Summary of your 'study carrel' ============================== This is a summary of your Distant Reader 'study carrel'. The Distant Reader harvested & cached your content into a collection/corpus. It then applied sets of natural language processing and text mining against the collection. The results of this process was reduced to a database file -- a 'study carrel'. The study carrel can then be queried, thus bringing light specific characteristics for your collection. These characteristics can help you summarize the collection as well as enumerate things you might want to investigate more closely. This report is a terse narrative report, and when processing is complete you will be linked to a more complete narrative report. Eric Lease Morgan Number of items in the collection; 'How big is my corpus?' ---------------------------------------------------------- 190 Average length of all items measured in words; "More or less, how big is each item?" ------------------------------------------------------------------------------------ 4191 Average readability score of all items (0 = difficult; 100 = easy) ------------------------------------------------------------------ 49 Top 50 statistically significant keywords; "What is my collection about?" ------------------------------------------------------------------------- 190 PPE 70 COVID-19 31 patient 27 SARS 24 covid-19 11 N95 9 care 7 mask 6 dental 5 surgical 5 infection 5 Health 5 Ebola 4 ICU 4 HCP 4 EVD 3 waste 3 transmission 3 risk 3 Pakistan 3 NHS 3 HCW 3 EMS 2 worker 2 virus 2 training 2 surgery 2 skin 2 simulation 2 research 2 program 2 procedure 2 pandemic 2 healthcare 2 health 2 case 2 PCR 2 March 2 MERS 2 Italy 2 India 2 IPC 2 HEPA 2 Fig 2 China 2 CDC 1 visitor 1 veterinary 1 unit 1 uncertainty Top 50 lemmatized nouns; "What is discussed?" --------------------------------------------- 5756 patient 3331 care 3171 % 2584 infection 2483 use 2483 risk 2410 mask 2282 health 2111 pandemic 1850 study 1831 case 1724 procedure 1711 transmission 1696 hospital 1544 worker 1543 disease 1537 healthcare 1526 staff 1469 time 1319 equipment 1218 room 1200 virus 1178 practice 1143 face 1122 control 1070 respirator 1052 outbreak 984 protection 952 management 946 contact 945 coronavirus 911 system 857 datum 851 exposure 845 training 818 setting 815 guideline 814 level 806 area 794 emergency 784 number 772 response 766 testing 766 team 738 aerosol 704 glove 693 day 692 nurse 683 facility 682 unit Top 50 proper nouns; "What are the names of persons or places?" -------------------------------------------------------------- 4907 PPE 3210 COVID-19 1424 SARS 865 CoV-2 829 N95 807 Health 662 al 583 et 532 • 430 China 402 . 384 CDC 374 Ebola 364 Coronavirus 315 US 312 United 306 March 304 Disease 303 UK 290 Control 284 HCWs 266 States 257 EMS 250 World 243 ICU 232 Care 225 April 223 COVID 219 MERS 216 NHS 210 Wuhan 205 Table 202 Prevention 198 Organization 197 HCP 188 HCW 186 EVD 180 Pandemic 178 Hospital 174 Infection 170 PCR 170 Healthcare 166 National 164 ED 162 Italy 160 Fig 158 May 156 sha 153 C 151 Society Top 50 personal pronouns nouns; "To whom are things referred?" ------------------------------------------------------------- 2278 it 1702 we 1227 they 431 them 243 i 166 you 147 themselves 120 he 99 us 65 one 61 itself 35 she 27 me 16 him 13 himself 12 yourself 12 ourselves 7 oneself 5 herself 4 her 4 's 3 ours 3 myself 2 theirs 2 s 2 mine 2 em 1 ii.f.2.a 1 i.e.2 1 i.b.3.e 1 hypoxic‖ 1 his 1 gingivitis/ 1 covid-19 1 601 Top 50 lemmatized verbs; "What do things do?" --------------------------------------------- 26068 be 5443 have 2804 use 1793 include 1297 provide 1189 do 1156 report 1136 require 939 perform 913 base 811 increase 795 consider 780 need 774 wear 747 recommend 730 make 716 reduce 693 follow 633 take 605 prevent 592 confirm 585 work 561 protect 543 develop 531 associate 488 show 481 ensure 476 suspect 473 give 462 don 459 allow 452 infect 433 identify 409 test 400 involve 397 relate 394 generate 393 describe 392 remain 389 doff 385 limit 381 become 379 suggest 379 compare 369 occur 364 regard 364 continue 354 find 354 avoid 349 know Top 50 lemmatized adjectives and adverbs; "How are things described?" --------------------------------------------------------------------- 3136 not 1663 other 1636 high 1479 also 1424 respiratory 1363 such 1353 covid-19 1197 surgical 1161 more 1120 - 1091 medical 1089 protective 1083 clinical 890 available 845 personal 835 only 827 infectious 812 well 777 however 773 most 667 patient 648 as 626 low 596 acute 586 many 584 appropriate 583 possible 575 non 563 severe 563 first 561 important 550 viral 540 public 540 positive 536 new 520 different 516 dental 506 current 482 social 471 critical 459 significant 441 early 437 airborne 429 potential 412 negative 399 large 393 long 384 specific 376 likely 370 even Top 50 lemmatized superlative adjectives; "How are things described to the extreme?" ------------------------------------------------------------------------- 312 most 193 good 137 least 131 high 120 Most 36 large 34 great 30 late 28 low 17 bad 12 big 10 safe 8 N95s 7 old 7 early 6 short 5 close 4 few 3 small 3 sick 3 poor 3 new 2 simple 2 rich 2 near 2 long 2 deadly 2 dark 2 busy 2 # 1 young 1 weak 1 tough 1 strong 1 steep 1 stark 1 slight 1 quick 1 pre-/postt 1 postt 1 plotly 1 hot 1 fast 1 easy 1 cheap 1 Least 1 COVID-19 1 /r 1 /33 1 -some Top 50 lemmatized superlative adverbs; "How do things do to the extreme?" ------------------------------------------------------------------------ 461 most 80 least 27 well 5 hard 2 lowest 2 -fnomceo 1 worst 1 near 1 n95s 1 long 1 early 1 -generate Top 50 Internet domains; "What Webbed places are alluded to in this corpus?" ---------------------------------------------------------------------------- 67 doi.org 17 www.cdc.gov 11 orcid.org 9 github.com 5 www.fda.gov 4 covid19analytics.scinet.utoronto.ca 3 www.who.int 3 www.researchregistry.com 2 www.ecdc.europa.eu 2 www.cnn.com 2 www.acog.org 2 vimeo.com 2 creativecommons.org 1 www.wjx.cn 1 www.thinkglobalhealth.org 1 www.thingiverse.com 1 www.thejournal.ie 1 www.surveymonkey.com 1 www.shinyapps.io 1 www.sgh.com.sg 1 www.safety.jrgoicp.org 1 www.rcn.org.uk 1 www.prusaprinters.org 1 www.prusa3d.com 1 www.nmc.org.uk 1 www.mdpi.com 1 www.matterhackers.com 1 www.materialise.com 1 www.louisville 1 www.jcaho.org 1 www.irishtimes.com 1 www.hra-decisiontools.org.uk 1 www.hpa.org.uk 1 www.headspace.com 1 www.gov.uk 1 www.frontiersin.org 1 www.fda 1 www.facebook.com 1 www.epicov.org 1 www.ena.org 1 www.dph.illinois.gov 1 www.creality3dofficial.com 1 www.cam.ac.uk 1 www.calm.com 1 www.aornj 1 www.adledlight.com 1 www 1 weibo.com 1 studio.cul.columbia.edu 1 simulation.health.ufl.edu Top 50 URLs; "What is hyperlinked from this corpus?" ---------------------------------------------------- 18 http://doi.org/10.1101/2020.10.30.20223149 9 http://doi.org/10.1101/2020.09.25.20197061 9 http://doi.org/10.1101/2020.05.24.20107193 8 http://doi.org/10.1101/2020.04.24.20073924 7 http://doi.org/10.1101/2020.04.09.20060129 6 http://doi.org/10.1101/2020.10 4 http://doi.org/10.1101/2020.05.09.20096099 4 http://covid19analytics.scinet.utoronto.ca 3 http://www.cdc.gov/ 2 http://www.researchregistry.com 2 http://www.cnn.com/2014/09/25/health/ebola-Fatu-family/index.html 2 http://github.com/mponce0/covid19analytics.datasets 2 http://github.com/mponce0/covid19.analytics 2 http://creativecommons.org/licenses/by/4.0/ 1 http://www.wjx.cn/ 1 http://www.who.int/news-room/feature-stories/detail/whochina-joint-mission-on-coronavirus-disease-2019-(covid-19 1 http://www.who.int/news-room/detail/27-04-2020-who-timeline---covid-19 1 http://www.who.int/csr/sarsarchive/2003_05_07a/en/ 1 http://www.thinkglobalhealth.org/article/updatedtimeline-coronavirus 1 http://www.thingiverse.com/ 1 http://www.thejournal.ie/emergency-ventilators-irishresearchers-crowdfund-5061521-Mar2020/ 1 http://www.surveymonkey.com/r/PPE-SAFE 1 http://www.shinyapps.io 1 http://www.sgh.com.sg 1 http://www.safety.jrgoicp.org/ppe-3-usage-glove 1 http://www.researchregistry.com/browse-the-registry#home/registrationdetails/5eb063278ebf30001609bdd8/ 1 http://www.rcn.org.uk/news-andevents/news/half-of-nursing-staff-under-pressure-to-work-without-ppe-reveals-rcn 1 http://www.prusaprinters.org/prints/25857-prusa-face-shield 1 http://www.prusa3d.com/covid19/ 1 http://www.nmc.org.uk/news/news-andupdates/nmc-statement-on-personal-protective-equipment-during-the-covid-19-pandemic/ 1 http://www.mdpi.com/1660-4601/17/14/5141/s1 1 http://www.matterhackers.com/covid-19 1 http://www.materialise.com/en/handsfree-door-opener 1 http://www.louisville 1 http://www.jcaho.org 1 http://www.irishtimes.com/business/ 1 http://www.hra-decisiontools.org.uk/research/ 1 http://www.hpa.org.uk/infections/topics_az/cjd/ 1 http://www.headspace.com/health-covid-19)-a 1 http://www.gov.uk/government/organisations/department-of-health-andsocial-care 1 http://www.frontiersin.org/articles/10.3389/fmed 1 http://www.fda.gov/medicaldevices/emergency-situations-medical-devices/emergency-use-authorizations#covid19ppe 1 http://www.fda.gov/media/136842/download 1 http://www.fda.gov/media/136529/download 1 http://www.fda.gov/cdrh/ode/guidance/094.html#4 1 http://www.fda.gov/cber/gdlns/cjdvcjd.htm 1 http://www.fda 1 http://www.facebook.com/groups/Coronavirusmediciitaliani/" 1 http://www.epicov.org/epi3/ 1 http://www.ena.org/about/media/ebola/Pages/default.aspx Top 50 email addresses; "Who are you gonna call?" ------------------------------------------------- 1 research@f1000.com 1 lindsay.grayson@austin.org.au 1 ewilson@gastro.org Top 50 positive assertions; "What sentences are in the shape of noun-verb-noun?" ------------------------------------------------------------------------------- 19 masks are not 13 ppe was not 11 ppe is not 9 ppe is important 9 ppe was also 8 respirators are not 8 study did not 7 % did not 7 ppe is generally 7 workers did not 6 covid-19 is not 6 transmission is also 5 % were female 5 masks are available 5 patients did not 5 procedures are not 5 room is not 5 study has several 5 workers were not 4 patient is not 4 patients are not 4 patients taking low 4 patients were not 4 ppe including n95 4 ppe is challenging 4 ppe was adequately 4 ppe was generally 4 respirator is not 4 respirators were not 4 transmission is not 4 transmission is possible 3 % had heart 3 % had other 3 % had pulmonary 3 % were aged 3 % were immunocompromised 3 covid-19 are not 3 covid-19 is primarily 3 hospital did not 3 masks were available 3 pandemic has also 3 pandemic is highly 3 pandemic was almost 3 patient was not 3 patients are likely 3 patients had not 3 patients requiring surgical 3 ppe are also 3 ppe do not 3 ppe includes n95 Top 50 negative assertions; "What sentences are in the shape of noun-verb-no|not-noun?" --------------------------------------------------------------------------------------- 5 room is not available 3 % had no comorbidities 3 ppe was not available 3 respirators are not available 3 respirators were not available 2 covid-19 is no longer 2 masks are not available 2 masks are not fit 2 patients did not consistently 2 procedures is not just 2 respirator is not available 2 study showed no significant 2 workers did not routinely 1 % had no training 1 % provided no operating 1 % wore no personal 1 care was not uniform 1 cases show no symptoms 1 cases was not necessarily 1 cases were not time 1 control is not possible 1 controls are not feasible 1 controls include not only 1 covid-19 are not adequate 1 covid-19 are not exhaustive 1 covid-19 are not fully 1 covid-19 had no symptoms 1 covid-19 is not already 1 covid-19 is not just 1 covid-19 is not transmissible 1 covid-19 were not more 1 disease includes not only 1 equipment is not available 1 hospitals have not yet 1 hospitals showed no difference 1 infection are not seriously 1 infection is no longer 1 infection is not effective 1 infection is not high 1 mask is not necessarily 1 masks are not adequate 1 masks are not appropriate 1 masks are not custom 1 masks are not inferior 1 masks are not protective 1 masks is not readily 1 masks provide no additional 1 masks were not fluid 1 pandemic are not surprising 1 pandemic is not completely A rudimentary bibliography -------------------------- id = cord-309751-7elnvjk3 author = Abdelnasser, Mohammad Kamal title = COVID-19. An update for orthopedic surgeons date = 2020-07-01 keywords = PPE; covid-19; pandemic; patient; surgical summary = The resultant information was organized under 5 main headings; the impact of pandemic on the orthopedic practice, COVID-19 and the trauma patient, elective and emergency surgeries during the pandemic, peri-operative management of the patient with COVID-19, Miscellaneous effects of the pandemic such as those on training programs and the evolution of telemedicine. Relevant information was digested and organized under 5 main headings; the impact of COVID-19 pandemic on the orthopedic practice, COVID-19 and the trauma patient, elective and emergency surgeries during the pandemic, perioperative management of the patient with COVID-19, Miscellaneous effects of the pandemic such as those on training programs and the evolution of telemedicine. Guidelines for ambulatory surgery centers for the care of surgically necessary/time-sensitive orthopaedic cases during the COVID-19 pandemic Perioperative considerations in urgent surgical care of suspected and confirmed COVID-19 orthopedic patients: Operating rooms protocols and recommendations in the current COVID-19 pandemic doi = 10.1051/sicotj/2020022 id = cord-355827-e38itktq author = Adisesh, Anil title = COVID-19 in Canada and the use of Personal Protective Equipment date = 2020-05-18 keywords = Canada; PPE summary = It lists specific micro-organisms including the virus responsible for SARS, severe acute respiratory syndrome coronavirus (SARS-CoV), for which contact and droplet precautions are advised, except during aerosol-generating medical procedures, when airborne precautions are to be instituted. The routine practices and additional precautions lay out in some detail the PPE to be used together with descriptions of the different types of medical grade gloves, masks and respirators, and eye protection. It is noteworthy that if this approach were followed for exposure to SARS-CoV-2, a biosafety Risk Group 3 organism [7], the choice of respiratory protection for any patient encounter for suspected or known COVID-19 disease would be at least a filtering face-piece respirator. Canada usually tends to align closely with US practices, but it is notable that the guidance from the US Centers for Disease Control and Prevention (CDC) is different in recommending an N95 respirator in all situations for a patient suspected or known to have COVID-19 [9] . doi = 10.1093/occmed/kqaa094 id = cord-307697-ds4uw7y1 author = Ahmed, Jawad title = Availability of Personal Protective Equipment (PPE) Among US and Pakistani Doctors in COVID-19 Pandemic date = 2020-06-10 keywords = PPE; Pakistan; doctor summary = Whereas, doctors in Pakistan reported to have poor availability of PPE with only 37.4% having access to masks/N95 respirator, 34.5% to gloves, 13.8% to face-shields or goggles, and 12.9% to full-suit/gown. Whereas, doctors in Pakistan reported to have poor availability of PPE with only 37.4% having access to masks/N95 respirator, 34.5% to gloves, 13.8% to face-shields or goggles, and 12.9% to full-suit/gown. In contrast, doctors in Pakistan reported to have poor availability of PPE with only 37.4% (n = 130) having access to masks/N95 respirator, 34.5% (n = 120) to gloves, 13.8% (n = 48) to face-shields or goggles, and 12.9% (n = 44) to full-suit/gown. In our study, 73% of doctors from Pakistan and 58.4% from the US reported that HCWs in their hospitals had been infected with COVID-19. To conclude, there is a shortage of PPE in hospitals of the US and Pakistan due to COVID-19 and doctors are feeling scared working without adequate protection in the pandemic situation. doi = 10.7759/cureus.8550 id = cord-311401-7ugqjg5c author = Alser, O. title = Healthcare workers preparedness for COVID-19 pandemic in the occupied Palestinian territory: a cross-sectional survey date = 2020-05-13 keywords = COVID-19; PPE summary = Sufficient training of healthcare workers (HCWs) in how to manage COVID-19 and the provision of personal protective equipment (PPE) to enable them to do so will be key tools in allowing oPt to mount a credible response to the crisis. (4) Other LMICs in the Middle East and Africa have also reported scarcity of personal protective equipment (PPE) for front line healthcare workers (HCWs).(5, 6) We hypothesize that (HCWs) in the oPt are largely underprepared to address COVID-19 related needs of the Palestinian population in both the West Bank and Gaza Strip. The secondary outcome was to assess the differences between Gaza Strip and West Bank, and between governmental and non-governmental in oPt in terms of availability of PPE and HCWs preparedness to face the COVID-19 pandemic. doi = 10.1101/2020.05.09.20096099 id = cord-355431-efwuy8p9 author = Ambrosio, Luca title = The role of the orthopaedic surgeon in the COVID-19 era: cautions and perspectives date = 2020-05-27 keywords = COVID-19; Orthopaedic; PPE; patient; surgical summary = Due to the higher protective potential, the WHO recommends that all healthcare workers should wear a respirator (≥FFP2/N95) when performing AGPs. In all other situations, wearing a surgical mask is reasonably safe when providing direct care to COVID-19 patients, especially in case of respirator scarcity [51, 58] . (1) Patient and provider safety: interpersonal distancing is required together with proper use of PPE and patient contact restricted to the minimum needed; (2) Provision of necessary care: orthopaedic residents must continue to participate in the diagnosis and treatment of musculoskeletal disorders; (3) System sustainability: resident workforce should be disposed to obtain the maximum output with minimum effort in respect of resource availability and institutional necessities; (4) System flexibility: the strategy should be tailored to the evolving pandemic and able to adapt to future unpredictable changes; (5) Preservation of command and control: hospital overload, redeployment in COVID-19 departments and disruption of the daily routine are posing a significant stress for residents and trainees. doi = 10.1186/s40634-020-00255-5 id = cord-297704-70nbsrl4 author = Ananda-Rajah, M. title = Hearing the voices of Australian healthcare workers during the COVID-19 pandemic date = 2020-09-27 keywords = PPE; September; VIC summary = doi = 10.1101/2020.09.25.20197061 id = cord-016223-nk8xwa0t author = Andersen, Bjørg Marit title = Strict Isolation date = 2018-09-25 keywords = PPE; infection; isolation summary = The unit should be located in a separate ward, preferably in a separate building with direct access via an external sluice and internal access through a negative air pressure sluice with sufficient areal for donning and doffing and for a safe treatment of infectious equipment and waste. Technical staff, handling medical equipment, including collection tanks and autoclaves, shall be specially trained in infection control and must be able to use a sluice function with the use of PPE, when entering these disinfection areas. • Out sluicing needs plenty of space for washbasin and suitable hand disinfectant, for doffing (undressing) and for the use of at least three waste bags (disposal, textiles and reusable equipment). Option if not autoclave/decontaminator in the isolation unit: Infectious waste bag is treated exterior with 5% chloramine and double packed in new yellow thick plastic bag in the sluice. doi = 10.1007/978-3-319-99921-0_19 id = cord-270348-5804ffwx author = Angelino, Andrew F. title = Design and implementation of a regional inpatient psychiatry unit for asymptomatic SARS-CoV-2 positive patients. date = 2020-07-02 keywords = PPE; SARS; patient; unit summary = To prevent COVID-19 outbreaks in our units, we next decided to require universal nasal swab testing for SARS-CoV-2 for all medically asymptomatic patients being admitted to psychiatric units 3 . Second, we realized that we needed to decide where to care for SARS-CoV-2 positive, medically asymptomatic patients with mental illnesses who required hospitalization-those without symptoms of COVID-19. In light of the above, we concluded it would best serve our patients if we developed an inpatient psychiatric unit capable of accepting SARS-CoV-2 infected patients without COVID-19 symptoms, or with mild enough symptoms that they would not require medical hospitalization. Further, it is highly beneficial for continuity of care if the patient requires transfer to a medical COVID-19 unit that the psychiatrist be able to follow them there and maintain the psychiatric treatments as indicated. doi = 10.1016/j.psym.2020.06.018 id = cord-205941-npp6566r author = Armani, Andrea M title = Low-tech solutions for the COVID19 supply chain crisis date = 2020-04-27 keywords = Maker; PPE summary = A global effort is ongoing in the scientific community and in the Maker Movement, which focuses on creating devices and tinkering with them, to reverse engineer commercial medical equipment and get it to healthcare workers. [H1] The manufacturing ecosystem Innovative Makers and hobbyists are stepping in to fill the gaps in the PPE supply chain resulting from the COVID-19 public health emergency, and the U.S. Food and Drug Administration (FDA) has issued emergency use authorizations (https://www.fda.gov/medicaldevices/emergency-situations-medical-devices/emergency-use-authorizations#covid19ppe) to waive requirements for labeling and good manufacturing practices. Although the emergency use authorizations issued by the FDA for face shields (https://www.fda.gov/media/136842/download) and for systems developed by industry, such as the Battelle Decontamination System (https://www.fda.gov/media/136529/download), which can disinfect thousands of masks at a time using a vapor-phase hydrogen peroxide, are only effective for the duration of the COVID-19 crisis, this does not diminish the important role of the community as a stopgap in this time of need. doi = nan id = cord-273748-xy4f5kon author = Armijo, Priscila R. title = 3D Printing of Face Shields to Meet the Immediate Need for PPE in an Anesthesiology Department during the COVID-19 Pandemic date = 2020-08-04 keywords = PPE; face; shield summary = To overcome this challenge, stringent policies and appropriate use of PPE, such as face shields, safety glasses, and N95 masks, are indicated for providers performing aerosol-generating procedures [7] . In response to the COVID-19 Pandemic, The University of Nebraska Medical Center (UNMC), Department of Anesthesiology, mandated that anesthesia providers use face shields during patient care to extend the life of N95 masks and adequately protect providers from infection with SARS-CoV-2. Given this information, we developed a decontamination protocol that utilized a dilute bleach solution that would allow penetration into any of the pores that are generated in the 3D printing process and permit the reuse of the face shields. After careful consideration, we chose to use a Prusa i3 MK3S model printer for our 3D face shield printing needs. As a positive control, organism suspensions were inoculated to each face shield part, allowed to dry, and swabbed without decontamination. doi = 10.1016/j.ajic.2020.07.037 id = cord-031378-iy67xnec author = Atif, Iqra title = The Role of Digital Technologies that Could Be Applied for Prescreening in the Mining Industry During the COVID-19 Pandemic date = 2020-09-03 keywords = COVID-19; Fig; PPE; mining summary = Potential digital technologies that could be applied to tackle various problems related to COVID-19 pandemic are artificial intelligence (AI), data analytics, Internet of medical things (IoMT), smart biosensors and sanitizing equipment. Smart bio-sensor-based face shields can also be used in the mining industry, not only for protection purposes, but also as display screens to highlight any critical information related to the miner''s health and safety. Smart boots is another digital technology that can be useful to prevent infectious viruses like COVID-19 by providing the worker contact tracing and ensure social distancing (Fig. 8) . The National Academies of Sciences, Engineering and Medicine reported that ultraviolet (UV) light-based walkthrough gates possibly could eradicate the coronavirus that contains the deadly Fig. 9 IoT-Q-Band system for real-time monitoring of the health condition of individual and ensure social distancing to prevent the spread of COVID-19 virus, source: Singh et al. doi = 10.1007/s41403-020-00164-0 id = cord-299346-f13xly6q author = Awad, Mohamed E. title = Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed Coronavirus Disease 2019 Orthopaedic Patients: Operating Room Protocols and Recommendations in the Current Coronavirus Disease 2019 Pandemic date = 2020-04-10 keywords = PPE; SARS; covid-19; patient summary = title: Perioperative Considerations in Urgent Surgical Care of Suspected and Confirmed Coronavirus Disease 2019 Orthopaedic Patients: Operating Room Protocols and Recommendations in the Current Coronavirus Disease 2019 Pandemic To reduce the occupational risk in treating suspected or confirmed COVID-19 urgent orthopaedic patients, recommended precautions and preventive actions (triage area, ED consultation room, induction room, operating room, and recovery room) are reviewed. HCPs in high-risk areas should adhere to infection prevention and control practices, which includes the appropriate use of engineering controls (negative pressure rooms), administrative controls, and personal protective equipment (PPE) ( 6 Per CDC recommendations, a clinically suspected/ confirmed COVID-19 patient should wear a cloth face covering, over nose, and mouth and a surgical mask should be reserved for HCP and first responders. It is recommended for an environmental services worker to increase the Flowchart demonstrating the the recommended use of personal protective equipment for different activities at various settings managing suspected/clinically Coronavirus disease 2019 patients. doi = 10.5435/jaaos-d-20-00227 id = cord-302463-uw7xantz author = AĞALAR, Canan title = Protective measures for COVID-19 for healthcare providers and laboratory personnel date = 2020-04-21 keywords = COVID-19; HCP; PPE summary = During the care of these patients, HCP should wear their personal protective equipment (PPE) in accordance with the procedure and should not neglect hand hygiene. The novel coronavirus (COVID-19) carries a high risk for society and healthcare providers (HCP) because it can be transmitted even when the disease progresses asymptomatically in some patients [1] . European Centre of Diseases and Prevention Control (ECDC) states that if there is a shortage of FFP2/FFP3, if the HCP will be in contact with a diagnosed or suspected COVID-19 case, if there is no risk of aerosol transmission, surgical masks (alongside eye protection, gown, and gloves) can be used. However, ECDC states that if the HCP will be performing procedures like sample collecting that will generate aerosol, they should use FFP2/FFP3 masks that provide high-level protection [7] . Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings doi = 10.3906/sag-2004-132 id = cord-348038-9v16k6gi author = Bagnasco, Annamaria title = COVID 19—A message from Italy to the global nursing community date = 2020-05-08 keywords = Italy; PPE summary = With the global pandemic now accelerating in areas of the world yet to see Italian levels of infection, it is vital that PPE equipment is procured and delivered to the COVID-19 front-line critical care environments. Learn also from Italian nurses'' experiences of the harm long-term use of PPE: facial lesions and sores produced by the pressure and sweat caused by masks and goggles worn far beyond the usual time frame in normal clinical practice. To healthcare providers and policy makers in areas at the start of their COVID-19 epidemic, our message is to plan for the replacement of staff in critical care areasthink about how this will be done, how they can be prepared and how you plan to recall recently retired nurses back to the hospitals. One last but very important lesson from the epidemic is the need to plan for the possibility of caring for patients in their own homes. doi = 10.1111/jan.14407 id = cord-318348-7ns7r2g7 author = Bandaru, S V title = The effects of N95 mask and face shield on speech perception among healthcare workers in the coronavirus disease 2019 pandemic scenario date = 2020-09-28 keywords = PPE; speech summary = This study aimed to assess the effect of using an N95 mask and face shield on speech perception among healthcare workers with normal hearing. Speech reception threshold and speech discrimination score were obtained, first without using personal protective equipment and then repeated with the audiologist wearing an N95 mask and face shield. Our aim was to quantitatively assess the effect of using an N95 mask and face shield on speech understanding among healthcare workers with normal hearing by determining its effect on speech reception thresholds and speech discrimination scores. • N95 masks and face shields are being used to protect from aerosol-related spread of infection • However, this personal protective equipment (PPE) hampers communication • This study found a significant increase in speech reception threshold (mean of 12.4 dB) with PPE use • The speech discrimination score worsened by 7 per cent with PPE (vs without PPE) when stimuli were presented at the same level doi = 10.1017/s0022215120002108 id = cord-286977-330p60oh author = Barcala-Furelos, Roberto title = Plastic blanket drowning kit: A protection barrier to immediate resuscitation at the beach in the Covid-19 era. A pilot study. date = 2020-09-16 keywords = HEPA; PPE summary = title: Plastic blanket drowning kit: A protection barrier to immediate resuscitation at the beach in the Covid-19 era. OBJECTIVE: Introducing a new, simple and inexpensive portable equipment for lifeguards, consisting of a pre-assembled full-size plastic blanket with a mask and HEPA filter, which could offer significant time-saving advantages to reduce COVID-19 risk transmission in the first few minutes of CPR after water rescue, avoiding the negative impact of delayed ventilation. METHOD: A pilot study was carried out to determine the feasibility of the pre-assembled kit of face-mask and HEPA filter adapted on a pre-set plastic-blanket. The PPE kit consists of a pre-assembled full-size transparent plastic blanket with an adaptation to a ventilation face mask with a High Efficiency Particulate Air (HEPA) filter. Plastic blanket drowning kit: a protection barrier to immediate resuscitation at the beach in the Covid-19 era. doi = 10.1016/j.ajem.2020.08.101 id = cord-284484-oak1lfmi author = Barratt, Ruth title = Enablers of, and barriers to, optimal glove and mask use for routine care in the emergency department: an ethnographic study of Australian clinicians date = 2019-12-04 keywords = IPC; PPE; mask summary = doi = 10.1016/j.auec.2019.10.002 id = cord-311795-kvv3fx2n author = Barratt, Ruth title = Clinician perceptions of respiratory infection risk; a rationale for research into mask use in routine practice date = 2019-08-31 keywords = PPE; disease; mask; protective summary = An important area of infection prevention and control (IPC) is the optimal use of personal protective equipment (PPE) by healthcare workers (HCWs), including masks for protection against respiratory pathogens. An important area of infection prevention and control (IPC) is the optimal use of personal protective equipment (PPE) by healthcare workers (HCWs), including masks for protection against respiratory pathogens. Respiratory infectious diseases are transmitted via contact, droplet and/or airborne modes, necessitating healthcare worker (HCW) use of surgical masks or respirators and other personal protective equipment (PPE) together with appropriate hand hygiene. During periods of high-risk for respiratory infectious disease, such as the annual influenza season or a novel influenza pandemic, health departments have, and may, encourage or mandate the use of a protective respiratory mask by the general public to minimise the transmission from symptomatic people to others [49] . doi = 10.1016/j.idh.2019.01.003 id = cord-264479-s20oacr9 author = Bern-Klug, Mercedes title = COVID-19 Highlights the Need for Trained Social Workers in Nursing Homes date = 2020-05-25 keywords = PPE; social summary = This editorial provides examples of how nursing home social workers are adapting the way they connect with residents and families during the pandemic and concludes with suggestions. In nursing homes experiencing PPE shortages, the lack of equipment means activities and social services staff cannot safely enter resident rooms. While a core function of the social work role has always been to anticipate, assess and address resident psychosocial needs, social workers have also been key liaisons between the family and the facility. In nursing homes with multiple COVID deaths, social workers leave work with a pit in their stomach from the phone conversations with family members to discuss what to do with the decedent''s body and their belongings. Including degreed and licensed social workers as part of the core team is a basic way to provide psychosocial care in nursing homes and enhance resident quality of life. doi = 10.1016/j.jamda.2020.05.049 id = cord-299592-ymurfkbs author = Bhattacharya, Sudip title = Addressing the shortage of personal protective equipment during the COVID-19 pandemic in India-A public health perspective date = 2020-04-15 keywords = India; PPE summary = title: Addressing the shortage of personal protective equipment during the COVID-19 pandemic in India-A public health perspective Nonetheless, it is only possible to address COVID-19 if we can flatten the epidemic curve by classical intervention measures like lockdown and social distancing processes, which may give lead time to many health care systems to arrange further management of the outbreak. When health care systems become stressed and enter the contingency mode, CDC recommends conserving resources by selectively cancelling nonemergency procedures, cancelling outpatient encounters which might require face masks/PPEs. When face masks are unavailable, the CDC recommends use of face shields without masks, taking clinicians at high risk for COVID-19 complications out of clinical service, staffing services with convalescent HCWs presumably immune to SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), and use of homemade/handmade masks, perhaps from bandanas or scarves if necessary [2] . doi = 10.3934/publichealth.2020019 id = cord-277350-zwu254n6 author = Bianco, F. title = Preventing transmission among operating room staff during COVID-19 pandemic: the role of the Aerosol Box and other personal protective equipment date = 2020-05-24 keywords = COVID-19; PPE summary = title: Preventing transmission among operating room staff during COVID-19 pandemic: the role of the Aerosol Box and other personal protective equipment During aerosol-generating medical procedures (AGMP; e.g. intubating and extubating patients or any surgical procedures), the production of both airborne particles and droplets may increase the risk of infection. During aerosol-generating medical procedures (AGMP), the production of both airborne particles and droplets may increase the risk of infection. The World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) defined a list of AGMP, during which the use of personal protective equipment (PPE) should be recommended for all involved theater staff [4, 5] . We report a retrospective case series of six COVID-19 positive male patients undergoing emergent surgical treatment for gastrointestinal complications. Considering the high risk of disease transmission during AGMP, we support the use of both PPE and AB to protect surgical staff during the current COVID-19 outbreak. doi = 10.1007/s13304-020-00818-2 id = cord-318944-13zk6cco author = Bizzoca, Maria Eleonora title = Covid-19 Pandemic: What Changes for Dentists and Oral Medicine Experts? A Narrative Review and Novel Approaches to Infection Containment date = 2020-05-27 keywords = COVID-19; PPE; SARS; dental; infection; patient; procedure summary = The authors performed a narrative review on Severe Acute Respiratory SyndromeCoronaVirus-2 ( SARS-CoV-2) and all infectious agents with the primary endpoints to illustrate the most accepted models of safety protocols in dentistry and oral medicine, and to propose an easy view of the problem and a comparison (prevs post-COVID19) for the most common dental procedures. After a brief excursus on all infectious agents transmittable at the dental chair, the authors described all the personal protective equipment (PPE) actually on the market and their indications, and on the basis of the literature, they compared (before and after COVID-19 onset) the correct safety procedures for each dental practice studied, underlining the danger of underestimating, in general, dental cross-infections. The precautions for infection control require wearing gloves, aprons, as well as eye and mouth protection (goggles and mask, such as medical masks and Filtering Face Piece or FPP) for each procedure involving direct contact with the patient body fluids. doi = 10.3390/ijerph17113793 id = cord-258504-pnd46ipd author = Bleasdale, Susan C. title = Experience of Chicagoland acute care hospitals in preparing for Ebola virus disease, 2014–2015 date = 2019-07-08 keywords = EVD; Ebola; HCP; PPE summary = During the 2014–2015 Ebola Virus Disease (EVD) outbreak, hospitals in the United States selected personal protective equipment (PPE) and trained healthcare personnel (HCP) in anticipation of receiving EVD patients. Semistructured interviews were conducted with HCP involved with decision-making during EVD preparations at acute care hospitals in the Chicago, IL area to gather information about the PPE selection and training process. For example, an interviewed trainer from a hospital where HCP "wanted to be encased [in PPE] like a mummy" noted that preferences "started to change after like the 4th or 5th simulation where people were like, ''[M]an, [I] can''t work like this.''" When asked to identify the three training modalities that had the greatest positive impact on their confidence to care for an Ebola patient, surveyed trainees most frequently identified: hands-on activities in group (n ¼ 39) or individual settings (n ¼ 28), trained observers (n ¼ 21), instructional videos (n ¼ 11), training in a simulated care area with (n ¼ 10) or without task trainers (n ¼ 8), and using markers for evaluation of self-contamination during PPE doffing (n ¼ 8) ( Table 2 ). doi = 10.1080/15459624.2019.1628966 id = cord-345806-3ghtpji4 author = Boelig, Rupsa C. title = Obstetric Protocols in the Setting of a Pandemic date = 2020-07-24 keywords = PPE; delivery; labor summary = The purpose of this article is to review key areas that should be considered and modified in our obstetric protocols, specifically: 1) Patient triage, 2) Labor and delivery unit policies, 3) Special considerations for personal protective equipment (PPE) needs in obstetrics, 4) Intrapartum management, and 5) Postpartum care The purpose of this article is to review key areas that should be considered and modified in our obstetric protocols, specifically: 1) Patient triage, 2) Labor and delivery unit policies, 3) Special considerations for personal protective equipment (PPE) needs in obstetrics, 4) Intrapartum management, and 5) Postpartum care If patients cannot be appropriately isolated on labor and delivery unit, there need to be contingency plans for isolation off of the unit while still providing maternal and fetal monitoring and care. Labor unit leaders should work closely with hospital administration, nursing, anesthesia, neonatalogy/pediatrics, infectious disease, and critical care medicine to best address the unique needs and challenges of labor and delivery in the setting of particular pathogens. doi = 10.1016/j.semperi.2020.151295 id = cord-316327-0hpthrjo author = Brar, Branden title = A Survey Assessing the Early Effects of COVID-19 Pandemic on Oral & Maxillofacial Surgery Training Programs date = 2020-08-18 keywords = COVID-19; PPE; omfs; program summary = The coronavirus disease 2019 (COVID-19) pandemic has specific implications for oral and maxillofacial surgeons due to an increased risk of exposure to the virus during surgical procedures of the aero-digestive tract. CMS also increased access to Medicare telehealth services for its beneficiaries under the Coronavirus Preparedness and Response Supplemental Appropriations Act. This rapid turn of events led to some urgent modifications to clinical care including surgery, by US health care providers in all specialties, to accommodate the critical shortages of hospital resources as the pandemic was evolving. This evoked the need to survey OMFS training programs and to start a discussion regarding some of the changes in emergency triage, urgent surgical procedures, and use of PPE to protect health care personnel. [16] The aim of this survey was to assess the impact of COVID -19 on Oral and Maxillofacial Surgery (OMFS) training programs in the different regions of USA during the early phase of this pandemic between March 6 th to May 6 th 2020. doi = 10.1016/j.oooo.2020.08.012 id = cord-319232-qowtuhh6 author = Brazil, Victoria title = Translational simulation for rapid transformation of health services, using the example of the COVID-19 pandemic preparation date = 2020-06-03 keywords = PPE; covid-19; simulation summary = We describe our strategy development and context, simulation delivery activities and outcomes and offer principles and practical suggestions for how simulation can directly and rapidly respond to urgent need for health service transformation. Turning the promise of simulation into reality for COVID-19 preparation requires a translational approacha simulation program that is attuned to emerging priorities, has strong relationships with clinicians and service leadership and with the skills and capacity to apply (or develop) simulation strategies to address those issues. The program includes educationally focused simulation but extends to ''in situ'' simulation in clinical areas designed for translational impact-diagnosing and addressing important process and teamwork issues in patient care. Our experience with using simulation for COVID-19 pandemic preparation has sharped reflection on the role of simulation in health service performance and change management, albeit in a unique and urgent context. doi = 10.1186/s41077-020-00127-z id = cord-272726-ljjirt4g author = Brethauer, Stacy A. title = Redesigning a Department of Surgery during the COVID-19 Pandemic date = 2020-04-28 keywords = COVID-19; PPE; faculty summary = The department of surgery played a leading role in establishing clinical protocols, guidelines, and policies in preparation for a surge of COVID-19 patients. Within the department of surgery, these challenges required leadership to form new workgroups and reporting structures, establish clear communication strategies, redefine clinical activities for the faculty, and modify the workloads of trainees. For services still performing some essential operations (e.g., advanced cancer, emergent cardiac, trauma, or acute care surgery), every effort was made to minimize the number of faculty coming to work with coverage provided by those who were coming in for operative cases or on call. This "second surge" of elective cases will present its own set of logistic challenges and requires early planning to facilitate care of surgical patients once the COVID-19 surge has passed. doi = 10.1007/s11605-020-04608-4 id = cord-301582-922zyhti author = Bury, Gerard title = COVID-19 community assessment hubs in Ireland—the experience of clinicians date = 2020-09-26 keywords = PPE; hub summary = A half-day training course-''Clinical PPE training''-was developed by the departments, with significant input from the National Ambulance Service (NAS) staff with experience and expertise in the use of personal protective equipment (PPE) from the already established COVID-19 testing sites. The timing of hub availability-and therefore, potential exposure of clinicians to risk-is also considered by comparing Department of Health national data on daily case occurrence with ''real-time'' COVID-19-related emergency calls to Dublin Fire Brigade Ambulance Service. More than 500 GPs and GP registrars came forward to complete relevant clinical training in order to work in hubs, during April 2020-this represents around 15% of the general practice population. No data exists on the total number of clinicians who worked in hubs but the 170 GPs and GP registrars who responded to this study are likely to be a significant proportion of the doctors who carried out shifts and may therefore provide useful insights into this novel clinical setting. doi = 10.1007/s11845-020-02381-6 id = cord-270156-qrzjgzyk author = Cafferkey, J. J. title = Using HoloLens™ to reduce staff exposure to aerosol generating procedures during a global pandemic date = 2020-05-26 keywords = PPE; preprint summary = OBJECTIVES: In a tertiary centre in London we aim to implement HoloLens technology, allowing other medical staff to remotely join the consulting clinician when in a high-risk patient area delivering oxygen therapy. MAIN RESULTS: Mean self-reported time in the high-risk zone was less when using HoloLens (2.69 hours) compared to usual practice (3.96 hours) although this difference was not statistically significant (p = 0.3657). In the CPAP unit of a UK teaching hospital we implemented HoloLens2™ as a pragmatic technology-led improvement project to facilitate remote care during the COVID-19 pandemic in a "Red zone" where NIV/CPAP/HFNO is delivered. . https://doi.org/10.1101/2020.05.24.20107193 doi: medRxiv preprint deployment practice was two or more staff donning personal protective equipment (PPE) for ward rounds and to review deteriorating patients. Evaluation of the intervention saw ward staff (doctors, nurses and allied health professionals) completing self-report questionnaires comparing pre-and post-HoloLens2™ deployment. . https://doi.org/10.1101/2020.05.24.20107193 doi: medRxiv preprint usual practice and 240 hours of HoloLens2™ use. doi = 10.1101/2020.05.24.20107193 id = cord-330666-puhijixa author = Carrico, Ruth M. title = Changing health care worker behavior in relation to respiratory disease transmission with a novel training approach that uses biosimulation date = 2007-02-02 keywords = PPE; patient; training summary = BACKGROUND: This pilot study was conducted to determine whether supplementing standard classroom training methods regarding respiratory disease transmission with a visual demonstration could improve the use of personal protective equipment among emergency department nurses. CONCLUSION: Supplementing the standard training methods with a visual demonstration can improve the use of personal protective equipment during care of patients exhibiting respiratory symptoms. We used pre-/posttest knowledge assessments and observations of HCW-patient interactions to evaluate the impact of the visual demonstration of respiratory disease transmission on PPE use by HCWs. The study was conducted during the peak of the 2005 influenza season (January to March) to ensure that the HCWs could be observed interacting with the greatest number of patients with respiratory symptoms. Observers with experience in the education and training of health care personnel were trained to recognize and evaluate the use of PPE by study participants during real patient interaction. doi = 10.1016/j.ajic.2005.12.013 id = cord-279396-qmixem8i author = Carter, Chris title = COVID-19 Disease: a critical care perspective date = 2020-06-01 keywords = COVID-19; PPE; care; patient summary = In addition to the relatively high numbers of COVID-19 patients developing severe respiratory failure resulting in acute respiratory distress syndrome (ARDS) and requiring intubation and ventilatory support, the current data suggests an average length of stay for COVID patients in intensive care of eight days. The critical care nurse needs to recognise that patients who develop severe COVID-19 can rapidly develop Type 1 Respiratory Failure, ARDS and therefore require ventilatory support. 18 In non COVID-19 patients with increasing respiratory failure the use of High Flow Nasal Oxygen (HFNO) or Non-Invasive Ventilation (NIV) such as Continuous Positive Airway Pressure (CPAP) may be used as a treatment strategy. 40 There is also a suggestion that an increased number of healthcare professionals is needed when providing care, particularly in critical care for procedures requiring two nurses to one patient (2:1) when PPE is worn. doi = 10.1016/j.intcar.2020.100003 id = cord-333509-dnuakd6h author = Chan, Hui Yun title = Hospitals’ Liabilities in Times of Pandemic: Recalibrating the Legal Obligation to Provide Personal Protective Equipment to Healthcare Workers date = 2020-10-17 keywords = Health; NHS; PPE; healthcare; hospital; worker summary = Recent developments have witnessed strong responses from the public and healthcare workers, ranging from pursuing legal actions against the government or their employers (hospitals) for breaching their obligations of care towards employees to calling for a full public inquiry into pandemic management, including the status of the PPE stockpile. PPE under the Regulations means "all equip-ment…intended to be worn or held by a person at work and which protects the person against one or more risks to that person''s health or safety, and any addition or accessory designed to meet that objective." 29 Consequently, PPE in the hospital context is broad enough to include all equipment that protect healthcare workers from infectious particles arising from aerosol generating procedures, ventilators, respirators or testing facilities with high concentrations of droplets or airborne diseases. Imposing the duty to provide PPE is therefore central in ensuring healthcare workers are protected from the risks of infection and to realise the aim of delivering patient-centred care to the public. doi = 10.1007/s10991-020-09270-z id = cord-285804-lyj9tua8 author = Chen, Yu-Ju title = Stockpile Model of Personal Protective Equipment in Taiwan date = 2017-04-01 keywords = PPE; Taiwan summary = In addition, a joint electronic procurement platform has been established for merchandising the replaced PPE to local health authorities and medical and other institutions for their routine or epidemic use. Based on the act, the central government, local health authorities, and medical institutions are required to maintain a minimum stockpile of PPE (including surgical masks, N95 respirators, and coveralls) to ensure a sufficient supply for epidemic prevention and frontline healthcare personnel during the early phase of an epidemic. After the SARS epidemic, the Taiwan CDC proposed ''''A Strategy Plan for PPE Minimum Stockpile'''' and established the 3-tier stockpiling framework-a central health authority (managed by the Taiwan CDC), local health authorities, and medical institutions-to effectively respond to emergent demands and spread the risk of stockpiling. In addition, to ensure the surge capacity during epidemic periods, the contractors must guarantee to provide 5 million surgical masks, 100,000 N95 respirators, and 15,000 coveralls within 14 days in response to an emergency request from the Taiwan CDC. doi = 10.1089/hs.2016.0103 id = cord-276265-gjqqfudb author = Chiang, James title = Elastomeric respirators are safer and more sustainable alternatives to disposable N95 masks during the coronavirus outbreak date = 2020-07-20 keywords = N95; PPE summary = Since the coronavirus (2019-nCoV) or coronavirus disease (COVID-19) outbreak, shortage of personal protective equipment (PPE) has become a significant issue in numerous countries worldwide [1] , with an estimate of 89 million masks required monthly due to increased demand within and outside healthcare settings [2] . Some of these recommendations include using N95 masks for extended durations, using one mask for several different patients, reserving disposable N95 masks for aerosol generating procedures, and using reusable elastomeric respirators with appropriate filters [3] . Given the persistent shortage of disposable N95 masks, the authors review the safety and practicality of elastomeric respirators as an alternative for protection against the coronavirus COVID-19. Currently, the CDC recommends that health care providers that will be within 3 ft of a suspected or confirmed COVID-19 patient without a mask, or if providers are in the room for an aerosolizing procedure, the provider may voluntarily utilize higher level of protection than N95 masks, such as elastomeric respirators or PAPR. doi = 10.1186/s12245-020-00296-8 id = cord-305503-j5e6fp61 author = Choi, Gordon Y.S. title = Preparedness for COVID-19: in situ simulation to enhance infection control systems in the intensive care unit date = 2020-04-10 keywords = PPE; simulation summary = 5 Within the ICU, potentially aerosol generating procedures such as manual ventilation and tracheal intubation are known to enhance transmission of respiratory viral disease to HCWs, 6 and therefore introducing robust infection control processes as soon as possible is of paramount importance. To examine system and operational issues related to our infection control guidelines, we designed and implemented a high-fidelity in situ clinical simulation to replicate admission, including tracheal intubation, of a patient with suspected or known COVID-19 infection. The main objective of the simulation was to test the ability of the HCW team to effectively implement use of personal protective equipment (PPE), and the practicality of the intubation protocol and preliminary outbreak infection control guidelines. doi = 10.1016/j.bja.2020.04.001 id = cord-035137-uxtaw02u author = Chowdhury, Anis Z. title = Responding to the COVID-19 Pandemic in Developing Countries: Lessons from Selected Countries of the Global South date = 2020-11-10 keywords = COVID-19; Health; Kerala; PPE; Vietnam; country summary = But most national authorities outside of East Asia did not take adequate early precautionary measures speedily enough to contain the spread of the outbreak, typically by promoting safe ''physical distancing'', obligatory use of masks in public areas, and other measures