India: Novel Coronavirus Disease 2019 (COVID-19): Guidelines On Rational Use Of Personal Protective Equipment

Recently, Ministry of Health and Family Welfare came out with guidelines on use of Personal Protective Equipment for health care workers and those others working in points of entries (POEs), quarantine centers, hospitals, laboratories and primary health care / community settings. The guidelines set an approach to guide on the type of personal protective equipment to be used in different settings.¹

Background

Coronaviruses are a large family of viruses that circulate among animals, including camels, cats and bats, and some cause illness in people and others. Rarely, animal coronaviruses do evolve and infect people and then spread between people such as has been seen with MERS and SARS. The outbreak of Novel coronavirus disease (now named COVID-19) initially noticed from a seafood market in Wuhan city in Hubei Province of China in mid-December 2019, has spread to more than 185 countries/territories worldwide including India. The causative agent for COVID-19, earlier termed provisionally as novel Coronavirus has been officially named as SARS-CoV-2

Personal Protective Equipment (PPE)

Personal Protective Equipment (PPE) cover protective gears designed to safeguard the health of workers by minimizing their exposure to a biological agent.

Components of PPE

Components of PPE are goggles, face-shield, mask, gloves, coverall/gowns (with or without aprons), head cover and shoe cover:

• Face shield and goggles: Contamination of mucous membranes of the eyes, nose and mouth is likely in a scenario of droplets generated by cough, sneeze of an infected person coming in touch with / close proximity of an infected person. Hence, protection of the mucous membranes of the eyes/nose/mouth by using face shields/ goggles is an integral part of standard and contact precautions. The flexible frame of goggles should provide good seal with the skin of the face, covering the eyes and the surrounding areas and even accommodating for prescription glasses.
• Masks: Respiratory viruses of coronavirus variety target mainly the upper and lower respiratory tracts. Protecting the airway from the particulate matter generated by droplets / aerosols prevents human infection. Hence, the droplet precautions/airborne precautions using masks are crucial while dealing with a suspect or confirmed case of COVID-19/performing aerosol generating procedures. Different types of relevant masks are:
  • Triple layer medical mask
  • N-95 Respirator mask
• Gloves: Nitrile gloves are preferred over latex gloves because they resist chemicals, including certain disinfectants such as chlorine.
• Coverall/Gowns: Coverall/gowns are designed to protect torso of healthcare providers from exposure to virus. Coveralls typically provide 360-degree protection because they are designed to cover the whole body, including back and lower legs and sometimes head and feet as well, whereas the design of medical/isolation gowns does not provide continuous whole-body protection (e.g., possible openings in the back, coverage to the mid-calf only).

Conclusion

With the health ministry developing the Personal Protective Equipment (PPE) it has helped the society to combat the disease effectively at personal level without putting major burden on health care officials. This guidance will help the common man to know the standards of the components of Personal Protective Equipment and methods of their uses as well as the procedure to discharge them effectively.

Footnote

1. https://www.mohfw.gov.in/pdf/GuidelinesonrationaluseofPersonalProtectiveEquipment.pdf

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.