ◽  
Statistical Significance ◽  
Predictor Variable ◽  
Vaccination Status ◽  
Protective Equipment ◽  
Online Questionnaire ◽  
Cross Sectional ◽  
The Impact

Study Design Comparative cross-sectional. The Objective To measure the impact that COrona VIrus Disease-19 (COVID-19) has had on craniomaxillofacial (CMF) surgeons after 1 year and compare it with 2020 data by ( 1) measuring access to adequate personal protective equipment (PPE), ( 2) performance of elective surgery, and ( 3) the vaccination status. This should be investigated because most CMF surgeons felt that hospitals did not provide them with adequate PPE. Methods The investigators surveyed the international AO CMF membership using a 30-item online questionnaire and compared it to a previous study. The primary predictor variable was year of survey administration. Primary outcome variables were availability of adequate personal protective equipment (adequate/inadequate), performance of elective surgery (yes/no), and vaccination status (fully vaccinated/partly vaccinated/not vaccinated). Descriptive and analytic statistics were computed. Binary logistic regression models were created to measure the association between year and PPE availability. Statistical significance level was set at P < .05. Results The sample was composed of 523 surgeons (2% response rate). Most surgeons reported access to adequate PPE (74.6%). The most adequate PPE was offered in Europe (87.8%) with the least offered in Africa (45.5%). Surgeons in 2021 were more likely to report adequate PPE compared to 2020 (OR 3.74, 95% CI [2.59–4.39]). Most of the respondents resumed elective surgery (79.5% vs 13.3% in 2020) and were fully vaccinated (59.1%). Conclusion Most CMF surgeons now have access to adequate PPE, resumed elective surgery, and are either fully or partly vaccinated. Future studies should investigate the long-term impact of the fast-evolving COVID-19 pandemic on CMF surgeons.

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