to reduce the spread and likelihood of infection. Government capacity to respond depends crucially on system capacity and capabilities-e.g., authorities'' ability to speedily trace, isolate and treat the infected-and available fiscal resources-e.g., to quickly enhance testing capacity and secure personal protective equipment (PPE). Finally, it draws some implications of different policy responses in East Asia, Southeast Asia-especially Vietnam, and India''s Kerala state-Argentina, Brazil and Peru, that are relevant for other countries. And where communities or clusters had significant infection rates, urgent, targeted measures could have helped ''turn the tide'' on COVID-19 with decisive early actions, as in China, Korea and Vietnam, without imposing nationwide ''stay in shelter'' or ''shelter in place'' lockdowns, 16 or restrictions on movements of people within its borders. doi = 10.1057/s41301-020-00256-y id = cord-267791-v10eh408 author = Chughtai, Abrar Ahmad title = Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review date = 2019-02-07 keywords = PPE; Pakistan; infection summary = doi = 10.1016/j.jiph.2019.01.064 id = cord-305146-iprzeigk author = Chughtai, Abrar Ahmad title = Use of personal protective equipment to protect against respiratory infections in Pakistan: A systematic review date = 2020-03-04 keywords = PPE; Pakistan; infection summary = We conducted a systematic review of studies on PPE use for respiratory infections in healthcare settings in Pakistan. Face masks (or medical masks) and respirators are the most commonly used PPE to protect from influenza and other respiratory infection in healthcare settings. The aim of this study was to examine the use of PPE for respiratory infections in healthcare settings in Pakistan. Studies where PPE was examined for general infection control were also included, given respiratory protective equipment (face masks and/or respirators) was mentioned. Two studies examined the guidelines and current practices on the use of face masks/respirators for influenza, tuberculosis and SARS in Pakistan [21, 22] . Medical masks were generally used to protect from influenza, tuberculosis and other respiratory infections, while the use of respirators was limited to high-risk situations [21, 22] . doi = 10.1016/j.jiph.2020.02.032 id = cord-330737-6khv4kbj author = Cohen, Jennifer title = Contributing factors to personal protective equipment shortages during the COVID-19 pandemic date = 2020-10-02 keywords = Health; PPE; healthcare; supply; worker summary = Problems from a dysfunctional costing model in hospital operating systems were magnified by a very large demand shock triggered by acute need in healthcare and panicked marketplace behavior that depleted domestic PPE inventories. Removing the profit motive for purchasing PPE in hospital costing models and pursuing strategic industrial policy to reduce the US dependence on imported PPE will both help to better protect healthcare workers with adequate supplies of PPE. Since early 2020 the US has experienced a severe shortage of personal protective equipment (PPE) needed by healthcare workers fighting the COVID-19 pandemic (Emanuel et al., 2020; Livingston, Desai, & Berkwits, 2020) . We now turn to our analysis of PPE shortages, which identifies on four contributing factors: the way that hospitals budget for PPE, domestic demand shocks, federal government failures, and disruptions to the global supply chain (Figure 2 ). doi = 10.1016/j.ypmed.2020.106263 id = cord-285960-1zuhilmu author = Conly, John title = Use of medical face masks versus particulate respirators as a component of personal protective equipment for health care workers in the context of the COVID-19 pandemic date = 2020-08-06 keywords = COVID-19; PPE; SARS; transmission summary = The report by the World Health Organization (WHO) Joint Mission on Coronavirus Disease 2019 (COVID-19) in China supports person-to-person droplet and fomite transmission during close unprotected contact with the vast majority of the investigated infection clusters occurring within families, with a household secondary attack rate varying between 3 and 10%, a finding that is not consistent with airborne transmission. Based on the scientific evidence accumulated to date, our view is that SARS-CoV-2 is not spread by the airborne route to any significant extent and the use of particulate respirators offers no advantage over medical masks as a component of personal protective equipment for the routine care of patients with COVID-19 in the health care setting. The findings from multiple systematic reviews and meta analyses over the last decade have not demonstrated any significant difference in the clinical effectiveness of particulate respirators compared to the use of medical masks when used by HCWs in multiple health care settings for the prevention of respiratory virus infections, including influenza [57] [58] [59] . doi = 10.1186/s13756-020-00779-6 id = cord-339517-93nuovsj author = Consolo, Ugo title = Epidemiological Aspects and Psychological Reactions to COVID-19 of Dental Practitioners in the Northern Italy Districts of Modena and Reggio Emilia date = 2020-05-15 keywords = COVID-19; PPE; dental; patient summary = The one-way ANOVA showed a main effect of age group for perceived patient''s likelihood of contracting the infection (F 2,353 -Statistic = 1157, p < 0.001), and reported levels of concern about the professional future ( To the question "During clinical activity, which measures do you use to prevent COVID-19 infection?", dentists replied highlighting a good knowledge of what is reported in the most recent indications from the literature. To the question "Which aids do you think could help dental professionals during COVID-19 pandemic?", for which two preferences could be expressed, the dentists replied indicating "Economic relieves from Italian government" (65.7%), "Social security institutions support and subsidy" (44.1%)," Economic relieves from dental associations" (32.1%) and "Improvement of communication with patients" (8.1%). doi = 10.3390/ijerph17103459 id = cord-356041-tc2cumv2 author = Cotrin, Paula title = Healthcare Workers in Brazil during the COVID-19 Pandemic: A Cross-Sectional Online Survey date = 2020-10-09 keywords = Brazil; PPE; covid-19 summary = This study compared the impact of COVID-19 pandemic among three categories of healthcare workers in Brazil: physicians, nurses, and dentists, about workload, income, protection, training, feelings, behavior, and level of concern and anxiety. The healthcare workers reported a significant impact of COVID-19 pandemic in their income, workload and anxiety, with differences among physicians, nurses and dentists. This way, this study aimed to compare the impact of COVID-19 pandemic in the healthcare workers: physicians, nurses, and dentists, regarding workload, income, PPE, training, behavior, feelings, and level of anxiety. Inclusion criteria were: healthcare workers (physicians, nurses or dentists), above 22 years of age, working in the front line of the pandemic in private and public hospitals, healthcare units and private clinics, but not necessarily with direct contact with COVID-19 infected patients. doi = 10.1177/0046958020963711 id = cord-276945-gly0stxm author = Coxon, Kirstie title = The impact of the Coronavirus (COVID-19) pandemic on maternity care in Europe date = 2020-06-10 keywords = COVID-19; PPE summary = This observation, also seen in other countries which gather and report case ethnicity (Khunti et al., 2020) , has shocked many; the reasons are not fully understood, but it is clear that people with BAME ethnicity, whether they are pregnant women, members of the public, essential workers or health care providers, need to be pro-actively protected from contracting COVID-19. Yet women and midwives remain very much affected; care during pregnancy, birth and the postnatal weeks has changed radically and fast, and basic elements of the midwife-woman relationship such as meeting in person and providing a comforting touch have been upended in an attempt to maintain distance and reduce cross-infection. Commonalities include concerns around supply of PPE, high numbers of healthcare staff affected by the virus, and steps taken to reduce pregnant women''s exposure to health settings by switching to online and telephone consultations where possible. doi = 10.1016/j.midw.2020.102779 id = cord-028595-p7cn71t5 author = Croser, David title = A good fit with indemnity date = 2020-07-06 keywords = PPE summary = Although it is recommended that AGPs should currently be avoided where possible, there will be occasions when such treatments are in the patient''s best interests and the dental team will need to prevent aerosol transmission, using a disposable, fluidrepellent surgical gown (or waterproof long-sleeved protective apron), gloves, eye protection and suitable respiratory protective equipment (RPE) such as an FFP3 respirator (or FFP2 when these are not available). The SOP guidance advises contractors to inform their employers liability (EL) insurer that all staff undertaking aerosol generating procedures are required to be fit tested for appropriate PPE, to ensure their EL insurance cover is sufficient. In addition, dentists should check with their indemnity provider if they are performing the fit testing for their own staff or that of other local dental contractors, again to ensure they have adequate cover. 2 BDA indemnity cover allows policyholders to fit-test respiratory protective equipment (RPE) for dental staff in their own and other practices. doi = 10.1038/s41404-020-0444-2 id = cord-333554-0wlgg450 author = Curzen, Nick title = An Extended Statement by the British Cardiovascular Intervention Society President Regarding the COVID-19 Pandemic date = 2020-04-16 keywords = PPE summary = The presidents of BCS and BCIS have released a joint statement of support and advice to our members, and have contributed to an NHS England statement about recommendations for ongoing cardiology activities. We suggest that clinical leads/senior cath lab staff have discussions across local networks regarding potential cross cover for emergency patients between local centres, in case this becomes necessary. To this end, the NHS England guidance continues to recommend primary PCI for STEMI and angiography with a view to revascularisation for all non-ST-elevation MI (NSTEMI) patients, except perhaps the lowest risk group. However, for BCIS members, it is the optimal PPE for cath lab procedures, especially primary PCI for STEMI, that has raised most anxiety and contention. For other situations the cath lab, when deemed low risk of AGP, can be regarded as an inpatient area or operating theatre with suspected or confirmed COVID-19 cases, and type 1 PPE is recommended for all those with direct patient contact. doi = 10.15420/icr.2020.10 id = cord-253933-29tedkf8 author = David, Abel P. title = Tracheostomy guidelines developed at a large academic medical center during the COVID‐19 pandemic date = 2020-04-27 keywords = COVID-19; PPE; SARS summary = 1 As an aerosol-generating procedure (AGP), tracheostomy is associated with high droplet and particle generation, placing health care providers at increased risk for transmission of respiratory viral infections. Factors relevant to our review included optimal timing of tracheostomy, duration of viral shedding in patients with COVID-19, risk to procedural teams from aerosol generation during tracheostomy, ICU capacity, and availability of PPE. In the context of the current pandemic, Tay et al conducted a literature review of tracheostomies performed during the SARS epidemic and concluded the following: (a) proper PPE (N95 mask, surgical cap, gown, goggles, and gloves) is of utmost importance; (b) surgical tracheostomy is preferably performed in a negative pressure ICU room by experienced providers with meticulous planning and seamless communication; (c) aerosol generation should be minimized through patient paralysis, ventilation hold during creation of tracheal window, and utilization of HEPA-filtered suction systems. doi = 10.1002/hed.26191 id = cord-002885-dhdyxnr3 author = Den Boon, Saskia title = Incorporating health workers’ perspectives into a WHO guideline on personal protective equipment developed during an Ebola virus disease outbreak date = 2018-03-09 keywords = Africa; EVD; PPE; health summary = The objective of this study was to understand frontline physicians'' and nurses'' perspectives about personal protective equipment (PPE) use during the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the development process of a WHO rapid advice guideline. The specific objectives were to understand and describe frontline physician and nurses'' perspectives about PPE use, while providing direct care for EVD patients in the unprecedented conditions of the 2014-2016 EVD outbreak in West Africa and to incorporate these findings into the rapid advice guideline development process. The findings of the survey were presented at the guideline development meeting and incorporated into evidence-to-decision tables (Supplementary File 2) to inform the formulation of recommendations for PPE components in the context of an EVD outbreak. We developed the study protocol, obtained WHO ethics approval, contacted the participants, delivered the survey, analysed the data, and presented the findings as part of the evidence-to-decision tables at the expert panel meeting where the recommendations were formulated in a period of 8 weeks. doi = 10.12688/f1000research.12922.2 id = cord-293055-8scoocvx author = Deressa, W. title = Availability of personal protective equipment and satisfaction of healthcare professionals during COVID-19 pandemic in Ethiopia date = 2020-11-03 keywords = COVID-19; November; PPE; international summary = Bivariate and multivariable logistic regression models were used to assess factors associated with the satisfaction level of healthcare workers with regard to the availability and use of proper PPE during the current COVID-19 pandemic. The independent predictors of the respondents satisfaction level about PPE were male gender (adjusted OR=1.39, 95% CI:1.05-1.85), healthcare workers who reported that PPE was adequately available in the hospital (adjusted OR=7.53, 95% CI:5.08-11.16), and preparedness to provide care to COVID-19 cases (adjusted OR=1.65, 95% CI:1.22-2.12). The purpose of this study was to assess the self-reported availability and use of PPE as well as satisfaction level of HCPs practicing in public hospitals in Addis Ababa during the current COVID-19 pandemic. ; https://doi.org/10.1101/2020.10.30.20223149 doi: medRxiv preprint Table 5 shows the satisfaction level of HCPs with regard to the current availability and use of PPE in the study hospitals, and 54.7% (n=584) and 17.5% (n=187) of the respondents reported that they were unsatisfied or somewhat unsatisfied with the availability of PPE, respectively. doi = 10.1101/2020.10.30.20223149 id = cord-301402-andxwyi3 author = Ding, Benjamin Tze Keong title = Operating in a Pandemic: Lessons and Strategies from an Orthopaedic Unit at the Epicenter of COVID-19 in Singapore date = 2020-05-06 keywords = N95; PPE; covid-19; patient summary = doi = 10.2106/jbjs.20.00568 id = cord-026765-cw4rh1on author = Dingle, M. title = Altered exodontia techniques date = 2020-06-12 keywords = PPE; dental summary = authors: Dingle, M.; Irshad, H.; McKernon, S.; Taylor, K. dosing protocols as accurately as possible (to standardise the dosing), and we anticipate the that the product will be available mid-May, initially in a 5L presentation, primarily for dentists, while a nasal and throat spray will follow in late May primarily for pre-procedural use in the hospital setting. Sir, we write to inform your readers about techniques for non-surgical exodontia we have adapted to at Liverpool University Dental Hospital during the COVID-19 pandemic. As cases in our population grew the dental clinic went on an emergency only protocol and to date we have provided dental care to almost 500 patients and performed approximately over 100 dental emergency procedures. Sir, I would like to share my thoughts and experiences on how COVID-19 has affected me as a year 13 student, applying to university to study dentistry this September. doi = 10.1038/s41415-020-1726-0 id = cord-339614-28s205p8 author = Dover, Jeffrey S. title = A Path to Resume Aesthetic Care: Executive Summary of Project AesCert Guidance Supplement—Practical Considerations for Aesthetic Medicine Professionals Supporting Clinic Preparedness in Response to the SARS-CoV-2 Outbreak date = 2020-05-01 keywords = Guidance; PPE; covid-19; office; patient; procedure; treatment summary = Patient communication-establishing appropriate expectations for office visits and attendant risks; Clinic schedule management-considerations for schedule modification to convert non-treatment interactions to telehealth consultations, separate patients from one another in the office and avoid unnecessary staff contact; Facility management-physical modification of office common areas and treatment rooms, as well as check-in and check-out procedures, to promote safe practices and physical distancing; Cleaning procedures-discussion of disinfection methods and practices in each office area, ranging from medical instruments and treatment rooms to administrative items and reception areas; Personal Protective Equipment (PPE) for providers, staff and patients-recommendations for PPE types and use depending upon procedure-based risk assessment, and recognizing current global equipment shortages; Employee health screening and training-procedures and methods for identifying staff members who may be unwell before, during, and after work, and training of staff to identify potential COVID-19 presentation in coworkers, patients, and other office visitors; risks associated with exposure to known or suspected COVID-19-positive individuals are also discussed; Patient health and screening-procedures and methods for symptom recognition in patients before, during, and after office visits, with follow-up monitoring where appropriate; Remedial measures following onsite symptom presentation-a framework for addressing isolation of symptomatic individuals, office containment and disinfection, and contact tracing; Treatment room setup-preparing and securing treatment rooms for patient entry to contain office contamination and reduce overall potential COVID-19 exposure; and Aesthetic treatment considerations-pretreatment preparation and precautions, and other suggestions for minimizing risk of transmission in performing the most common types of office-based aesthetic procedures, such as neurotoxin and dermal filler injections, noninvasive body contouring, lasers and other similar energy-emitting devices, and a range of medical skin care treatments. doi = 10.1089/fpsam.2020.0239 id = cord-264614-2x7cdul3 author = Díaz-Guio, Diego Andrés title = COVID-19: Biosafety in the Intensive Care Unit date = 2020-08-27 keywords = COVID-19; ICU; PPE; SARS summary = PURPOSE OF REVIEW: COVID-19 is a new, highly transmissible disease to which healthcare workers (HCWs) are exposed, especially in the intensive care unit (ICU). This article aims to show the different strategies to prevent the widespread of the disease to critical care healthcare workers based on the review of the recent literature and the author''s experience with the personal protective equipment (PPE) in the care of patients with COVID-19 and work on human factors in crisis management. Nonetheless, to date, there is no robust evidence that medical masks are inferior to N95/FFP2 respirators for protecting healthcare workers against laboratory-confirmed COVID-19 during patients care and non-AGPs [31] . While personal protective equipment is an essential part of safety to prevent SARS-CoV-2 transmission, it must be employed appropriately, together with frequent hand hygiene, and mastering specific techniques and non-technical skills like awareness, closed-loop communication, leadership, team working, appropriate resource management, and cognitive aids [14, 34] . doi = 10.1007/s40475-020-00208-z id = cord-266905-j9ljwqv0 author = Ecker, Jeffrey L. title = Laboring Alone?: Brief Thoughts on Ethics and Practical Answers During the COVID-19 Pandemic date = 2020-05-15 keywords = PPE; patient; visitor summary = Condensation: To minimize risk of exposure to health care workers, some have proposed eliminating 4 spouses, partners and other visitors to support women during their labor and delivery. In most institutions, however, labor and delivery units have been rare exceptions to the "no-visitor" 23 rules, for visitors there are felt to have, in the words of the New York Department of Health, an 24 "essential" role in process of care, and not having a partner present for the birth of a child seems 25 unimaginable,unkind and, for some, even traumatic. As 100 noted above, the process of labor and delivery requires close quarters, but it is difficult to estimate the 101 true incremental risk that comes with accompanying and supporting a patient, especially if members of 102 the health care team are symptom free and wearing appropriate PPE. doi = 10.1016/j.ajogmf.2020.100141 id = cord-258965-g47n531n author = Ekpenyong, Bernadine title = Assessment of Knowledge, Practice and Guidelines towards the Novel COVID-19 among Eye Care Practitioners in Nigeria–A Survey-Based Study date = 2020-07-16 keywords = COVID-19; Nigeria; PPE; ecp summary = The aim of this study was to explore knowledge, practice of risk and guidelines of the novel corona virus disease (COVID-19) infection among the eye care practitioners and the potential associated factors. ECPs in Nigeria displayed good knowledge about COVID-19 and provided eye care services during the COVID-19 lockdown in Nigeria, despite the majority not receiving any training on the use of PPEs with concerns over attending to patients. The aim of this study was to assess knowledge and practice of COVID-19 exposure risk among ECPs as well as understand their confidence in current Federal Ministry of Health (FMoH) guidelines for identifying possible COVID-19 cases, knowledge of Personal Protective Equipment (PPE) recommendations and training in its usage when managing such cases. The impact of COVID-19 pandemic on practitioners, their family members and practices, including questions on their confidence in the current FMoH guidelines for identifying possible COVID-19 cases, their knowledge of Personal Protective Equipment (PPE) recommendations, and training in its usage during consultation were assessed. doi = 10.3390/ijerph17145141 id = cord-271048-tq1sk01g author = Ellis, R. title = Operating during the COVID-19 pandemic: How to reduce medical error date = 2020-04-13 keywords = COVID-19; PPE summary = Many surgical colleagues are being trained in managing unwell patients suffering with coronavirus on the wards, others have been supporting emergency departments and intensive care units. Despite covering an increasing number of patients admitted with COVID-19, surgeons will still be dealing with emergency surgical admissions and will continue to operate on emergency cases. In light of these new and unfamiliar challenges, there are resources available to help surgeons revise their knowledge of acute medicine and receive updates on COVID-19 via webinars 5, 6 ; critical care websites with up to date guidelines and handbooks (such as the intensive care society: www.ics.ac.uk/ICS/handbooks.aspx); Systemic Training in Acute Illness Recognition and Treatment for Surgery (START) course, that includes a human factors presentation, on the RCS website; Non-Technical Skills for Surgeons course (NOTSS) presentations are available on the RCS Edinburgh website (www.rcsed.ac.uk) to both members and non-members. doi = 10.1016/j.bjoms.2020.04.002 id = cord-349008-x750xe8n author = Ertl-Wagner, Birgit B. title = Preparedness for the COVID-19 pandemic in a tertiary pediatric radiology department date = 2020-06-03 keywords = COVID-19; PPE; pandemic summary = doi = 10.1007/s00247-020-04704-2 id = cord-335648-lbmhprjn author = Estrich, Cameron G. title = Estimating COVID-19 prevalence and infection control practices among US dentists date = 2020-10-15 keywords = PPE; SARS; covid-19 summary = Dentists from every US state (n = 2,195) answered questions about COVID-19–associated symptoms, SARS-CoV-2 infection, mental and physical health conditions, and infection control procedures used in their primary dental practices. As early as March 2020, Journal of Dental Research published the infection control guidelines that dentists at Wuhan University used, 7 and, in April and May 2020, the American Dental Association (ADA) and the Centers for Disease Control and Prevention (CDC), respectively, released interim guidance on infection control protocols and changes to the practice and office environments. In this article, we used the first month of study data to estimate the prevalence of COVID-19 among US dentists and to determine the rate of compliance with CDC and ADA infection prevention and control procedures. 14, 15 Respondents who reported providing oral health care in the past month were asked about infection prevention or control procedures in their primary dental practice. doi = 10.1016/j.adaj.2020.09.005 id = cord-330870-l0ryikhv author = Eubanks, Allison title = Obstetric Simulation for a Pandemic date = 2020-07-23 keywords = COVID-19; PPE; patient summary = Conclusion: In the current COVID-19 pandemic, simulating obstetrical patient care from presentation to the hospital triage through postpartum care can prepare teams for even the most complicated patients while increasing their ability to protect themselves and their patients. Conclusion: In the current COVID-19 pandemic, simulating obstetrical patient care from presentation to the hospital triage through postpartum care can prepare teams for even the most complicated patients while increasing their ability to protect themselves and their patients. Communication, teamwork, and process efficiency are dramatically increased with simulations, which is why they are quickly being adapted as an essential part of medical training for small team events like codes and postpartum hemorrhages and large-scale, multi-hospital emergencies, disasters, and pandemics. The Ebola outbreak in 2014-2016 was the most recent event that demonstrated a need for pandemic and disaster preparedness throughout the country, as hospitals quickly realized they did not have plans for admitting, transporting, and caring for these highly contagious patients 6, 8, 15, 16 . doi = 10.1016/j.semperi.2020.151294 id = cord-344262-5yk1keg3 author = Evans, Lauran K. title = COVID-19 Drive-Through Point of Screening and Testing (POST) System: A Safe, Efficient, and Adaptable Model for Nasopharyngeal Swab Collection date = 2020-09-02 keywords = COVID-19; POST; PPE summary = METHODS: Initially, a small drive-through site was constructed at a converted tuberculosis clinic, but due to an increase in testing needs, an expanded point of screening and testing (POST) system was developed in an event center parking lot to administer tests to a higher volume of patients. CONCLUSIONS: This POST drive-through system serves as an efficient, safe, and adaptable model for high volume COVID-19 nasopharyngeal swabbing that the authors recommend other COVID-19 testing sites nationwide consider adopting for their own use. The authors also believe that the WCHD POST system, similar to those previously reported in the literature, represents a particularly efficient, safe, and adaptable model for COVID-19 testing, and recommend that other COVID-19 testing sites nationwide consider adopting it for their own purposes. The following parameters were collected from the WCHD: COVID-19 tests performed each day, number of required staff and their responsibilities, positive COVID-19 tests per week, PPE use per shift, distances of the POST system route via measurement wheel, and safety concerns. doi = 10.1017/dmp.2020.313 id = cord-316682-4360s2yu author = Fischer, William A. title = Personal Protective Equipment: Protecting Health Care Providers in an Ebola Outbreak date = 2015-11-01 keywords = Ebola; HCP; PPE; virus summary = Given that the Ebola virus is primarily transmitted through direct contact of mucous membranes and cuts in the skin with infected patients and/or their bodily fluids, it is necessary to cover these potential portals of infection with PPE as part of a structured and instructed donning and doffing procedure. Personal protective equipment (PPE) plays a critical role in mitigating the risk of health care personnel (HCP) exposure to contaminated body fluids in the care of patients with communicable infectious diseases, including EVD. 5 In the PAPR PPE set HCP wore a Tyvek (DuPont, Wilmington, Delaware) suit, shoe covers, a surgical gown, and a large hood, whereas the enhanced respiratory and contact precautions system included only a surgical gown, indicating that a second covering significantly reduced exposure to contaminated body fluids and provided evidence for the use of aprons on top of gowns or coveralls in the care of Ebola-infected patients. doi = 10.1016/j.clinthera.2015.07.007 id = cord-319865-g3qxu6uv author = Frountzas, Maximos title = Personal protective equipment against COVID-19: Vital for surgeons, harmful for patients? date = 2020-09-21 keywords = COVID-19; PPE summary = All surgical societies published specific criteria about high-risk surgical procedures and management of oncologic patients with alternative treatment options, such as chemotherapy or radiotherapy, after discussion by virtual Tumor Boards, that included surgeons, medical oncologists and radiologists [3] . Therefore, the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), followed by most GI surgical communities all over the world, suggested the following PPE during GI surgery of a confirmed or highly suspected COVID-19 patient [7] : Surgical gowns, caps and shoe covers for skin and clothing protection. In addition, 91.3% of the healthcare workers with a primary headache in the past, reported that the prolonged (over 4 hours) use of PPE during COVID-19 outburst worsened their headaches and affected their job performance [9] . The PPE-associated discomfort and side effects during surgery may increase surgeons'' anxiety and fatigue while performing difficult operations. doi = 10.1016/j.amjsurg.2020.09.014 id = cord-277167-qdi6hu82 author = Fuzaylov, Gennadiy title = Adjustment for international surgical outreach missions due to COVID-19 date = 2020-07-30 keywords = PPE summary = Doctors Collaborating to help Children is one such non-profit organization which started a global health campaign to improve burn care in Ukraine [4] . The incidence of burn injury, and other surgically treated diseases is unlikely to acutely change in the setting of the COVID-19 pandemic, undoubtably creating an increase in patients seeking care [5] . However, discontinuing international surgical missions is critical in preventing regional viral spread, preserving PPE, and protecting ourselves and our patients. In line with CDC recommendations to increase telemedicine care, we encourage providers involved in surgical outreach to do the same. Limitations in testing and ventilators, PPE requirements, and a call for reducing global spread necessitate a stop in international travel for providers involved in surgical outreach missions. We continuing to work with doctors and health care ministers abroad remotely through increasing telemedicine efforts. doi = 10.1016/j.burns.2020.07.016 id = cord-314492-483rn3aw author = Gallagher, Jennifer E. title = Relevance and paucity of evidence: a dental perspective on personal protective equipment during the COVID-19 pandemic date = 2020-07-24 keywords = Cochrane; PPE; dental summary = It examined evidence on which type of full body PPE and which method of donning (putting on) or doffing (removing) are most effective, while having the least risk of contamination or infection for healthcare workers, as well as which training methods increase compliance with PPE protocols. The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, 1 has highlighted the importance of personal protective equipment (PPE) for health and social care personnel. The global COVID-19 pandemic, caused by the SARS-CoV-2 virus, 1 has highlighted the importance of personal protective equipment (PPE) for health and social care personnel. 8 The evidence from this review is of great importance where there is a risk of highly infectious diseases, and even though COVID-19 is no longer considered to be a high consequence disease in the UK, 9 its findings remain relevant to the current pandemic 10 and continue to be updated. doi = 10.1038/s41415-020-1843-9 id = cord-342642-qzoowc97 author = García-Méndez, Nayely title = Anesthesiologists and the High Risk of Exposure to COVID-19 date = 2020-05-04 keywords = PPE summary = key: cord-342642-qzoowc97 title: Anesthesiologists and the High Risk of Exposure to COVID-19 cord_uid: qzoowc97 (1) PPE are all the set of elements and devices, that are specifically designed to protect the HCP against accidents and illnesses that could be caused by agents during the performance of their daily basis activities as well as in the emergency care; and (2) the occupational risk related to the exposure of the HCP must be identified and analyzed. The JCI has been calling for action at all government levels to address the shortage and protect those who work heroically to care for infected patients with COVID-19. We can confirm that in Mexico, there have been "hospital outbreaks" with 329 HCPs who have been infected with COVID-19 throughout the country. Prevención y control de infección en enfermedades respiratorias agudas con tendencia epidémica y pandémica durante la atención sanitaria Pautas. Available at: www.paho.org/es/documentos/ prevencion-control-infeccion-enfermedades-respiratoriasagudas-con-tendencia-epidemica Anesthesiologists and the High Risk of Exposure to COVID-19 doi = 10.1213/ane.0000000000004919 id = cord-280419-odqo3o4w author = Gibbons, John P. title = Custom solution for PPE in the orthopaedic setting: retrofitting Stryker Flyte T5® PPE system date = 2020-10-26 keywords = HEPA; PPE summary = In this study the authors made modifications to two different SS systems to incorporate high-efficiency particulate air (HEPA) filters to the inlets to the fan to assess their potential as a method of providing a reusable system for PPE for the surgeon with regard to protection from a respiratory droplet spread virus. The results show that using a layer of HEPA filter cut to size, and sealed to the inlet for the fan in the helmet will reduce the downstream particulate at the user''s mouth by over 99.5% which is equivalent to that of a respirator mask. With the modification of the HEPA filter to the inlet of the T5 helmet as described, the downstream penetration was reduced to 0.46% (σ = 0.24%) which is significantly better than all other test configurations and offers a particulate filtration similar to FFP3 and N99 or other equivalent respirator mask. doi = 10.1016/j.jhin.2020.10.016 id = cord-314460-dbrp4vxc author = Gibbs, Shawn G. title = Review of Literature for Air Medical Evacuation High-Level Containment Transport date = 2019-10-31 keywords = EVD; HLCT; PPE summary = We conducted a review of the literature to evaluate the processes and procedures utilized for safe AE high-level containment transport (AE-HLCT) of patients with HHCDs. Methods A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019). A literature search was performed in PubMed/MEDLINE (from 1966 through January 2019) with the following terms: 1) "aeromedical isolation," 2) "aeromedical evacuation" OR "transportation of patients" OR "air ambulance" OR "HEMS" OR "Helicopter" AND "ebola" OR "lassa" OR "viral hemorrhagic" OR "highly infectious" OR "highly hazardous" OR "contagious" OR "communicable" OR "Middle East respiratory syndrome (MERS)" OR "SARS" OR "smallpox", and 3) "mobile" OR "transport" AND "high-level isolation" OR "high containment". Biselli et al 22 noted training includes personal protective equipment (PPE), patient management on ground and inflight, and equipment decontamination, whereas Christopher and Eitzen, 17 24 which detailed a 2006 Royal Air Force mission, remarked on the benefit of in-flight, just-in-time training that occurred on the flight to the patient, while also stating that the mission resulted in routine air transport isolator exercises. doi = 10.1016/j.amj.2019.06.006 id = cord-270781-f9nra823 author = Gulia, Ashish title = Sarcoma Care Practice in India During COVID Pandemic: A Nationwide Survey date = 2020-07-31 keywords = COVID-19; Fig; PPE summary = We conducted a survey amongst oncologists across India who are involved in the management of bone and soft tissue sarcomas, to analyse the patterns of screening, prioritising, and managing these patients within the constraints of resources and policies available with them. The purpose of this survey was to determine the consistency, or the lack of it, in the patterns of care offered to sarcoma patients between centres and the policies followed. This survey covered three main domains (a) participants speciality and working environment (b) Institutes'' policies related general COVID-19 prevention and management (c) practices related to musculoskeletal tumor management in COVID-19 pandemic. Surgical management of sarcomas was as per usual only in 15.5% of respondents, with the rest adapting, including 42% who were avoiding procedures requiring long duration and blood loss, 27% were operating only emergency cases, while in 15.5% surgery was done only in high grade sarcomas with curative intent (Fig. 5) . doi = 10.1007/s43465-020-00206-3 id = cord-027880-1apexs6o author = Hankenson, F. Claire title = Vaporized Hydrogen Peroxide Decontamination of N95 Respirators in a Dedicated Animal Research Facility for Reuse During a Novel Coronavirus Pandemic date = 2020-06-24 keywords = N95; PPE; VHP; room summary = To contribute to the decontamination effort for PPE needed in health sites in proximity to our institution, we repurposed a vacant animal research housing facility to establish a center for application of vaporized hydrogen peroxide (VHP) to disinfect critical medical materials for their return into service. 22 Building on our decontamination efforts to date, the VHP process for human medical equipment was assessed internally with the intent to return disinfected N95 respirators to their original owners at our hospital partner sites and assist safety groups (police and fire departments) with equipment disinfection across the state of Michigan. Institutions with AAALAC-accredited animal research areas, all of which comply with regulated environmental controls, will be able to use our protocols, specific VHP cycle times, and BI exposure and collection instructions to deliver VHP decontamination of used medical materials for their regions as well. doi = 10.1177/1535676020936381 id = cord-351527-u12obtvp author = Harvey, Jessica title = Perspectives COVID-19 and PPE in context: an interview with China date = 2020-05-30 keywords = PPE summary = In addition, the time taken to transport product ex-China has increased-previously our freight forwarder could move express items to the UK within 3 working days direct from our Chinese factories by air. We are advising our customers to seriously consider ordering with a buffer of 1-3 months worth of stock as lead time for PPE such as gowns and aprons is now up to 30 days including shipping to the UK even via express air freight. Under the extensive lead times currently required (and increasing) and the inherent uncertainty in the situation we are advising our customers, including NHS and care homes, to put in orders now and plan to stock up for the near future''. New rules imposed by the Chinese government mean that PPE for the international market is subject to stricter quality requirements compared to the products meant for the local Chinese health service. doi = 10.1093/pubmed/fdaa077 id = cord-255264-2kj961en author = Hasan, Syed Shahzad title = Social distancing and the use of PPE by community pharmacy personnel: Does evidence support these measures? date = 2020-05-01 keywords = PPE; SARS summary = While the United States adopted a universal mask approach and Turkey recommended the use of masks and protective goggles for their pharmacy personnel, almost all of the countries recommended against routine use of face mask and other PPE (gloves or aprons/gowns), except when dealing with suspected COVID-19 patients or performing activities requiring close contact (unable to maintain recommended social distance) with the patients. Though the observation from such case study cannot be regarded as conclusive, the assumption, for now, should be that airborne transmission of SARS-CoV-2 is possible unless being discredited in the future, and therefore we opine that the wearing of appropriate PPE is of utmost importance for healthcare workers, including community pharmacy personnel dealing with individuals may or may not be infected on a day-to-day basis, regardless if they manage to observe social distancing in their workplace or if they perform close contact activities. doi = 10.1016/j.sapharm.2020.04.033 id = cord-017569-fv88n70v author = Hewlett, Angela title = Viral Hemorrhagic Fever Preparedness date = 2017-09-10 keywords = EVD; Ebola; HLCC; PPE; VHF; care; patient summary = Although each facility may wish to tailor the composition of the HICS team to their own particular needs, and each situation may require adjustment, key team members would typically include logisticians to plan to replenish PPE supply levels and address waste management issues, a public information officer (PIO), medical technical specialists to include infectious disease physicians and nurse leaders to manage the clinical care of the patient and staffing within the patient care unit, a laboratorian to address testing logistics and specimen transport challenges, a clinical research expert to facilitate the use of experimental therapies when necessary, a nurse concierge or other dedicated individual to support family needs, and a behavioral health expert to address staff well-being as well as the psychological and emotional needs of patients and families. The HLCC facilities in the United States that admitted patients infected with Ebola virus disease (EVD) have well developed teams of nurses who are able to provide skilled and effective patient care within their isolation units. doi = 10.1007/978-3-319-60980-5_21 id = cord-021907-omruua6n author = Hick, John L. title = Personal Protective Equipment date = 2009-05-15 keywords = CFR; EMS; OSHA; PPE; protection summary = • Use of respirators made it difficult for workers to communicate with each other, often resulting in users breaking the face seal to talk • Turnout gear (the common protective garments used by firefighters) increased heat stress and physical fatigue • At the WTC, the rubble pile was so hot in places that it melted the soles of workers'' boots; providing wash stations to cool the boots resulted in wet feet and serious blisters for many workers; some 440 WTC disaster response workers sought treatment for blisters • Steel-reinforced boots (soles and toes) protected against punctures by sharp objects but conducted and retained heat, which contributed to blisters and burns • Structural firefighting gloves worked well until they got wet and hardened, reducing their dexterity • WTC disaster response workers did not consistently protect their hands against potential hazards such as human remains and bodily fluids • Safety glasses were readily available but often were open at the sides and did not offer adequate protection against airborne particles • Goggles were uncomfortable, hindered peripheral vision, tended to fog, and did not fit well in conjunction with half-face respirators • Many disaster response workers at the WTC (especially law enforcement officers) did not consistently use hearing protection, even around heavy machinery, because they needed to hear their radios and voices and listen for tapping when they were searching for survivors • Most volunteers at the WTC, Pentagon, and Oklahoma City did not receive pre-event training on PPE and hazardous materials • Although firefighters generally received detailed pre-event training, this was less true for law enforcement officers • Accurate "real-time" hazard information was not readily available, especially during the anthrax incidents • Protection from falls was available at some sites (in the form of ropes and harnesses) but was inconsistently used doi = 10.1016/b978-0-323-03253-7.50043-1 id = cord-281627-8cq18gja author = Hon, Chun-Yip title = Personal protective equipment in health care: Can online infection control courses transfer knowledge and improve proper selection and use? date = 2008-12-31 keywords = PPE summary = title: Personal protective equipment in health care: Can online infection control courses transfer knowledge and improve proper selection and use? We used observational evaluation to assess the ability of an online learning course to effectively transfer knowledge on personal protective equipment (PPE) selection and removal. The present study evaluated PPE selection and use by HCWs through observational analysis, both before and after the HCWs took an online infection control course. 14-17 From March to June 2007, nurses, care aides, and allied health staff attending the orientation program were invited to participate in a structured observation of PPE use before and after taking the infection control course. [18] [19] [20] 22 For the PPE sequence evaluation, the participant was given a ''''1 point, 1 task'''' score based on the observed structured clinical examination method, with a total maximum score based on the number of donning and doffing and hand hygiene tasks performed. doi = 10.1016/j.ajic.2008.07.007 id = cord-294591-793ywpcd author = Hu, Xiaoyun title = Self-Reported Use of Personal Protective Equipment among Chinese Critical Care Clinicians during 2009 H1N1 Influenza Pandemic date = 2012-09-05 keywords = H1N1; ICU; PPE summary = This study examined the knowledge, attitudes, and self-reported behaviors, and barriers to compliance with the use of PPE among ICU healthcare workers (HCWs) during the pandemic influenza. As the second part of the above survey, we wish to evaluate the self-reported compliance to the use of PPE during the current influenza pandemic among critical care clinicians in Chinese ICUs, as well as independent predictors of the compliance. In this survey of Chinese critical care clinicians, only 55% of respondents reported high compliance (.80%) to recommended PPE use, consistent with other relevant studies [16, 19] . Despite the lack of data validating such concept with regards to 2009 H1N1 influenza in ICU, studies did suggest that implementation of protocoled care and/or educational program, by addressing knowledge, attitude, and behavioral barriers, might significantly reduce catheter-related bloodstream infection [31] , and improve mortality in patients with severe sepsis [32] . Only 55% of Chinese critical care clinicians reported high compliance to PPE use during pandemic influenza, putting HCWs and their patients at risk. doi = 10.1371/journal.pone.0044723 id = cord-314517-n1yj2zdy author = Huang, Dayong title = Social media survey and web posting assessment of the COVID-19 response in China: Health worker attitudes towards preparedness and personal protective equipment shortages date = 2020-08-31 keywords = PPE summary = title: Social media survey and web posting assessment of the COVID-19 response in China: Health worker attitudes towards preparedness and personal protective equipment shortages BACKGROUND: Understanding health worker awareness, attitudes, and self-confidence in the workplace can inform local and global responses towards emerging infectious threats, like COVID-19 pandemic response. Health workers satisfied with current preparedness to address COVID-19 were more likely to be female, to obtain knowledge about the SARS-CoV-2 outbreak from government organizations, and to consider their hospital prepared for the outbreak management. They cannot function effectively if they lack personal protective equipment (PPE), essential to ensure continuity of healthcare services during a public health emergency and to avoiding nosocomial acquisitions 5 A c c e p t e d M a n u s c r i p t 6 As of April 4, 2020, 60 Chinese health workers have died, of whom 22 (36.7%) were confirmed dead of COVID-19, according to reports by China Central Television. doi = 10.1093/ofid/ofaa400 id = cord-269900-7mzyib4r author = Ierardi, Anna Maria title = How to Handle a COVID-19 Patient in the Angiographic Suite date = 2020-04-10 keywords = COVID-19; PPE summary = All the staff of the angiographic suite must use personal protective equipment (PPE), according to accepted infectious disease and epidemiology guidelines. Geographic isolation of COVID-19 positive patients should occur in designated suites only, in order to minimize different room exposures and familiarize cleaning staff with the same rooms. When carrying out these procedures on Covid-19 patients, the WHO recommends N95 or FFP2 standard masks or equivalent, and gowns, gloves, eye protection, aprons and shoe covers [4, 6] . According to the internal guidelines of our hospital, all staff members and every person operating in the same room as a positive or suspected COVID-19 patient have to wear N95 or FFP2 masks. To minimize the in and out movement from the potentially contaminated room, the staff must remain close to the angiographic table with PPE and sterile equipment. Strict attention to probe cover removal is required post-procedure (with full PPE and eye protection) to avoid contamination. doi = 10.1007/s00270-020-02476-8 id = cord-316157-7nci4q1q author = Iheduru‐Anderson, Kechi title = Reflections on the lived experience of working with limited personal protective equipment during the COVID‐19 crisis date = 2020-10-03 keywords = COVID-19; PPE; care; nurse summary = This study used a descriptive phenomenological design to describe the lived experience of acute care nurses working with limited access to PPE during the COVID‐19 pandemic. Existing studies have focused on hospital preparation, availability of resources, and the safety of patients (Barbisch & Koenig, 2006; Karabacak, Ozturk, & Bahcecik, 2011; Ruchlewska et al., 2014; Tzeng & Yin, 2008) , the education of hospital staff (Powers, 2007) , emergency room nurses'' description and management during a crisis (Vasli and Dehghan-Nayeri, 2016) , and the psychological impact of disease outbreaks on hospital workers (Sun et al., 2020; Wu et al., 2009; Yin & Zeng, 2020) . The purpose of this study was to describe the lived experience of acute care nurses working with limited access to PPE during the COVID-19 pandemic. This qualitative descriptive phenomenological study explored the lived experiences of acute care nurses working on the frontline during the COVID-19 disease outbreak. Descriptive phenomenology was chosen as the design for the current study because it explored and described the participants'' everyday experiences as they lived them while working with limited PPE on the frontline of the 2020 COVID-19 crisis. doi = 10.1111/nin.12382 id = cord-009432-0ahamczt author = Ip, Vivian title = VID-19 pandemic: the 3R’s (reduce, refine, and replace) of personal protective equipment (PPE) sustainability date = 2020-04-14 keywords = PPE summary = title: VID-19 pandemic: the 3R''s (reduce, refine, and replace) of personal protective equipment (PPE) sustainability The 3R-mantra of sustainability (reduce, refine, and replace) not only applies to ''''green anesthesia'''' practice, 2 but is also well-suited to PPE preservation. The World Health Organization continues to recommend droplet and contact precautions for general care but airborne precautions for HCPs performing aerosol-generating medical procedures (AGMP) in COVID-19 patients. A On the other hand, US Centers for Disease Control and Prevention (CDC) now recommends the use of respirator masks as part of the first line of protection of HCP caring for suspected COVID-19 patients. The need to refine the current culture of using disposable PPE to sustainable PPE solutions is essential for demand to meet supply-ideally, before a pandemic. Simulation as a tool for assessing and evolving your current personal protective equipment: lessons learned during the coronavirus disease (COVID-19) pandemic doi = 10.1007/s12630-020-01653-0 id = cord-309521-2cb992u1 author = Iqbal, Muhammad Rafaih title = “COVID-19: Results of a national survey of United Kingdom healthcare professionals’ perceptions of current management strategy – a cross-sectional questionnaire study” date = 2020-05-21 keywords = COVID-19; PPE summary = title: "COVID-19: Results of a national survey of United Kingdom healthcare professionals'' perceptions of current management strategy – a cross-sectional questionnaire study" METHOD: A questionnaire survey, drafted using Google Forms, was distributed among Healthcare professionals working in the National Health Service (NHS) across the United Kingdom. Respondents were asked five questions regarding their trust preparation for the pandemic: whether they felt supported at their trust, availability of adequate facilities (specialist beds, specified isolated areas) to treat COVID-19 patients, availability of enough PPE, whether there was enough local guidance regarding the pandemic and if sufficient local training was provided. For "daily source of information regarding the COVID-19 pandemic", nearly half of the respondents (n=558, 55.41%) used multiple sources (daily hospital emails, news, social media, Gov.uk, friends and family and other health professionals) while a quarter (n=249, 24.73%) relied on daily hospital emails (Table 3) . doi = 10.1016/j.ijsu.2020.05.042 id = cord-281099-l2i7r1bp author = Izzetti, Rossana title = A perspective on dental activity during COVID‐19: the Italian survey. date = 2020-08-13 keywords = COVID-19; PPE; dental summary = MATERIALS AND METHODS: An online anonymous questionnaire was administered to retrieve data on the dental procedures performed, the preventive measures adopted, and the predictions on the future changes in dentistry following the pandemic. Standard procedures appear insufficient in protecting from SARS-CoV-2, and thus specific measures to prevent virus transmission should be adopted to safeguard the health of both patients and oral care providers (Izzetti et al. -Post-dental treatment management of the dental office (Phase IV) A focus on highly epidemic areas, registering the higher number of cases, was also performed in order to evaluate the potential presence of differences between the regions in Northern Italy and the rest of the country. The set-up of the waiting room (non-clinical area) was adapted to the new situation by almost the totality of the sample, by providing a hydro-alcoholic solution for hand disinfection, removing objects at risk of contamination, and reorganizing the schedule in order to guarantee social distancing. doi = 10.1111/odi.13606 id = cord-318660-47dqa1dd author = Jain, Mehr title = Efficacy and Use of Cloth Masks: A Scoping Review date = 2020-09-13 keywords = PPE; cloth; mask summary = Cloth masks have limited inward protection in healthcare settings where viral exposure is high but may be beneficial for outward protection in low-risk settings and use by the general public where no other alternatives to medical masks are available. Although guidelines from the World Health Organization (WHO) and Centre for Disease Control and Prevention (CDC) suggest various strategies to optimize the supply of PPE in healthcare settings [4, 7] , there are limited data on alternatives to surgical masks. In the current COVID-19 pandemic, Chinese recommendations on face mask use in community settings suggest that cloth masks could be used in a very low-risk population to prevent the spread of disease [13] . This review aims to integrate current studies and guidelines to determine the efficacy of cloth masks as both inward and outward protective equipment and whether they can be used in healthcare settings and/or the community in light of the PPE shortage. doi = 10.7759/cureus.10423 id = cord-317323-wp3vh4c1 author = Kandhari, Rajat title = The changing paradigm of an aesthetic practice during the COVID‐19 pandemic: An expert consensus date = 2020-10-28 keywords = COVID-19; N95; PPE summary = It is pertinent that the physician today understands the infection, disinfection measures, and personal protective equipment to reduce chances of viral transmission and provide safe clinical settings for oneself, the staff and the patients. While certain guidelines and expert consensus have recently been published [2] [3] [4] providing an overview of "safe" working protocols, it appears that we are evolving every day in our practices with respect to "what works" and "what does not." Our article aims to bridge the gap between guidelines and in-clinic experiences to provide a set of best practices to follow for aesthetic procedures after reopening our practices. In contrast, the occurrence of airborne transmission is due to smaller particles, which maybe suspended in the air for long periods and can infect people distant from the source (eg, AGP''s)PPE consists of protective apparel and/or equipment designed for providing protection against infectious agents to HCW''s and their patients. Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings doi = 10.1111/dth.14382 id = cord-283900-4pa93xqi author = Khan, M. Ali title = Perceptions of Occupational Risk and Changes in Clinical Practice of U.S. Vitreoretinal Surgery Fellows during the COVID-19 Pandemic date = 2020-05-22 keywords = COVID-19; PPE summary = Abstract Purpose To assess perceptions of occupational risk and changes to clinical practice of ophthalmology trainees in the United States during the COVID-19 pandemic. Main outcome measures Survey questions assessed policies guiding COVID-19 response, known or suspected exposure to SARS-CoV-2, changes in clinical duties and volume, and methods to reduce occupational risk including availability of personal protective equipment. Survey questions assessed training program environment, policies guiding 106 COVID-19 response, changes in fellow duties and clinical volume, and methods to reduce 107 occupational risk including availability of PPE. Discussion of data regarding differential reduction of SARS-CoV-2 or other coronavirus 307 transmission with surgical or N95 respirator masks is outside the scope of this study assessing ophthalmology trainee perceptions of occupational risk. This study reports 323 occupational risk perceptions, currently utilized risk mitigation strategies, and surgical volume 324 training concerns for second year US vitreoretinal surgery fellows mid-pandemic escalation. doi = 10.1016/j.oret.2020.05.011 id = cord-310285-ua894psi author = Khatri, Anadi title = COVID-19 and ophthalmology: An underappreciated occupational hazard date = 2020-07-20 keywords = PPE summary = Letter to the Editor-We read the article "COVID-19 and ophthalmology: an underappreciated occupational hazard" by Kuo and O''Brien 1 with great interest. Personal protective equipment (PPE) has become the gold standard during the COVID-19 pandemic for prevention of infection. In the long term, these difficulties may hamper the performance of healthcare workers like ophthalmologists, whose work demands high precision. Although it has become a norm, the evidence is already clear that many ophthalmologists and eye care professionals are having difficulties related to PPE use. 6 Although this may be an advantage because much of the "design for the greatest ease of use" would have already been already improvised, many such DIY efforts remain unproven in terms of the actual protection they provide. COVID-19 and ophthalmology: an underappreciated occupational hazard Safety testing improvised COVID-19 personal protective equipment based on a modified full-face snorkel mask doi = 10.1017/ice.2020.344 id = cord-340887-k88hchau author = Khusid, Johnathan A. title = Well‐Being and Education of Urology Residents During the COVID‐19 Pandemic: Results of an American National Survey date = 2020-05-27 keywords = COVID-19; PPE; resident summary = To address this gap, in the current study we aim to assess the well-being, clinical practice, and education of urology residents throughout the USA during the COVID-19 pandemic through the use of an anonymous survey. Potential risk factors included: resident age, gender identity, level of training, practice setting (urban/suburban/rural), AUA geographical section, perception of local COVID-19 severity (Likert), marital status, children, perceived household susceptibility to disease (Likert), history of COVID-19 symptoms, months of intensive care unit training, redeployment status, perceptions of availability of PPE (Likert) and COVID-19 testing, cancellation of elective cases, number of weekly operations before the pandemic, perceived program and hospital support (Likert), perception of shared responsibility with attendings (Likert), and perceived difficulty meeting case minimums (Likert). Perception of support from hospital administration (β=-0.23, 95% CI=-0.40, -0.05) and shared responsibility between residents and attendings (β=-0.22, 95% CI=-0.39, -0.07) were associated with lower declination of redeployment whereas concern regarding ability to reach graduation case requirements was associated with higher declination of redeployment (β=0.16, 95% CI=0.00, 0.32). doi = 10.1111/ijcp.13559 id = cord-316632-rr9f88oi author = Kimura, Yurika title = Society of swallowing and dysphagia of Japan: Position statement on dysphagia management during the COVID-19 outbreak date = 2020-07-23 keywords = PPE; SARS; covid-19 summary = On April 14, the Society of Swallowing and Dysphagia of Japan (SSDJ) proposed its position statement on dysphagia treatment considering the ongoing spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This statement is arranged into separate sections providing information and advice in consideration of the COVID-19 outbreak, including "terminology", "clinical swallowing assessment and examination", "swallowing therapy", "oral care", "surgical procedure for dysphagia", "tracheotomy care", and "nursing care". The current set of statements on dysphagia management in the COVID-19 outbreak is not an evidence-based clinical practice guideline, but a guide for all healthcare workers involved in the treatment of dysphagia during the COVID-19 epidemic to prevent SARS-CoV-2 infection. 48 This statement is arranged into separate sections provid-49 ing information and advice considering the COVID-19 out-50 break, including "clinical swallowing assessment and ex-51 amination", "dysphagia rehabilitation", "oral care", "nursing 52 care", "surgical procedure for dysphagia", and "tracheotomy 53 care". doi = 10.1016/j.anl.2020.07.009 id = cord-315358-22srds0e author = Kovacs, George title = Just the Facts: Airway management during the coronavirus disease 2019 (COVID-19) pandemic date = 2020-03-30 keywords = COVID-19; PPE summary = 3 COVID-19 pneumonia patients in respiratory distress with persistent hypoxemia and who are showing signs of fatigue (altered mental status) despite escalation of oxygen therapy (i.e., non-rebreather face mask at 15 L/min) are at significant risk for requiring urgent intubation. 5 Another major reason why airway management in COVID-19 patients is different relates to the details and sequencing related to provider safety. Answer: There is considerable discussion and concern amongst healthcare providers around the availability and access of appropriate personal protective equipment (PPE) for high-risk AGPs such as intubation. 6 While every institution should have access to PPE for providers performing an AGP, it is important to ask the question of whether these recommendations are what is best for a provider in a room (negative pressure or not) preparing to intubate the sickest of COVID-19 patients. • Airway management of COVID-19 patients requires a paradigm shift from a focus primarily on patientoriented outcomes to one that focuses on provider safety. doi = 10.1017/cem.2020.353 id = cord-355577-w1yhtbz8 author = Kowalski, Luiz Paulo title = Effect of the COVID-19 Pandemic on the Activity of Physicians Working in the Areas of Head and Neck Surgery and Otorhinolaryngology date = 2020-05-22 keywords = COVID-19; PPE; SARS summary = Conclusion The study demonstrated a direct impact of the COVID-19 pandemic on the clinical practice of specialties related to the treatment of patients with diseases of the head and neck region already in the beginning of the illness management in Brazil. Specifically, we collected data regarding the impact of de COVID-19 pandemic on: 1) the amount and type of outpatient appointments, surgeries and exams with the risk of generating aerosols; 2) availability of adequate PPE in different settings and practices; 3) the preparedness of the responder''s health institution in orienting their HCPs and developing strategies to manage COVID-19 suspected and confirmed patients. Although the pandemic is already in its 7 th week in Brazil, since the identification of the 1 st case, 45.3% and 48.8% of physicians in the private and public sectors, respectively, reported that they had not received face-to-face or distance training in the management of confirmed or suspected patients with COVID-19. doi = 10.1055/s-0040-1712169 id = cord-340799-1awmtj52 author = Krajewska, Joanna title = Review of practical recommendations for otolaryngologists and head and neck surgeons during the COVID-19 pandemic: Recommendations for otolaryngologists during the COVID-19 pandemic date = 2020-06-06 keywords = ENT; Neck; PPE; SARS; covid-19; patient summary = Laryngectomy patients and individuals after tracheotomy with COVID-19 carry a particularly high risk of infecting ENT specialists and other members of medical staff as the way of breathing is these individuals is modified and enables the easy spread of SARS-CoV-2 containing aerosolized tracheal secretions [11] . In accordance with such high risk of infection, only emergency consultations and procedures should be performed by ENT specialists in times of COVID-19 pandemic in areas with confirmed SARS-CoV-2 cases [23, 28] . American Head and Neck Society, AAO-HNS, and the American Colleges of Surgeons, recommended that preoperative testing for SARS-CoV-2 presence should be performed in all individuals undergoing high-risk procedures [22, 30] . Patients with acute airway obstruction requiring tracheotomy should be considered as COVID-19 positive, as there is no time for SARS-CoV-2 testing in case of such urgent surgery [29] . doi = 10.1016/j.anl.2020.05.022 id = cord-335704-qejpc4x8 author = Kuhar, Hannah N. title = Otolaryngology in the Time of Corona: Assessing Operative Impact and Risk During the COVID-19 Crisis date = 2020-06-02 keywords = OHNS; PPE; covid-19 summary = 5 Regarding surgical management of otolaryngologic cases, it is recommended that patient COVID-19 status be determined ahead of surgery, that high-risk operations be performed in negativepressure operating rooms with appropriate personal protective equipment (PPE) worn by all staff, and that only essential staff be in the operating room for intubation and extubation. Immediately following the present study period of data collection (March 18-April 8, 2020), with the increasing availability of PPE, OHNS departments across all 3 centers developed standardized protocols for universal use of aerosol-protective PPE for all AGPs, regardless of the patient''s COVID-19 status. From the experience of OHNS departments at pediatric and adult academic medical centers, we identified availability of rapid COVID-19 testing and adequate aerosol-protective PPE to be significant limitations to operationalizing society recommendations. doi = 10.1177/0194599820930214 id = cord-320640-5m6sqwq8 author = Kumar, Harender title = COVID-19 Creating another problem? Sustainable solution for PPE disposal through LCA approach date = 2020-10-09 keywords = COVID-19; India; PPE; waste summary = In the present work, Life Cycle Assessment of PPE kits has been performed using GaBi version 8.7 under two disposal scenarios, namely landfill and incineration (both centralized and decentralized) for six environmental impact categories covering overall impacts on both terrestrial and marine ecosystems, which includes Global Warming Potential (GWP), Human Toxicity Potential (HTP), Eutrophication Potential (EP), Acidification Potential (AP), Freshwater Aquatic Ecotoxicity Potential (FAETP) and Photochemical Ozone Depletion Potential (POCP). With reported cases of COVID-19 infected health and sanitation workers (Satheesh 2020 ; Hindustan times 2020; New India Express 2020), waste management of used infectious safety gears has become a critical component to restrict the spread of novel coronavirus (Bherwani et al. The effective management of coronavirus infectious waste, including PPEs, has been identified by as a key area of concern by regulatory agencies in India, with the release of waste handling-treatment-disposal guidelines generated during treatment-diagnosis-quarantine of COVID-19 patients (CPCB Revision 2020; Aggarwal 2020). doi = 10.1007/s10668-020-01033-0 id = cord-295322-9kye4w9g author = Kumar, Parmeshwar title = Adaptation of the ‘Assembly Line’ and ‘Brick System’ techniques for hospital resource management of personal protective equipment, as preparedness for mitigating the impact of the COVID-19 pandemic in a large public hospital in India date = 2020-05-22 keywords = PPE summary = title: Adaptation of the ''Assembly Line'' and ''Brick System'' techniques for hospital resource management of personal protective equipment, as preparedness for mitigating the impact of the COVID-19 pandemic in a large public hospital in India An assembly line was put in place where components of the PPE kit were added in sequence until the final completed product was packed and ready for distribution. It is typically used inventory management of the personal kit issued to each fighting unit and also used by the United Nations Peace Keeping Forces (The UN Brick) [1] . The requisite number of in-house PPE kits for the various wards were then assembled into one brick(a carton) and supplied to that unit on a daily basis. Bricks of varying sizes and levels help in rationing of PPE between different wards based on differentiating essential and elective patients. doi = 10.1016/j.jhin.2020.05.029 id = cord-287653-69nfi379 author = Lacy, J. Matthew title = COVID-19: POSTMORTEM DIAGNOSTIC AND BIOSAFETY CONSIDERATIONS date = 2020-04-24 keywords = COVID-19; PPE; SARS summary =  Prosect cases in negative pressure isolation suite with at least 6-12 air changes per hour  Doff contact and droplet precaution PPE, as well as N95 respirator or PAPR  Limit personnel in the isolation suite to the minimum necessary to perform the examination  Employ splash and aerosol reduction techniques during prosection; oscillating saws are discouraged but if used should have vacuum shroud attachment  Use caution when handling sharps; allow only one person to prosect at a given time  Ensure a technician is outside isolation room to monitor procedure and provide support as needed  Procure synthetic nasopharyngeal (+/-lung) respiratory swabs in sterile tubes of 2-3 ml of viral transport media for SARS-CoV-2 testing as needed  Carefully decontaminate morgue surfaces and outer body bag following autopsy  Ensure body is fully enclosed in a secure bag, tag as infectious and ensure funeral home is informed  Consider modifying release procedures to prevent bag being opened in morgue for identification  Perform hand hygiene after doffing PPE A C C E P T E D doi = 10.1097/paf.0000000000000567 id = cord-273303-g86w0xt5 author = Latz, Christopher A. title = Early Vascular Surgery Response to the COVID-19 Pandemic: Results of a Nationwide Survey date = 2020-05-23 keywords = PPE; covid-19 summary = This survey study sought to identify practice changes, understand current personal protection equipment (PPE) use, and determine how caring for patients with COVID-19 differs for vascular surgeons practicing in states with high COVID-19 case numbers versus low case numbers. The majority of vascular surgeons are reusing PPE The majority of 5 respondents worked in an academic setting (81.5%) and were performing only urgent and 6 emergent cases (80.5%) during preparation for the surge. The majority of vascular surgeons are reusing PPE The majority of 5 respondents worked in an academic setting (81.5%) and were performing only urgent and 6 emergent cases (80.5%) during preparation for the surge. The majority of vascular surgeon respondents were also being asked to 22 reuse PPE, a common practice throughout the United States during the pandemic. In our initial response (early March 2020), vascular trainees were not involved in 7 COVID-19 cases and attendings saw these patients alone (both to protect our trainees and to 8 limit use of PPE). doi = 10.1016/j.jvs.2020.05.032 id = cord-302902-34vftqt9 author = Law, Brenda Hiu Yan title = Effect of COVID-19 Precautions on Neonatal Resuscitation Practice: A Balance Between Healthcare Provider Safety, Infection Control, and Effective Neonatal Care date = 2020-08-18 keywords = PPE; SARS; covid-19 summary = Adaptations have been proposed for resuscitation of infants born to women with COVID-19, to protect health care providers, maintain infection control, and limit post-natal transmission. Changes especially impact respiratory procedures, personal protective equipment (PPE) use, resuscitation environments, teamwork, and family involvement. Adaptations have been proposed for resuscitation of infants born to women with suspected or confirmed COVID-19, to protect health care providers (HCPs), limit post-natal transmission, and maintain infection control (7) . Neonatal resuscitation may be especially impacted by changes in (i) respiratory support, (ii) personal protective equipment (PPE), (iii) resuscitation environment, (iv) team-based activities, and (v) family involvement ( Table 1) . Modifications to ventilation practices during neonatal resuscitation have been proposed to protect HCPs during AGPs, based on limited evidence on vertical transmission and aerosolization of SARS-CoV-2 (7, 9) . General COVID-19 resuscitation guidelines recommend the use of viral filters on mask ventilation devices to decrease risks to HCPs (9) . doi = 10.3389/fped.2020.00478 id = cord-281403-yl7jdarm author = Le, Aurora B. title = U.S. Medical Examiner/Coroner capability to handle highly infectious decedents date = 2018-11-06 keywords = Ebola; PPE; infectious; remain summary = doi = 10.1007/s12024-018-0043-2 id = cord-331533-0toegbv8 author = Leiker, Brenna title = COVID – 19 CASE STUDY IN EMERGENCY MEDICINE PREPAREDNESS AND RESPONSE; FROM PERSONAL PROTECTIVE EQUIPMENT TO DELIVERGY OF CARE date = 2020-07-27 keywords = COVID; COVID-19; Illinois; March; NorthShore; PPE; patient summary = The approach to the coronavirus pandemic in the emergency department focused on identification and isolation of infected individuals, adequate protection of staff, reporting of positive cases to the health department, effective treatment, and education of patients and families. APP''s in the ICU have been critical in helping fill the gaps where additional staff where needed to care for COVID patients, make calls to update family members, and provide input for treatment protocols We, the authors of this article, work as APP''s within the NorthShore emergency department. 1,865 Illinois residents have tested positive for the virus, and 26 have died as of Thursday (03/26) at 2:30 p.m., according to the state''s Coronavirus (COVID-19) Response webpage." (Herscowitz, 2020) Despite the virus''s rapid spread, NorthShore and IDPH worked to match the testing protocol with the demand within the community. doi = 10.1016/j.disamonth.2020.101060 id = cord-334808-ds5yrr4w author = Liawrungrueang, Wongthawat title = Response to: Management of Traumatic Spinal Fracture in the Coronavirus Disease 2019 Situation date = 2020-05-12 keywords = PPE summary = I am wondering what your institute uses specifically for "full personal protective equipment (PPE)" for the high risk patients, i.e., National Institute for Occupational Safety and Health-approved (N95) respirator, face shield, etc. Our reply: In this review article, the authors concluded that an algorithm could help make decisions about surgical interventions for spine injuries in patients who are at risk for coronavirus disease 2019 (COVID-19) to prevent surgeons and nurses from contracting the virus. In this situation, where the health care professionals are in contact with a high-risk patient, the surgeons and nurses could use full PPE suits (Fig. 1A) . by anesthesiologists (B) , and intraoperative standard with full PPE according to Centers for Disease Control and Prevention guidelines (C). Management of traumatic spinal fracture in the coronavirus disease 2019 situation doi = 10.31616/asj.2020.0194.r1 id = cord-295514-vhymj0rw author = Lim, Peter A title = Impact of a viral respiratory epidemic on the practice of medicine and rehabilitation: Severe acute respiratory syndrome date = 2004-08-01 keywords = PPE; SARS; Singapore; patient; rehabilitation summary = Severe acute respiratory syndrome (SARS) is a new respiratory viral epidemic that originated in China but has affected many parts of the world, with devastating impact on economies and the practice of medicine and rehabilitation. Rehabilitation was significantly affected by SARS, because strict infection control measures run counter to principles such as multidisciplinary interactions, patients encouraging and learning from each other, and close physical contact during therapy. Rehabilitation medicine was increasingly affected by everstricter infection control measures regarding close contacts and interactions between health care workers. Rehabilitation medicine was directly affected when the entire neurology ward, including patients and health care staff, were transferred out to TTSH for isolation and observation because of suspicious clusters of fevers that involved both patients and staff. Severe acute respiratory syndrome (SARS) in Singapore: clinical features of index patient and initial contacts doi = 10.1016/j.apmr.2004.01.022 id = cord-002246-er9kqdjw author = Lim, Seong Mi title = Contamination during doffing of personal protective equipment by healthcare providers date = 2015-09-30 keywords = Ebola; PPE summary = OBJECTIVE: In this study, we aimed to describe the processes of both the donning and the doffing of personal protective equipment for Ebola and evaluate contamination during the doffing process. Participants were asked to carry out doffing and donning procedures with a helper after a 50-minute brief training and demonstration based on the 2014 Centers for Disease Control and Prevention protocol. For the donning process, the average interval until the end was 234.2 seconds (standard deviation [SD], 65.7), and the most frequent errors occurred when putting on the outer gloves (27.5%), respirator (20.6%), and hood (20.6%). CONCLUSION: A significant number of contaminations occur during the doffing process of personal protective equipment. 8, 9 Cases of contamination while treating Ebola patients rose rapidly during the current outbreak, and the Centers for Disease Control and Prevention (CDC) announced the new personal protective equipment (PPE) guidelines for healthcare providers treating Ebola patients. doi = 10.15441/ceem.15.019 id = cord-272182-5lunidrs author = Lim, Wan Yen title = Resuscitation during the COVID-19 pandemic: Lessons learnt from high-fidelity simulation date = 2020-05-22 keywords = PPE summary = High-fidelity simulation sessions were conducted in our institution to identify latent threats in existing workflows, and to formulate modified life support protocols focusing on: protection of healthcare workers (HCW) and patients, minimizing aerosolization and reducing delays in resuscitation. Suspected or confirmed COVID-19 patients are managed in negative pressure, single-bedded rooms in the acute care hospital. Due to geographical reasons, the mean (SD) code blue response time to the acute and community care wards were 3.28 (1.76) and 6.67 (2.06) minutes, respectively. In simulations, we adhered to hospital and COVID-19 guidelines of full PPE (including N95 mask or powered air-purifying respirator (PAPR), gown, gloves, goggles and face shield or visor) 2 . Frequent training and simulation sessions including PPE familiarization minimizes delays in resuscitation, reduces risk of viral transmission, enhances communication, teamwork and coordination, and allows latent threats identification and workflow refinement. doi = 10.1016/j.resuscitation.2020.05.024 id = cord-352233-avov4yxv author = Liu, Antonio title = Philanthropy and Humanity in the Face of a Pandemic – A letter to the editor on “World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)” (Int J Surg 2020; 76:71-6) date = 2020-05-12 keywords = PPE summary = title: Philanthropy and Humanity in the Face of a Pandemic – A letter to the editor on "World Health Organization declares global emergency: A review of the 2019 novel coronavirus (COVID-19)" (Int J Surg 2020; 76:71-6) The enormous pressure and struggles to secure sufficient and appropriate PPE for the front -line workers in order to provide safe and compassionate care to the COVID patients inevitably add to the tremendous difficulty we face in combating this aggressive and vicious disease, not only at home in the United States, but also resonating around the world. With no clear indication or assurance of assistance coming from the government, many institutions and organizations have ramped up their philanthropy effort to secure proper equipment and protective gears for their staff. World Health Organization Declares Global Emergency: A Review of the 2019 Novel Coronavirus (COVID-19) doi = 10.1016/j.ijsu.2020.05.012 id = cord-272585-346ef6qy author = Lombardi, JM title = Addressing a National Crisis: The Spine Hospital and Department''s Response to the COVID-19 Pandemic in New York City date = 2020-05-31 keywords = COVID-19; New; PPE; York; patient summary = title: Addressing a National Crisis: The Spine Hospital and Department''s Response to the COVID-19 Pandemic in New York City As peak infections spread across the United States, we hope this article will serve as a resource for other spine departments on how to manage patient care and healthcare worker deployment during the COVID-19 crisis. Our institution has been on the forefront of the COVID-19 pandemic, as we treated "patient zero" in New York City, who presented to our Emergency Department (ED) on February 28 th . Published data by healthcare providers in Asia and Europe demonstrated that the most substantial threat to COVID-19 patient morbidity and mortality was the lack of adequate critical care resources including intensive care unit (ICU) beds and respiratory support [8] [9] . It is vital to note that although redeployment was an important initiative to our department during this time of crisis, our primary concern was to maintain an adequate workforce to meet all orthopaedic surgical demands at our institution. doi = 10.1016/j.spinee.2020.05.539 id = cord-025623-1v9614f8 author = Mahapatra, Pallab Sinha title = Surface Treatments to Enhance the Functionality of PPEs date = 2020-05-29 keywords = PPE; SARS; coating summary = This paper focuses on improving PPE functionality in a scalable manner by surface treatment and coating with appropriate materials and other functional enhancements, such as exposure to UV rays or other sterilizing agents (e.g., hydrogen peroxide). Surface treatments to enhance resistance against diseasecausing microbes, i.e., antimicrobial coatings, have the potential to improve PPE functionalities dramatically. Hydrophobic coatings make it difficult for droplets/particles to adhere on surfaces and are known to provide antimicrobial characteristics, which are retained after multiple washes; antibacterial and antifungal properties were demonstrated by Mukherjee et al. Klibanov''s group at MIT has shown extended functionality of hydrophobic coating characteristics against influenza viruses, which get transmitted through respiratory droplets, like SARS-CoV-2; Halder et al. Scalable surface treatment strategies that combine antiviral action with liquid-repelling properties are one of many possible approaches to enhance the functionality of PPEs, thereby serving to satisfy their high demand in the healthcare industry and other fronts where the COVID-19 pandemic is being fought. doi = 10.1007/s41403-020-00110-0 id = cord-342666-7el8o6qq author = Mahmood, Syed Uzair title = Strategies for Rational Use of Personal Protective Equipment (PPE) Among Healthcare Providers During the COVID-19 Crisis date = 2020-05-23 keywords = PPE; mask summary = title: Strategies for Rational Use of Personal Protective Equipment (PPE) Among Healthcare Providers During the COVID-19 Crisis However, there are guidelines recommended by the World Health Organization (WHO) and the Centers for Disease Control and Prevention (CDC) to maintain the supply in the wake of this increased demand of PPE, how the manufacturers should track their supplies, and how the recipients should manage them. It should be noted that according to the World Health Organization (WHO) guidelines, medical masks and respirators should only be reserved for healthcare workers [10] . 1) The healthcare professionals who are working with patients of COVID-19 and are in direct contact should have PPE consisting of gloves, gowns, masks, face shields, and goggles. Use Personal Protective Equipment (PPE) When Caring for Patients with Confirmed or Suspected COVID-19 Rational Use of Personal Protective Equipment ( PPE) for Coronavirus Disease ( COVID-19) : Interim Guidance doi = 10.7759/cureus.8248 id = cord-352324-tle14vtm author = Martini, Chiara title = Phase 3 of COVID-19: treat your patients and care for your radiographers. A designed projection for an aware and innovative radiology department. date = 2020-10-23 keywords = PPE; covid-19 summary = The aim of this document is therefore to provide useful and operative recommendations to radiographers who perform imaging services, such as chest X-ray (XR) and Computer Tomography (CT) scans to three types of patients: negative, suspected or suffering from Severe Acute Respiratory Syndrome by Coronavirus (SARS-CoV-2). The aim of this document is therefore to provide useful and operative recommendations to radiographers who perform imaging services, such as chest X-ray (XR) and Computer Tomography (CT) scans to three types of patients: negative, suspected or suffering from Severe Acute Respiratory Syndrome by Coronavirus (SARS-CoV-2). The aim of this document is therefore to provide useful operative recommendations to radiographers who perform imaging services, such as chest X-ray (XR) and Computer Tomography (CT) scans, aimed at three kinds of patients: negative, suspected or suffering from Severe Acute Respiratory Syndrome by Coronavirus (SARS-CoV-2). doi = 10.1016/j.jmir.2020.08.019 id = cord-331978-y4uo7o8g author = Maxwell, Daniel N title = “The Art of War” in the Era of Coronavirus Disease 2019 (COVID-19) date = 2020-03-04 keywords = COVID-19; PPE summary = With rapidly increasing cases and local community transmission in multiple countries outside of China, including the United States, the outbreak has entered a new phase, which requires a shift in primary battle strategy from a focus on containment in China to international mitigation. As cases of COVID-19 explode internationally, a strategic shift is required away from primarily containment, keeping the virus "out there", to home-based mitigation and public health responses. Now, the task is bearing the burden of identifying, isolating, triaging and managing the rising number of cases, necessitating total engagement of the medical community, public health sector, governments and society as a whole. As Sun Tzu noted, "If in training soldiers'' commands are habitually enforced, the army will be well-disciplined." 1 The authors also highlight improvements in infection prevention and control (IPC) infrastructure, administrative controls, and public health coordination compared to their 2003 SARS experience. doi = 10.1093/cid/ciaa229 id = cord-347381-nn6jqqy5 author = Mazzola, Santina M. title = Maintaining Perioperative Safety in Uncertain Times: COVID‐19 Pandemic Response Strategies date = 2020-09-29 keywords = COVID-19; HUP; PPE summary = Perioperative and organizational leaders at the Hospital of the University of Pennsylvania (HUP) were challenged to establish and implement a variety of strategies quickly to help ensure patient and staff member safety during the COVID-19 crisis. At HUP, administrators requested that health care leaders and their teams develop protocols to prioritize patient and staff member safety while also conserving the PPE inventory. The HUP leaders consulted the most recent US Centers for Disease Control and Prevention (CDC) and World Health Organization COVID-19 recommendations before deciding to require all employees, patients, and visitors to wear face masks while inside the health care facility. The leaders directed all perioperative personnel to wear a surgical mask during low-risk AGPs on patients who tested negative for COVID-19, a practice unchanged from the standard process used when preparing the sterile field. doi = 10.1002/aorn.13195 id = cord-295305-dfulr6nu author = McIsaac, Sarah title = Just the Facts: Protected code blue – Cardiopulmonary resuscitation in the emergency department during the coronavirus disease 2019 pandemic date = 2020-04-24 keywords = PCB; PPE summary = However, given the potential association of chest compressions with aerosolization, enhanced airborne precautions should be worn by all team members prior to commencing any other resuscitative efforts. 5 ED and EMS providers should have PPE, including airborne precautions (i.e., N95), readily available at all times given the risk of coronavirus disease 2019 (COVID-19) infection in the undifferentiated cardiac arrest. An additional member outside of the room in enhanced airborne precautions PPE may allow for a quick relief of chest compression duties. Outside of the room, the PCB team dons enhanced airborne PPE under supervision of a safety officer. • Early defibrillation can be provided by staff wearing only contact/droplet precautions prior to entry of the PCB team. • All PCB team members should be in appropriate enhanced airborne precautions before entering the room and commencing higher risk resuscitation interventions. doi = 10.1017/cem.2020.379 id = cord-337785-fwo0r4bb author = Mercer, Scott Thomas title = A Comparative Study Looking at Trauma and Orthopaedic Operating Efficiency in the COVID-19 Era date = 2020-10-21 keywords = COVID-19; PPE summary = No increase in surgical time was observed in hand and wrist surgery or for debridement and washouts. The other increases in time demonstrated can largely be attributed to the PPE required for aerosol generating procedures and other measures taken to reduce spread of the virus. During the pandemic due to redeployment of staff members and overall reduced trauma/ urgent orthopaedic cases, we had 2 all day lists from 8am to 8pm. A further sub-group analysis of hand and wrist surgery showed that there was no significant increase in surgical time in 2020 (Table 5) . Changes implemented during COVID-19 have led to a significant reduction in the efficiency of ORs. This will have significant effect on increased waiting times for elective surgery. Increasing frequency of regional anaesthesia concurrently with safe non-aerosol generating surgeries may improve operating room efficiency however, further research is needed to prove this. doi = 10.1016/j.pcorm.2020.100142 id = cord-028605-ehercdou author = Merchan, Cristian title = COVID-19 pandemic preparedness: A practical guide from an operational pharmacy perspective date = 2020-06-16 keywords = COVID-19; PPE; medication; pharmacy summary = PURPOSE: To describe our medical center''s pharmacy services preparedness process and offer guidance to assist other institutions in preparing for surges of critically ill patients such as those experienced during the coronavirus disease 2019 (COVID-19) pandemic. It was essential to create guidance documents outlining workflow, provide comprehensive staff education, and repurpose non–intensive care unit (ICU)-trained clinical pharmacotherapy specialists to work in ICUs. Teamwork was crucial to ensure staff safety, develop complete scheduling, maintain adequate drug inventory and sterile compounding, optimize the electronic health record and automated dispensing cabinets to help ensure appropriate prescribing and effective management of medication supplies, and streamline the pharmacy workflow to ensure that all patients received pharmacotherapeutic regimens in a timely fashion. Our pharmacy residents'' training was redesigned to enable them to assist with both clinical and operational needs, including rounding in newly established units designated as "COVID-ICUs," participating in medical code responses, and assisting with operational needs such as sterile compounding, hand deliveries, and other tasks. doi = 10.1093/ajhp/zxaa212 id = cord-306770-hjzlj8k3 author = Mick, Paul title = Aerosol-generating otolaryngology procedures and the need for enhanced PPE during the COVID-19 pandemic: a literature review date = 2020-05-11 keywords = AGMP; COVID-19; Health; PPE; SARS summary = During the coronavirus disease 2019 (COVID-19) pandemic, personal protective equipment (PPE) worn by health care workers is critical for reducing transmission of the infection in health care settings, particularly when aerosol-generating medical procedures (AGMP) are being performed. For example, Givi et al and the Canadian Society of Otolaryngology-Head and Neck Surgery [2] call for airborne precautions when performing AGMP on patients for whom the index of suspicion for COVID-19 infection is not high, whereas the World Health Organization, the U.S. Centers for Disease Control, and the Public Health Agency of Canada do not [3, 14, 15] . Measuring the level of aerosolized viral particles in rooms where AGMPs are being performed on patients with COVID-19 would provide indirect evidence of the degree to which these procedures put health care workers at risk of aerosolized transmission, and whether exposure concentration affects risk of infection and/or severity of disease. doi = 10.1186/s40463-020-00424-7 id = cord-346894-iy35298o author = Miranda-Schaeubinger, Monica title = A primer for pediatric radiologists on infection control in an era of COVID-19 date = 2020-07-07 keywords = Health; PPE; SARS; covid-19; patient summary = In pediatric radiology departments, the risk involved ranges from low (e.g., office workers, remote workers, telemedicine) to very high (e.g., workers performing aerosol-generating procedures on known or suspected COVID-19 patients), depending on the job task assigned [28, 29] . Standard precautions to minimize the spread of infection within health care facilities from direct contact with contaminations include hand hygiene, use of PPE based on anticipated contact with contaminated material, respiratory hygiene/ cough etiquette, cleaning and disinfection of the environment, and proper handling of patient care equipment and waste [10] . Appropriate personal protective equipment usage stratified by COVID-19 status (Table 3) Because of the possibility of airborne transmission of the virus, the CDC recommends respirators for care of all patients with COVID-19 if adequate supplies are available. For all aerosol-generating procedures in children who have either unknown or confirmed positive COVID-19 status, radiologists should adhere to the highest level of respiratory protection available: a respirator, an eye shield, a disposable gown and gloves. doi = 10.1007/s00247-020-04713-1 id = cord-341531-w788qwya author = Montero Feijoo, A. title = Practical recommendations for the perioperative management of patients with suspicion or serious infection by coronavirus SARS-CoV date = 2020-05-04 keywords = PPE; SARS; patient summary = Protective measures should be maximised when caring for patients with confirmed infection, in critically ill patients with a high viral load, and in patients that require invasive aerosol-generating procedures and manoeuvres such as aerosol therapy and nebulisation, aspiration of respiratory secretions, bag-mask ventilation, non-invasive ventilation, intubation, respiratory sampling, bronchoalveolar lavage, tracheostomy or cardiopulmonary resuscitation. If postoperative surveillance is necessary, it will be carried out in adequately monitored isolation units, preferably with negative pressure Avoid using aerosols, high-flow nasal oxygen or non-invasive ventilation as far as possible in patients requiring postoperative oxygen therapy Healthcare personnel who care for patients during postoperative surveillance must wear appropriate personal protective equipment at all times and must be taught donning and doffing techniques The same recommendations for transferring patients to the operating room apply to postoperative transfer doi = 10.1016/j.redare.2020.03.002 id = cord-316063-9bg2dm8e author = Morgan, Marcus title = Why meaning-making matters: the case of the UK Government’s COVID-19 response date = 2020-10-15 keywords = COVID-19; Cummings; Guardian; Johnson; March; NHS; PPE; SAGE; Turner; british; government; public; virus summary = The paper also offers more specific contributions to cultural sociology by showing why social performance theory needs to consider the effects of casting non-human actors in social dramas, how metaphor forms a powerful tool of political action through simplifying and shaping complex realities, and how casting can shift responsibility and redefine the meaning of emotionally charged events such as human death. On 28th February, the first death of a British national occurred on the quarantined Diamond Princess cruise ship, and the Sunday Times reported that around the same time Dominic Cummings (Johnson''s Chief Advisor, and former director of the successful Vote Leave campaign) had ''outlined the government''s strategy'' for the UK''s national response to the virus ''at a private engagement'', quoting those present as claiming that it was ''herd immunity, protect the economy, and if that means some pensioners die, too bad'' (Shipman and Wheeler 2020) . doi = 10.1057/s41290-020-00121-y id = cord-316718-7gtgqmcn author = Murphy, D. L. title = Occupational Exposures and Programmatic Response to COVID-19 Pandemic: An Emergency Medical Services Experience date = 2020-05-24 keywords = EMS; PPE; covid-19 summary = We reviewed dispatch, EMS, and public health surveillance records to evaluate the temporal relationship between exposure and programmatic changes to EMS operations designed to identify high-risk patients, protect the workforce, and conserve PPE. Ideally, EMS strategies would incorporate COVID-19 risk assessment and target use of the limited PPE resource in order to achieve EMS provider safety, extend the supply of PPE, and support high-quality patient care. Of the 700 unique EMS providers caring for patients with confirmed COVID-19, 3 (0.4%) tested positive during the 14 days following an encounter (Table 3 ), yet none of these three had a documented occupational exposure. The series of practice changes involving dispatch advisement, patient COVID-19 risk criteria, and initial EMS scene deployment were associated with a temporal increase in adequate PPE use and conversely a decrease in EMS provider exposures (Figure 2, p<0.01) . doi = 10.1101/2020.05.22.20110718 id = cord-334124-w9jww3hk author = Murphy, David L title = Occupational exposures and programmatic response to COVID-19 pandemic: an emergency medical services experience date = 2020-09-21 keywords = COVID-19; EMS; PPE summary = We reviewed dispatch, EMS and public health surveillance records to evaluate the temporal relationship between exposure and programmatic changes to EMS operations designed to identify high-risk patients, protect the workforce and conserve PPE. We evaluated all 9-1-1 EMS responses to patients with COVID-19 to (1) determine occupational exposure, related workforce quarantine and potential transmission, and (2) understand how programmatic changes influenced occupational exposure, workforce quarantine and PPE use amidst the COVID-19 outbreak in Seattle and King County. The study is a retrospective cohort investigation of EMS providers responding to 9-1-1 calls for laboratory-confirmed COVID-19-positive patients in King County, Washington, USA between 14 February 2020 and 26 March 2020. The series of practice changes involving dispatch advisement, patient COVID-19 risk criteria and initial EMS scene deployment were associated with a temporal increase in adequate PPE use and conversely a decrease in EMS provider exposures (figure 2, p<0.01). doi = 10.1136/emermed-2020-210095 id = cord-346176-w6uaet7l author = Nayeri, Shadi title = Conducting Translational Gastrointestinal Research in the Era of COVID-19 date = 2020-08-26 keywords = PPE; SARS; research summary = In this document we provide a suggested roadmap for resuming gastrointestinal translational research activities, emphasising physical distancing and use of personal protective equipment. We discuss modes of virus transmission in enclosed environments [including clinical workplaces and laboratories] and potential risks of exposure in the endoscopy environment for research staff. Efforts focus primarily on physical distancing, use of PHASE personal protective equipment [PPE] , and addressing capacity needs of health care systems to deal with the outbreak. Local and institutional guidance is required to resume translational research activities, including patient interactions. • Invitation of persons currently infected with SARS-CoV-2 from the community into the research environment would cause unnecessary and inappropriate risk of viral transmission. These guidelines address safety precautions in relevant workspaces [including laboratory and endoscopy environments] as well as in specific research activities such as sample collection, handling, and transportation. doi = 10.1093/ecco-jcc/jjaa171 id = cord-302987-znogutwp author = Nguyen, Anne X title = Differences in SARS-CoV-2 recommendations from major ophthalmology societies worldwide date = 2020-07-07 keywords = AAO; COVID-19; PPE; SFO summary = doi = 10.1136/bmjophth-2020-000525 id = cord-342810-41dghl0c author = Nguyen, Thanh N. title = Subarachnoid hemorrhage guidance in the era of the COVID-19 pandemic -An opinion to mitigate exposure and conserve personal protective equipment date = 2020-06-05 keywords = COVID-19; PPE; SAH; patient summary = Previously established SAH treatment protocols are impractical to impossible to adhere to in the current COVID-19 crisis due to the need for infection containment and shortage of critical care resources, including personal protective equipment (PPE). Previously established SAH treatment protocols are impractical to impossible to adhere to in the current Coronavirus-Disease-2019 (COVID-19) crisis due to the need for infection containment and shortage of critical care resources, including personal protective equipment (PPE) and health care providers. When a patient with suspected or confirmed COVID-19 is at risk for impending respiratory failure (i.e. orthopnea or respiratory distress lying flat, high oxygen requirement, rapid neurological decline), consider early and controlled intubation in a negative pressure room in the ER/ICU/OR with staff wearing full PPE including N95 mask, gown, double gloves, face shield or per local institutional COVID-19 intubation policy. doi = 10.1016/j.jstrokecerebrovasdis.2020.105010 id = cord-322871-cf4mn0pu author = O''Keeffe, Dara Ann title = Ebola Emergency Preparedness: Simulation Training for Frontline Health Care Professionals date = 2016-08-08 keywords = PPE; participant; program summary = The primary goal of this program was to ensure the safety of staff, patients, and the general public by training staff in the correct use of personal protective equipment (PPE) before, during, and after care of patients with EVD. RESULTS: This program was effectively deployed in the STRATUS Center for Medical Simulation over a 4-month period, with 220 health care professionals participating in the training and 195 participants completing the pre-/posttraining questionnaires. DISCUSSION: This interprofessional simulation-based program has been shown to be a well-received method of training clinicians to manage patients collaboratively during an EVD outbreak. Here, we describe a simulation laboratory-based program that was used as the foundation training for frontline staff in the correct use of PPE for clinical care activities. Our interprofessional simulation-based program has been shown to be a well-received method of training clinicians to manage patients collaboratively during an EVD outbreak. doi = 10.15766/mep_2374-8265.10433 id = cord-335477-po201szv author = O''Leary, Fenton title = Personal Protective Equipment in the Paediatric Emergency Department during the COVID‐19 pandemic. Estimating requirements based on staff numbers and patient presentations. date = 2020-09-21 keywords = COVID-19; PPE summary = OBJECTIVES: To estimate the Personal Protective Equipment (PPE) required in a Paediatric Emergency Department during the COVID‐19 pandemic comparing the use per patient to use per patient zone, based on the NSW Clinical Excellence Commission (CEC) guidelines in place at the time of the study. The aim of this study was to identify the number of staff contacts and AGPs with patients in the Paediatric ED over a 24 hour period and attribute PPE required according to the NSW CEC guideline and compare this to the PPE required based on staff zone allocations. Estimated PPE requirements for each of the three levels of risk of infection and transmission based on staff roles and zone allocations are described in Table 3 -supplementary file and based on patient contacts and procedures in Table 4 -supplementary file. doi = 10.1111/1742-6723.13653 id = cord-294916-xc9ozxyn author = Oehmen, Josef title = Risk, uncertainty, ignorance and myopia: Their managerial implications for B2B firms date = 2020-07-31 keywords = Aven; COVID-19; PPE; management; risk; uncertainty summary = doi = 10.1016/j.indmarman.2020.05.018 id = cord-329921-mi71bet3 author = Ogoina, Dimie title = COVID-19: the need to redesign head coverings of personal protective equipment for manual stethoscopes date = 2020-08-11 keywords = PPE summary = In light of the absence of alternative technologies, and the need to define the chest signs of severe COVID-19 cases upon admission to our isolation ward, we explored redesigning the head covering of some of our PPE to enable auscultation of the lungs and hearts of COVID-19 patients using manual stethoscopes. The redesigned head covering is worn by a clinician, who can easily place the earpiece of the manual stethoscope into both ears through the refashioned ear pouches of the hood (Figure 1 ). In resource-limited settings where alternative technologies may be lacking, clinicians managing COVID-19 patients should consider redesigning the head covering of PPE to make provisions for the use of manual stethoscopes. Manufacturers of PPE should also consider creating ear pouches as part of the product design of head coverings to allow for the routine use of manual stethoscopes during the care of contagious infectious diseases such as COVID-19. doi = 10.1093/trstmh/traa063 id = cord-287707-ng0ha3vv author = Pal, Arghya title = ‘Masking’ of the mental state: unintended consequences of personal protective equipment (PPE) on psychiatric clinical practice date = 2020-06-04 keywords = PPE summary = title: ''Masking'' of the mental state: unintended consequences of personal protective equipment (PPE) on psychiatric clinical practice ''Masking'' of the mental state: unintended consequences of personal protective equipment (PPE) on psychiatric clinical practice "When your face says it all, your mouth waits its turn"this quotation by Anthony T. The mental state examination (MSE) derives significantly from simple observation of someone"s facial expressions and body language, in addition to clinical questions. The use of masks hampers the observation of facial expressions which is very important for any MSE. Apart from the difficulties in conducting MSE, PPE may also pose a barrier to observe some clinical signs which are as important to psychiatry as for other medical disciplines, e.g., injuries, pallor, icterus, cyanosis, etc. It would be highly beneficial for psychiatrists and patients alike if the national or international psychiatric bodies can prepare guidelines while weighing all the pros and cons, to conduct interviews and MSEs during the current pandemic. doi = 10.1016/j.psychres.2020.113178 id = cord-284374-sqxlnk9e author = Park, Jiyeon title = Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea date = 2020-01-15 keywords = East; MERS; Middle; PPE summary = title: Infection Prevention Measures for Surgical Procedures during a Middle East Respiratory Syndrome Outbreak in a Tertiary Care Hospital in South Korea Our experience with setting up a temporary negative-pressure operation room and our conservative approach for managing MERS-related patients can be referred in cases of future unexpected MERS outbreaks in non-endemic countries. Anesthesiologists were recommended to apply enhanced PPE (including PAPR from the middle of the outbreak) when managing all MERS-related patients because they were most directly exposed to the aerosol-producing high-risk procedures, such as endotracheal intubation and extubation. Almost all hospitals generally have positive-pressure operating rooms and they may experience an outbreak without facilities that are prepared for perioperative management of MERS patients, as our hospital did in 2015. First, although the previous guidelines recommended that asymptomatic MERS-exposed patients be managed as general patients undergoing surgery, we applied standard PPE to HCWs and we performed MERS-CoV PCR screening twice. doi = 10.1038/s41598-019-57216-x id = cord-268874-ldja6aa4 author = Park, Sun Hee title = Personal Protective Equipment for Healthcare Workers during the COVID-19 Pandemic date = 2020-06-24 keywords = COVID-19; N95; PPE; SARS summary = Although no study has conclusively linked SARS-CoV-2 transmission to contaminated environmental surfaces, indirect contact with fomites is considered a possible route based on the evidence of heavy environmental contamination in healthcare settings, objects used by COVID-19 patients [26, 27] , and the finding that the virus remains viable on plastic surfaces for as long as 3 days [28] . Initially, the Korea Center for Disease Control and Prevention (KCDC) guidelines recommended coveralls with shoe covers for contact precautions, goggles/face shields for eye protection, N95 or equivalent respirators for respiratory protection, and powered airpurifying respirators (PAPRs) when AGPs are performed [46] . PPE for droplet and contact precautions, such as surgical masks with eye protection, gowns, and gloves, are recommended for HCWs in contact with suspected or confirmed COVID-19 patients, and N95 or equivalent respirators should to be worn by HCWs whenever AGPs are performed. doi = 10.3947/ic.2020.52.2.165 id = cord-338365-9sd62a2w author = Patrício Silva, Ana L. title = Increased plastic pollution due to Covid-19 pandemic: challenges and recommendations date = 2020-08-17 keywords = COVID-19; PPE; SARS; SUP; environmental; plastic; waste summary = This paper provides a comprehensive review on the potential impact of COVID-19 pandemic precautionary measures in the environment while considering the shift on public behaviour and policies towards single-use items and waste management. At first glance COVID-19 pandemic seems to be indirectly contributing towards the UN 2030 Sustainable Development Goals (namely 11, 12, 13, 15 SGDs) by increasing overall health and safety of cities by reducing the greenhouse gas emissions (GHG), outdoor air pollution, environmental noise level (including underwater noise due to reduced marine transportation activities), land and wildlife pressure. While the positive impacts of COVID-19 in the environment are resulting from a "postponed" anthropogenic activity that soon will entail after the pandemic scenario; the negative short-term effects (that are mostly related with plastic use, consumption and waste mismanagement as discussed below) will shortly add-up to the current environmental issues, aggravating their impact in the natural ecosystems and compromising potential mitigation/remediation measures. doi = 10.1016/j.cej.2020.126683 id = cord-308409-0n2ysgsa author = Pawlak, Katarzyna M. title = Impact of COVID-19 on endoscopy trainees: an international survey date = 2020-06-11 keywords = COVID-19; PPE; trainee; training summary = Therefore, in this international survey, we aimed to assess the impact of the COVID-19 pandemic on endoscopy trainees, including procedure numbers, barriers to training, and the physical and emotional well-being of trainees. 2) Changes to institutional case volume 3) Trainee concerns regarding competency development and prolongation of training; 4) Anxiety, assessed using the Generalized Anxiety Disorder-7 (GAD-7) scale, 12 and rates of burnout, measured using the single item burnout scale. Of the 770 (93.8%) trainees who reported a reduction in endoscopy procedural volumes during the COVID-19 study period, the reasons cited included: changes to institutional policy to exclude trainees from procedures (79.9%); lack of cases (58.3%); shortage of available PPE (28.8%); redeployment to another clinical area (24.0%); and personal reasons (10.2%). Our study showed that the COVID-19 pandemic has led to drastic reductions in endoscopic volumes and restrictions on endoscopy training, with detrimental effects on trainee well-being, including high rates of anxiety and burnout among trainees worldwide. doi = 10.1016/j.gie.2020.06.010 id = cord-310944-tfn0ltrz author = Peck, Jessica L. title = COVID 19: Impacts and Implications for Pediatric Practice date = 2020-07-09 keywords = CDC; COVID-19; Curtis; PPE; child summary = Other populations at significant risk include older adults (> 65 years of age), persons with underlying medical conditions (e.g., asthma, cardiovascular disease, kidney disease), persons with immunocompromise, persons with severe obesity (body mass index >40), persons with diabetes, persons undergoing dialysis, and persons residing in long-term care or nursing homes (CDC, 2020c) . Ideal PPE when caring for a patient with known or suspected COVID-19 infection includes: a new N-95 mask, gown, medical grade gloves, and eye covers and/or a face shield (CDC, 2020b). Recommendations for families include: 1) supporting children as they ask questions about the pandemic, 2) close monitoring of child health and well-being with prompt contact of primary healthcare providers if changes are noticed, and 3) continuing to seek care in-person or using telehealth to maintain well visits and immunization schedules while receiving anticipatory guidance and necessary screenings. doi = 10.1016/j.pedhc.2020.07.004 id = cord-337633-arivuags author = Perkins, Douglas Jay title = COVID-19 Global Pandemic Planning: Decontamination and Reuse Processes for N95 Respirators date = 2020-04-14 keywords = N95; PPE; decontamination summary = 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). The primary means of protecting frontline healthcare personnel (HCP) from contracting COVID-19 is through the proper use of personal protective equipment (PPE), such as N95 filtering facepiece respirators (FFRs). The two most important lessons learned from our experience are: 1) develop an adequate reserve of PPE for efficiently implementing the reprocessing workflow, and 2) locate a suitable environment for the HPV decontamination procedure, such as an operating room, which has the pre-existing conditions required for conducing the HPV decontamination process. doi = 10.1101/2020.04.09.20060129 id = cord-287303-b7vg439c author = Piché-Renaud, Pierre-Philippe title = Healthcare worker perception of a global outbreak of novel coronavirus (COVID-19) and personal protective equipment: Survey of a pediatric tertiary-care hospital date = 2020-08-12 keywords = COVID-19; IPAC; PPE summary = OBJECTIVE: In this study, we aimed to capture perspectives of healthcare workers (HCWs) on coronavirus disease 2019 (COVID-19) and infection prevention and control (IPAC) measures implemented during the early phase of the COVID-19 pandemic. INTERVENTION: A self-administered survey was distributed to HCWs. We analyzed factors influencing HCW knowledge and self-reported use of personal protective equipment (PPE), concerns about contracting COVID-19 and acceptance of the recommended IPAC precautions for COVID-19. 13, 14 During the 2003 SARS outbreak in Canada, inconsistent use of PPE and lack of adequate infection control training were among the factors contributing to the infection of HCWs. 15 In this study, we aimed to capture attitudes and knowledge of HCWs regarding COVID-19 and IPAC measures in the early phase of the COVID-19 pandemic, especially related to PPE. We also sought to identify factors influencing HCW knowledge and self-reported use of personal protective equipment (PPE), concerns about contracting COVID-19, and acceptance of the recommended IPAC precautions for COVID19 . doi = 10.1017/ice.2020.415 id = cord-330333-un8lvw5o author = Pieterse, Pieternella title = Locally produced personal protective equipment can offer hospital staff protection against Covid‐19 if combined with surgical masks and rigorous personal protective equipment cleaning routine date = 2020-09-30 keywords = PPE summary = Locally made, washable and reusable personal protective equipment (PPE), used in combination with N95 masks that were reused safely, has proven to be a viable alternative to disposable gowns and caps for hospital staff in low‐ and middle‐income countries. Muhimbili University Hospital''s children''s cancer ward in Dar es Salaam, Tanzania, developed locally made PPE and created rigorous cleaning and disinfecting protocols, when the daily use of imported, disposable materials were not an option. In early March, when there were mere rumours of the virus across the continent, the children''s oncology ward management decided that everyone (including administrators, cleaners, patients and guardians, as well as nurses and doctors), would wear a mask at all times regardless of symptoms, and carry disinfectant gel to clean hands as frequently as possible. Locally produced personal protective equipment can offer hospital staff protection against Covid-19 if combined with surgical masks and rigorous personal protective equipment cleaning routine doi = 10.1002/hpm.3080 id = cord-131678-rvg1ayp2 author = Ponce, Marcelo title = covid19.analytics: An R Package to Obtain, Analyze and Visualize Data from the Corona Virus Disease Pandemic date = 2020-09-02 keywords = PPE; SIR; case; datum; function summary = This paper is organized as follow: in Sec. 2 we describe the covid19.analytics , in Sec. 3 we present some examples of data analysis and visualization, in Sec. 4 we describe in detail how to deploy a web dashboard employing the capabilities of the covid19.analytics package providing full details on the implementation so that this procedure can be repeated and followed by interested users in developing their own dashboards. As the amount of data available for the recorded cases of CoViD19 can be overwhelming, and in order to get a quick insight on the main statistical indicators, the covid19.analytics package includes the report.summary function, which will generate an overall report summarizing the main statistical estimators for the different datasets. The covid19.analytics package provides three different functions to visualize the trends in daily changes of reported cases from time series data. doi = nan id = cord-352902-isc3ek67 author = Powell, Adam W. title = The Adaptation of Pediatric Exercise Testing Programs to the Coronavirus/COVID-19 Pandemic date = 2020-09-21 keywords = COVID-19; PPE summary = The primary aims of this study were to (1) better understand current practice patterns in pediatric exercise laboratories in the United States and Canada, (2) assess local and institutional management during the COVID-19 pandemic, and (3) investigate how centers are affected by the lifting of hospital restrictions for COVID-19. Data were recorded regarding program location, changes to exercise laboratory staffing and operational protocols, current PPE use, changes to exercise testing protocols including deviations in measuring metabolic indicators of fitness, baseline pulmonary function testing, and noninvasive measures of cardiac output. Among the programs surveyed, 66% (23/35) reported discontinuing all exercise testing for a period of time during the COVID-19 pandemic, 31% (11/35) continued testing but only for patients triaged by medical need, and 3% (1/35) did not alter testing protocols. Specifically, the authors would like to thank all the pediatric exercise laboratories that responded to this survey for completing this item and for all the effort and diligence they have placed in caring for their patients and staff during the pandemic. doi = 10.1177/2150135120954816 id = cord-029722-85h5060v author = Proffitt, Edmund title = Decoding the English standard operating procedures for dentists and the dental industry date = 2020-07-24 keywords = England; PPE summary = It could be seen as a vehicle to herald what the CDO England has described as a ''COVID-19 legacy hallmarked by a determined revision of the current activitydriven clinical approach, optimising time with patients and delivered as an integrated oral health team.'' 3 Beyond the scope of the SOP document, there also appears to be an appetite for contract reform to support this ''revision'' going forwards. Seemingly, the raison d''être of the new standard operating procedures is not just to outline the detailed procedures for kick-starting dentistry, but also to support practices through transition and the shift towards a preventative and minimally invasive clinical approach that meets the current clinical challenges, and possibly then goes beyond. Seemingly, the raison d''être of the new standard operating procedures is not just to outline the detailed procedures for kick-starting dentistry, but also to support practices through transition and the shift towards a preventative and minimally invasive clinical approach that meets the current clinical challenges, and possibly then goes beyond. doi = 10.1038/s41415-020-1853-7 id = cord-259984-csdf1a69 author = Raffiq, Azman title = COVID-19 Pandemic and Its Impact on Neurosurgery Practice in Malaysia: Academic Insights, Clinical Experience and Protocols from March till August 2020 date = 2020-10-27 keywords = COVID-19; ICU; Malaysia; N95; PPE; care; case; patient; surgical summary = doi = 10.21315/mjms2020.27.5.14 id = cord-323008-xk89ew1b author = Rama, Asheen title = Individualized simulations in a time of social distancing: Learning on donning and doffing of an COVID-19 airway response team date = 2020-08-30 keywords = PPE summary = title: Individualized simulations in a time of social distancing: Learning on donning and doffing of an COVID-19 airway response team Recently, common biosafety breaches during donning and doffing of protective personal equipment (PPE) have been reported [2] . With the approval and wavier of institutional IRB, we report here our findings of examining our staff training regarding the common biosafety breaches in donning and doffing for aerosols generating medical procedures (AGMPs) based on key areas identified by Munoz-Leyva and Niazi [2] . Given the vast number of HCWs who are becoming infected with COVID-19 [6] , it is of vital importance that we not only distribute knowledge on PPE in the form of protocols, guidelines, demonstrations, and videos, but also provide simulations with personalized feedback which improves staff safety in anticipation of potential second wave infection as the world reopens [6] . Common breaches in biosafety during donning and doffing of protective personal equipment used in the care of COVID-19 patients doi = 10.1016/j.jclinane.2020.110019 id = cord-271925-85bixn27 author = Rao US, V. title = Droplet nuclei aerosol and Covid 19 - a risk to healthcare staff date = 2020-05-03 keywords = PPE summary = title: Droplet nuclei aerosol and Covid 19 a risk to healthcare staff The authors need to be complimented for a well-timed paper that addresses the current issue of exposure of health care workers to COVID 19. Authors mentioned that Flügge droplets travel up to 4.5 m, representing a risk to healthcare staff that is not directly involved in patient care. Health care workers and employers who are not directly involved in patient care are also at risk of virus transmission due to this and need to take adequate precautions. As rightly mentioned by the authors, the health care staff and the employee must receive adequate training to use personal protective equipment. Adequate training and education about droplet nuclei aerosol is very important for the safety of health care professionals and reducing risk of virus exposure. Personal protective equipment and COVID 19-a risk to healthcare staff? doi = 10.1016/j.bjoms.2020.04.036 id = cord-296306-xcomjvaa author = Rivett, Lucy title = Screening of healthcare workers for SARS-CoV-2 highlights the role of asymptomatic carriage in COVID-19 transmission date = 2020-05-11 keywords = COVID-19; HCW; PPE; SARS; test summary = Significant differences exist in the availability of healthcare worker (HCW) SARS-CoV-2 testing between countries, and existing programmes focus on screening symptomatic rather than asymptomatic staff. Table 3 outlines the total number of SARS-CoV-2 tests performed in each screening group (HCW asymptomatic, HCW symptomatic, and HCW symptomatic household contact) categorised according to the ward with the highest anticipated risk of exposure to high; ''amber'', medium; ''green'', low; . Three subgroups of SARS-CoV-2 positive asymptomatic HCW Each individual in the HCW asymptomatic screening group was contacted by telephone to establish a clinical history, and COVID-19 probability criteria ( Table 1) were retrospectively applied to categorise any symptoms in the month prior to testing ( Figure 2 ). 12/30 (40%) individuals from the HCW asymptomatic screening group reported symptoms > 7 days prior to testing, and the majority experiencing symptoms consistent with a high probability of COVID-19 had appropriately self-isolated during that period. doi = 10.7554/elife.58728 id = cord-253135-0tun7fjk author = Robin, Charlotte title = Zoonotic disease risk perceptions in the British veterinary profession date = 2017-01-01 keywords = PPE; risk; veterinary summary = doi = 10.1016/j.prevetmed.2016.11.015 id = cord-256112-zg63v8hh author = Rowan, Neil J. title = Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from Coronavirus disease (COVID19) pandemic – Case study from the Republic of Ireland date = 2020-07-10 keywords = COVID19; Ireland; PPE summary = title: Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from Coronavirus disease (COVID19) pandemic – Case study from the Republic of Ireland This REA_PPE team comprises experts representative of anaesthesia and intensive care, medical device technology, infection control, hospital disinfection and sterilization, minimal processing; microbiology, toxicology, virology, material science, software engineering, and social marketing Priority initially focused on delineating effective communication channels in order to inform stocks within healthcare from several routes that include use of dedicated webpage [https: //covidmedsupply.org/] established by researchers from NUI Galway and University of Limerick (Ireland) that collects donations of PPE from regional industries and academic institutions. Original equipment manufacturers (OEMs) of one-time-use PPE have recently provided new information on possible methods for reprocessing these items given the universal need to consider contingency plans arising from shortages during this pandemic (such as 3M Science of Life, 2020). doi = 10.1016/j.scitotenv.2020.138532 id = cord-305262-23qylbmg author = Rowan, Neil J. title = Unlocking the surge in demand for personal and protective equipment (PPE) and improvised face coverings arising from coronavirus disease (COVID-19) pandemic – Implications for efficacy, re-use and sustainable waste management date = 2020-09-10 keywords = COVID-19; N95; PPE; Rowan; SARS summary = doi = 10.1016/j.scitotenv.2020.142259 id = cord-316918-mz5r7yiy author = Rubin, Geoffrey A. title = Performance of electrophysiology procedures at an academic medical center amidst the 2020 coronavirus (COVID‐19) pandemic date = 2020-04-20 keywords = PPE; covid-19 summary = In this proposal, we detail the specific protocol changes that our EP department has adopted during the COVID‐19 pandemic, including performance of only urgent/emergent procedures, after hours/7‐day per week laboratory operation, single attending‐only cases to preserve PPE, appropriate use of PPE, telemedicine and video chat follow‐up appointments, and daily conferences to collectively manage the clinical and ethical dilemmas to come. In this proposal, we detail the specific protocol changes that our EP department has adopted during the COVID-19 pandemic, including performance of only urgent/emergent procedures, after hours/7-day per week laboratory operation, single attending-only cases to preserve PPE, appropriate use of PPE, telemedicine and video chat follow-up appointments, and daily conferences to collectively manage the clinical and ethical dilemmas to come. Unless urgent/emergent, we have avoided performing procedures on COVID-19 infected patients in the EP laboratory to prevent transmission not only during transport to the laboratory, but also to prevent seeding the lab itself in the case of a prolonged operation. doi = 10.1111/jce.14493 id = cord-284274-9uu7yflt author = Russi, Christopher S. title = Emergency Medicine Telehealth for COVID-19: Minimize Front-Line Provider Exposure and Conserve Personal Protective Equipment (PPE) date = 2020-08-13 keywords = COVID-19; PPE summary = doi = 10.1016/j.mayocp.2020.07.025 id = cord-310104-1c7q9m06 author = Sasangohar, Farzan title = Provider Burnout and Fatigue During the COVID-19 Pandemic: Lessons Learned From a High-Volume Intensive Care Unit date = 2020-04-20 keywords = COVID-19; HMH; PPE; care summary = T he novel Coronavirus Disease 2019 (COVID19) pandemic has resulted in an overall surge in new cases of depression and anxiety and an exacerbation of existing mental health issues, with a particular emotional and physical toll on health care workers. In this article, we share the lessons learned collectively by an interdisciplinary team of ICU leadership and collaborating scientists at the Center for Outcomes Research at HMH about the experience of occupational fatigue and burnout of intensive care personnel as a result of responding to the COVID-19 pandemic. Several factors may have exacerbated occupational fatigue and burnout in ICUs. Given our overarching roles across various facets of the health care system and our first-hand experiences with the response, the "lessons learned" documented here provide a holistic overview of major system-level problems exposed by the pandemic. doi = 10.1213/ane.0000000000004866 id = cord-329268-0zhabgkt author = Savoia, E. title = Factors Associated with Access and Use of PPE during COVID-19: A Cross-sectional Study of Italian Physicians date = 2020-05-01 keywords = COVID-19; Italy; PPE summary = This study aimed to understand physicians access to personal protective equipment (PPE) and to information about their use, risk perception and strategies adopted to prevent contracting the infection. This study aimed to understand physicians'' access to PPE, reception of information about their use, ability to perform donning and doffing procedures, risk perception and strategies adopted to prevent contracting the infection. Questions were designed to inform the development of training and policies in response to the crisis and included questions about the physician''s work experience (years of experience, specialty, experience in COVID-19 units and geographic area of work), and questions related to the use of PPE divided in four parts: 1) Access to PPE and strategies to cope with shortage, 2) Information received on the use of PPE, 3) Self-reported ability to perform donning and doffing procedures, and 4) Risk perception of contracting the disease. doi = 10.1101/2020.04.24.20073924 id = cord-341715-8h57tppr author = Sernicola, Alvise title = Treatment of nasal bridge ulceration related to protective measures for the COVID‐19 epidemic date = 2020-05-07 keywords = PPE; skin summary = Effective use of personal protective equipment (PPE) is of paramount importance to reduce the rates of infection among medical personnel, which is a leading cause of nosocomial spread among hospitalised patients and of loss of response capacity for health facilities, with HCWs constituting up to nine percent of total COVID-19 cases. 9 A 2019 study analysed the use of hydrocolloid medication in patients requiring NIV demonstrating a significantly reduced incidence of grade 2 pressure ulcers when a preventative hydrocolloid dressing was positioned on the nasal bridge compared with when the NIV mask was directly applied. We propose the use of a hydrocolloid dressing that successfully treated nasal bridge ulceration in our patient, to be applied as a simple and effective protection procedure in this setting, thanks to the specific properties of this advanced medication. The preventative effect of hydrocolloid dressings on Nasal bridge pressure ulceration in acute noninvasive ventilation doi = 10.1111/iwj.13397 id = cord-258498-0mvxwo3w author = Shah, Saleha title = COVID-19 and paediatric dentistry- traversing the challenges. A narrative review date = 2020-08-21 keywords = COVID-19; DHCP; N95; NSAID; PPE; care; dental; patient; risk summary = This review article informs about measures which reduce facility risk, manage symptomatic patients and protect personal health care and management with reference to paediatric dentistry. 5, 6, 7 The risk of SARS-CoV-2 transmission via aerosols generated during dental procedures cannot be eliminated when practicing in the absence of Airborne Precautions (airborne infection isolation rooms or single-patient rooms, respiratory protection program, N95 respirators). 47 Primary prevention encompasses prenatal health care, avoidance of night time bottle feed with sugary drinks or milk, restricting sugar intake and frequency for children younger than 24 months, avoiding frequent/nocturnal breast or bottle feeding after 1 year, exposure to dietary fluoridate (water, milk, salt), use of an age appropriate amount of fluoride toothpaste containing at least 1000ppm fluoride for brushing at least twice a day, dental visit in the first year of life and regular applications of 5% fluoride. doi = 10.1016/j.amsu.2020.08.007 id = cord-011413-yv4x8viu author = Shekar, Kiran title = Extracorporeal Life Support Organization Coronavirus Disease 2019 Interim Guidelines: A Consensus Document from an International Group of Interdisciplinary Extracorporeal Membrane Oxygenation Providers date = 2020-05-12 keywords = ECMO; ELSO; PPE; covid-19; patient summary = The Extracorporeal Life Support Organization (ELSO) Coronavirus Disease 2019 (COVID-19) Guidelines have been developed to assist existing extracorporeal membrane oxygenation (ECMO) centers to prepare and plan provision of ECMO during the ongoing pandemic. 11 The interim recommendations presented here balance the need to provide high-quality ECMO care to those who may benefit most while being cognizant of available resources and maintaining an environment of patient and staff safety (Figure 1) . In addition, the Extracorporeal Life Support Organization (ELSO) COVID-19 Working Group Members completed a survey on patient selection criteria for ECMO to build consensus. We recommend the following contraindications for ECMO in patients with cardiopulmonary failure due to COVID-19 (Table 1) in centers functioning under significant resource constraints, for example, Contingency Capacity ≥ Tier 1. International ECMO Network (ECMONet): Position paper for the organization of extracorporeal membrane oxygenation programs for acute respiratory failure in adult patients doi = 10.1097/mat.0000000000001193 id = cord-317884-zni0aj1n author = Shirodkar, Amy-lee title = Personal Protective Equipment (PPE) use among emergency eye care professionals in the UK during the COVID19 pandemic date = 2020-05-21 keywords = BEECS; PPE summary = EEC staff were provided with rapidly changing personal PPE guidance by Public Health England (PHE) with specific subspecialty advice from the British Emergency Eye Care Society (BEECS) and the Royal College of Ophthalmologists (RCOphth) UK during the COVID19 pandemic. BEECS undertook a baseline survey of its members after the initial response from the RCOphth 16/3/20 mirroring Public Health England (PHE) advice and a followup survey after the guidance was updated on 9/4/20. EEC staff were provided with rapidly changing personal PPE guidance by Public Health England (PHE) with specific subspecialty advice from the British Emergency Eye Care Society (BEECS) and the Royal College of Ophthalmologists (RCOphth) UK. BEECS undertook a baseline survey of its members after the initial response from the RCOphth 16/3/20 mirroring Public Health England (PHE) advice and a follow-up survey after the guidance was updated on 9/4/20. doi = 10.1038/s41433-020-0970-5 id = cord-281762-qwlfikfl author = Shorten, George D. title = Personal protective equipment during the COVID-19 pandemic (Letter #1) date = 2020-08-07 keywords = PPE summary = During the coronavirus disease pandemic, the circumstances under which donning and doffing of PPE is being learned, trained, and subsequently performed may be suboptimal. Although no overview exists of the training practices for donning and doffing PPE, it is likely that it is less than ideal. Ideally, in designing a training program for a new procedure, one would: 1) share a description of the procedure with ''''trainees'''' that contains unambiguous definitions of each step, and common and critical errors; 2) apply a pre-training preparation standard; 3) provide real-world materials (e.g., PPE) for repeated deliberate practice; 4) provide multiple training sessions based on performance; and 5) undertake an ''''exit'''' assessment. 4 Proficiencybased progression and other forms of metrics-based training decrease the incidence of errors amongst novice practitioners and the evidence of its consistent efficacy is particularly strong for procedural skills. Personal protective equipment (PPE) for both anesthesiologists and other airway managers: principles and practice during the COVID-19 pandemic doi = 10.1007/s12630-020-01784-4 id = cord-276758-k2imddzr author = Siegel, Jane D. title = 2007 Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Health Care Settings date = 2007-12-07 keywords = CDC; Control; MRSA; PPE; Precautions; SARS; Standard; Staphylococcus; States; United; base; care; health; infection; outbreak; patient; transmission summary = Activities currently assigned to ICPs in response to emerging challenges include (1) surveillance and infection prevention at facilities other than acute care hospitals (eg, ambulatory clinics, day surgery centers, LTCFs, rehabilitation centers, home care); (2) oversight of employee health services related to infection prevention (eg, assessment of risk and administration of recommended treatment after exposure to infectious agents, tuberculosis screening, influenza vaccination, respiratory protection fit testing, and administration of other vaccines as indicated, such as smallpox vaccine in 2003); (3) preparedness planning for annual influenza outbreaks, pandemic influenza, SARS, and bioweapons attacks; (4) adherence monitoring for selected infection control practices; (5) oversight of risk assessment and implementation of prevention measures associated with construction and renovation; (6) prevention of transmission of MDROs; (7) evaluation of new medical products that could be associated with increased infection risk (eg, intravenous infusion materials); (8) communication with the public, facility staff, and state and local health departments concerning infection control-related issues; and (9) participation in local and multicenter research projects. doi = 10.1016/j.ajic.2007.10.007 id = cord-343865-wbd0hqqc author = Singh, Ajay title = Real-Time Remote Surveillance of Doffing During COVID-19 Pandemic: Enhancing Safety of Health Care Workers date = 2020-05-12 keywords = PPE summary = Worldwide a significant number of health care workers (HCWs) have been infected till to date with Asia-Pacific region reporting 35 deaths and over 4000 quarantined cases, as on April 3, 2020. Effective use of PPE by HCWs is an integral part of COVID-19 prevention in the health care setting. Two-way audio-visual communication system with closed circuit television (CCTV) cameras in the doffing area has the potential to ensure HCW safety from the offsite location through a trained observer, qualified to guide round the clock (Figure) . He will communicate, visually inspect, protect, and guide HCWs through the protocols of doffing PPE. Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19): interim guidance Use of personal protective equipment among health care personnel: results of clinical observations and simulations Alternative doffing strategies of personal protective equipment to prevent self-contamination in the health care setting doi = 10.1213/ane.0000000000004940 id = cord-317574-wyzscmtr author = Singh, Narendra title = Environmentally Sustainable Management of Used Personal Protective Equipment date = 2020-06-29 keywords = PPE; waste summary = The lack of a coordinated international strategy to manage the PPE production and waste lifecycle threatens to impact progress toward achieving key components of the United Nation''s Sustainable Development Goals (SDGs), including SDG 3 good health and wellbeing, SDG 6 clean water and sanitation, SDG 8 decent work and economic growth, SDG 12 responsible consumption and production and SDG 13 climate action. Therefore, the local waste management agency deployed mobile incinerators in the city to dispose of the unprecedented quantities of discarded face masks, gloves, and other contaminated single-use protective gear. 7 The United Nation''s Basel Convention on the Transboundary Movement of Hazardous Wastes and their Disposal has recently urged member countries to treat waste management amid COVID-19 as an urgent and essential public service to minimize possible secondary impacts upon health and the environment. In summary, the COVID-19 pandemic has strained solid waste management globally, while also highlighting the bottleneck supply chain challenges regarding PPE manufacture, demand-supply, use, and disposal. doi = 10.1021/acs.est.0c03022 id = cord-271603-zy4l9vtf author = Skali, Hicham title = Guidance and Best Practices for Reestablishment of Non-Emergent Care in Nuclear Cardiology Laboratories During the Coronavirus Disease 2019 (COVID-19) Pandemic: An Information Statement from ASNC, IAEA, and SNMMI date = 2020-10-17 keywords = COVID-19; PPE; patient summary = title: Guidance and Best Practices for Reestablishment of Non-Emergent Care in Nuclear Cardiology Laboratories During the Coronavirus Disease 2019 (COVID-19) Pandemic: An Information Statement from ASNC, IAEA, and SNMMI • For SPECT myocardial perfusion imaging studies in inpatients who are not eligible for stress only testing, consider performing the rest injection in the patient''s inpatient room, to avoid completely or minimize waiting time in the laboratory. The nuclear cardiology laboratory''s protocols and patient scheduling templates will need to be closely monitored and refined multiple times over the coming months as the COVID-19 pandemic slowly recedes, with potential for local or widespread waves of new COVID-19 infections. • Providers and institutions should monitor local data and follow national, state, and department of public health recommendations for possible second COVID-19 waves that may require decreasing nuclear cardiology laboratory activities and enhanced protective measures. doi = 10.2967/jnumed.120.251355 id = cord-305419-l68ewxar author = Smart, Hiske title = Preventing Facial Pressure Injury for Health Care Providers Adhering to COVID-19 Personal Protective Equipment Requirements date = 2020-06-11 keywords = N95; PPE; mask; skin summary = CONCLUSIONS: This creative and novel stepwise process of developing a safe skin protection method by which staff could apply a repurposed silicone border dressing beneath an N95 mask was largely effective and aided by the creation of the enabler. Accordingly, the Nursing Quality Committee advised the Pressure Injury Prevention Committee to follow this approach in developing and testing a skin care bundle specifically applicable to the work environment of KHUH for those HCPs providing acute COVID-19 care. One staff member with Fitzpatrick type 2 skin was willing to test the mask without facial protection for 2 hours on a different day, before the leak tests were conducted. This article describes a holistic approach to facial skin injury prevention for HCPs to "HELP" staff to embrace a Longer periods of PPE use (with each participant serving as their own control) produced a distinct difference between mask wear with and without protection, including improved facial condition and comfort without compromising mask seal. doi = 10.1097/01.asw.0000669920.94084.c1 id = cord-032498-5ugoi1tu author = Smith, Peter M. title = The Association between the Perceived Adequacy of Workplace Infection Control Procedures and Personal Protective Equipment with Mental Health Symptoms: A Cross-sectional Survey of Canadian Health-care Workers during the COVID-19 Pandemic: L’association entre le caractère adéquat perçu des procédures de contrôle des infections au travail et de l’équipement de protection personnel pour les symptômes de santé mentale. Un sondage transversal des travailleurs de la santé canadiens durant la pandémie COVID-19 date = 2020-09-21 keywords = ICP; PHQ-2; PPE summary = OBJECTIVES: To examine the relationship between perceived adequacy of personal protective equipment (PPE) and workplace-based infection control procedures (ICP) and mental health symptoms among a sample of health-care workers in Canada within the context of the current COVID-19 pandemic. Regression analyses examined the proportion of GAD-2 and PHQ-2 scores of 3 and higher across levels of PPE and ICP, adjusted for a range of demographic, occupation, workplace, and COVID-19-specific measures. 5, 8, 9 The objective of this study is to examine the relationship between perceived adequacy of PPE and workplace-based ICP and anxiety and depression symptoms among a large sample of health-care workers in Canada, within the context of the current COVID-19 pandemic. 5 In this sample of almost 6,000 health-care workers in Canada, we observed a graded relationship between the perceived adequacy of PPE provision and ICP implementation with symptoms of anxiety and depression, with lower symptoms among respondents whose PPE and ICP needs were being met. doi = 10.1177/0706743720961729 id = cord-308100-tvk47fd7 author = Soetikno, Roy title = Considerations in performing endoscopy during the COVID-19 pandemic date = 2020-03-27 keywords = PPE; SARS; covid-19 summary = Based on experiences and the literature, our objective is to provide practical suggestions for performing endoscopy in the setting of COVID-19 pandemic. 6 It is unknown how much of the risk was related to the direct care of infected patients or to the inadequate use of personal protective equipment (PPE). 9 With numbers of COVID-19 cases continuing to rise in North America and Europe, we aim to provide practical suggestions to potentially avoid the transmissions of COVID-19 in the endoscopy unit. Possible routes of SARS-CoV-2 transmission include (1) person-to-person, (2) respiratory droplets, (3) aerosols generated during endoscopy, and (4) contact with contaminated surroundings and body fluids. 13 Recently, the World Health Organization (WHO) has published an extensive guideline on the rational use of personal protective equipment (PPE) for COVID-19 and provided specific instructions for healthcare workers performing AGP on patients with COVID-19. 17 Note that as an AGP, endoscopy of PUI/COVID patients requires the use of respiratory protection. doi = 10.1016/j.gie.2020.03.3758 id = cord-290456-cgrn5c36 author = Soliman, Mohamed A. R. title = Endoscopic endonasal skull base surgery during the COVID-19 pandemic: A developing country perspective date = 2020-09-25 keywords = COVID-19; PCR; PPE summary = [16] e aim of this study is to present the current situation from a developing country perspective in dealing with emergency endoscopic endonasal skull base surgeries at the time of the COVID-19 pandemic in terms of preoperative patients'' screening, surgical techniques, and intraoperative PPE utilization. e survey consisted of 12 questions designed to explore three domains; patients'' information (age, clinical manifestations [neurological and COVID-19 related], diagnosis, preoperative COVID-19 screening, and COVID-19 symptoms during the first 3 weeks postsurgery), surgical team information (age, chronic medical conditions, and COVID-19 symptoms during the first 3 weeks postsurgery), and operative information (PPE utilization and basal craniectomy). ere was only one surgeon who developed a high-grade fever, malaise, and bony aches in the first 3 days after surgery who had undergone two nasopharyngeal swabs with RT-PCR testing 1 week apart and both came back negative representing 2.1% of the surgical team members [ Figure 2c ]. doi = 10.25259/sni_547_2020 id = cord-309324-vatugz84 author = Sorbello, Massimiliano title = Personal protective equipment, airway management and systematic reviews. Comment on Br J Anaesth 2020 date = 2020-06-30 keywords = PPE; Sanfilippo summary = However significant limitations in their data hamper our ability to interpret the evidence base, but their data do highlight that the real concern is not measuring how limited airway management is by PPE, but rather the need for better understanding of PPE diversity, correct use of PPE and development and training in new techniques, protocols and devices to overcome such difficulties. Systematic review of simulated airway management whilst wearing personal protective equipment A randomised crossover simulation study comparing the impact of chemical, biological, radiological or nuclear substance personal protection equipment on the performance of advanced life support interventions The impact of respiratory protective equipment on difficult airway management: a randomised, crossover, simulation study The aerosol box for intubation in coronavirus disease 2019 patients: an in-situ simulation crossover study Utility of the Pentax-AWS in performing tracheal intubation while wearing chemical, biological, radiation and nuclear personal protective equipment: a randomised crossover trial using a manikin doi = 10.1016/j.bja.2020.06.038 id = cord-294557-4h0sybiy author = Stogiannos, N. title = Coronavirus disease 2019 (COVID-19) in the radiology department: What radiographers need to know date = 2020-06-04 keywords = CXR; PPE; covid-19; patient summary = Objectives include to: i) outline pathophysiology and basic epidemiology useful for radiographers, ii) discuss the role of medical imaging in the diagnosis of Covid-19, iii) summarise national and international guidelines of imaging Covid-19, iv) present main clinical and imaging findings and v) summarise current safety recommendations for medical imaging practice. CXR imaging of suspected or confirmed Covid-19 cases should be performed with portable equipment within specifically designated isolated rooms for eliminating the risks of cross-infection within the Radiology department. After the outbreak of the Covid-19 pandemic, many professional bodies and learned societies have been quick to issue official guidelines on how medical imaging should optimally be performed for early diagnosis and related management of these patients, but also how staff should be protected from cross-infection. Chest radiographic and CT findings of the 2019 novel Coronavirus disease (COVID-19): analysis of nine patients treated in Korea Imaging and clinical features of patients with 2019 novel coronavirus SARS-CoV-2: a systematic review and meta-analysis doi = 10.1016/j.radi.2020.05.012 id = cord-314507-fgrvrlht author = Sule, Harsh title = Maintenance of Skill Proficiency for Emergency Skills With and Without Adjuncts Despite the Use of Level C Personal Protective Equipment date = 2020-03-27 keywords = PPE summary = Objective To determine the impact of Level C personal protective equipment (PPE) on the time to perform intravenous (IV) cannulation and endotracheal intubation, both with and without the use of adjuncts. Methods This prospective, case-control study of emergency medicine resident physicians was designed to assess the time taken by each subject to perform endotracheal intubation using both direct laryngoscopy (DL) and video laryngoscopy (VL), as well as peripheral IV cannulation both with and without ultrasound guidance and with and without PPE. Our primary objective was to determine the impact of Level C PPE on the time to perform intravenous cannulation and endotracheal intubation, both with and without the use of adjuncts. studied 40 emergency physicians (residents) with and without Level C PPE and found no difference in the mean time to successful endotracheal intubation (17.86 sec vs. doi = 10.7759/cureus.7433 id = cord-335638-p84nmtfp author = Swaminathan, Ashwin title = Personal Protective Equipment and Antiviral Drug Use during Hospitalization for Suspected Avian or Pandemic Influenza(1) date = 2007-10-17 keywords = PPE; api; hcw summary = This study aimed to estimate the resource needs that a hospital might face in the fi rst few hours of management of a single patient who sought treatment with possible avian or pandemic infl uenza (API) or similar highly virulent respiratory infection. The study outcome measures were the following: 1) number of close contacts associated with the API patient during the initial 6 hours of patient management, including how many of these were HCW close contacts; 2) the total number of exposures experienced by close contacts; 3) overall quantity and type of PPE items (gowns, gloves, N95 masks, eyewear) actually used during the simulation by HCW close contacts and ancillary HCWs; 4) overall "opportunities for PPE item use" for HCW close contacts and ancillary HCWs (i.e., actual use plus missed opportunities for appropriate PPE use); and 5) stratifi cation of HCW close contacts into medium-or low-risk groups for the purpose of recommending antiviral postexposure prophylaxis. doi = 10.3201/eid1310.070033 id = cord-284640-tl9nmvog author = Tabah, Alexis title = Personal protective equipment and intensive care unit healthcare worker safety in the COVID-19 era (PPE-SAFE): An international survey date = 2020-06-13 keywords = HCW; PPE; covid-19 summary = PURPOSE: To survey healthcare workers (HCW) on availability and use of personal protective equipment (PPE) caring for COVID-19 patients in the intensive care unit (ICU). While pain, heat stress and fluid loss with using Powered Air-Purifying Respirators (PAPR) were predicted by experimental data (14) , there are no real-life reports of this issue when using PPE that is available to HCWs. The objective of this study was to describe the current reported practices, availability, training, confidence in the use and adverse effects due to extended use of PPE by HCWs from around the world caring for COVID-19 patients who require ICU management. This survey provides a snapshot of the reported availability, perceived adequacy of training and provided protection, adverse effects and usage of PPE among HCW managing COVID-19 patients in critical care environments from across the globe. doi = 10.1016/j.jcrc.2020.06.005 id = cord-345210-6f8niif5 author = Tadavarthy, Silpa N. title = Developing and Implementing an Infection Prevention and Control Program for a COVID-19 Alternative Care Site in Philadelphia, PA date = 2020-07-19 keywords = CSF; IPC; PPE summary = The rapid creation and unusual configuration of this facility, together with the challenges of new clinical teams unfamiliar with one another, and working together in uncomfortable PPE to provide high-quality patient care, necessitated some basic approaches to the development of our IPC program. The plan identified the need for engineering controls (e.g. specifications for heating, ventilation, and air conditioning systems) and specified occupational IPC health and safety requirements, including PPE standards, daily monitoring of staff for acute illness, sanitation standards for both hand hygiene and equipment sanitation, as well as laundry and waste management recommendations. Key lessons learned included the need to: develop strategies to cope with real and potential shortages of critical supplies; adapt existing guidance for unique sites of care; standardize and continually assess staff use of PPE and fundamental IPC practices; and the importance of communication of IPC principles and concerns throughout the planning and management of this COVID ACS. doi = 10.1016/j.ajic.2020.07.006 id = cord-306090-i8sriw08 author = Tan, Zihui title = Protecting health care workers in the front line: Innovation in COVID-19 pandemic date = 2020-05-15 keywords = PPE; patient summary = doi = 10.7189/jogh.10.010357 id = cord-102456-6jt4ksha author = Taylor-Cousar, Jennifer L. title = How I Do It: Restarting Respiratory Clinical Research in the Era of the COVID19 Pandemic date = 2020-11-13 keywords = COVID-19; PPE; SARS; research summary = However, now that we have navigated the initial surge of SARS-CoV-2 cases, many are considering how to reintroduce non-COVID-19 clinical research conduct while protecting participants, staff and ensuring data integrity. Here we review key considerations and suggest a step-wise approach for resuming clinical research including observational research, registry trials, and interventional trials, as well as potential data confounding related to COVID-19 infections that are important to consider as research studies restart and data are analyzed. In the spirit of "Do No Harm", it is critical that institutional policies and processes are in place to ensure that there is no significant additional risk of contracting viral respiratory or other infections in the normal course of participation in research studies; now during the COVID-19 pandemic, these principles are even more critical. Throughout the subject''s participation in clinical research during the pandemic, she expressed her appreciation for the opportunity to continue in the study from which she believed she was benefiting, with minimal risk of exposure to infection from SARS-CoV-2. doi = 10.1016/j.chest.2020.11.001 id = cord-290653-48swl1aq author = Teng, Margaret title = Endoscopy during COVID-19 pandemic: An overview of infection control measures and practical application date = 2020-09-16 keywords = PPE; covid-19 summary = doi = 10.4253/wjge.v12.i9.256 id = cord-266173-gmz6oxf6 author = Tino, Rance title = COVID-19 and the role of 3D printing in medicine date = 2020-04-27 keywords = PPE; mask summary = Access to such models is still limited for many local 3D printing community members and will require close collaboration between companies and hospitals to ensure adequate manufacturing approaches and appropriate clinical use. The reverse-engineered 3D printable model of the Isinnova valve is not widely available at the time of writing, with the authors maintaining the position that such resources should be adequately evaluated and used only when such equipment is not available from the original manufacturers. Members of the global 3D printing community have designed a plethora of reusable personal protective equipment devices with insertable filters, primarily manufactured using low-cost desktop filament extrusion printers. To ensure the best fit, personalizing these masks may be achieved by printing in several sizes, experimenting with flexible materials, or surface scanning intended users'' faces and carrying out additional CAD to virtually fit these masks on an individual basis [9] . doi = 10.1186/s41205-020-00064-7 id = cord-267996-5l9shks8 author = Tysiąc-Miśta, Monika title = The Attitudes and Professional Approaches of Dental Practitioners during the COVID-19 Outbreak in Poland: A Cross-Sectional Survey date = 2020-06-30 keywords = PDA; PPE; covid-19; dentist summary = variables, such as a lack of access to adequate, enhanced PPE; individuals'' COVID-19 contraction risk assessments; self-reported feelings of anxiety regarding the disease; gender; the acknowledgement of national guidance on how to treat patients during the recent health care crisis; and other factors such as age, years of clinical experience, marital status, having children, place of residence, risk group for coronavirus infection due to comorbidities and, finally, dentists'' acknowledgement of the professional recommendations launched by the PDA and PMH. We also investigated factors such as age, years of clinical practice (Table 5) , marital status, having children, place of residence, belonging to the risk group for coronavirus infection due to comorbidities, and dentists'' opinions on the lasting impact of COVID-19 on dental procedures (Table 6 ) in relation to the decision to continue dental practice or not. doi = 10.3390/ijerph17134703 id = cord-321443-89o13sox author = Umazume, Takeshi title = Survey on the use of personal protective equipment and COVID‐19 testing of pregnant women in Japan date = 2020-08-10 keywords = PCR; PPE summary = AIM: To clarify the status of personal protective equipment (PPE) and coronavirus disease 2019 (COVID‐19) tests for pregnant women, we conducted an urgent survey. Our study also determined that around 65.0% of facilities for doctors and 73.5% of facilities for midwives used PPE beyond the "standard gown or apron, surgical mask, goggles or face shield" during labor of asymptomatic women. 3 In order to clarify the status of PPE usage during labor and delivery and COVID-19 tests for pregnant women, we conducted an urgent survey in Japan. Status of PPE use beyond "standard gown or apron, surgical mask, goggle or face shield" during labor of women without symptoms of COVID-19 Pregnant women were tested for COVID-19 not only in perinatal medical centers and university hospitals, but also other facilities, at a rate of 9-17% (Table S2) . Appropriate guidelines for PPE usage by medical providers and COVID-19 testing for pregnant women before delivery are necessary in Japan. doi = 10.1111/jog.14382 id = cord-007571-xzm36og6 author = Valdez, Anna Maria title = Are You Covered? Safe Practices for the use of Personal Protective Equipment date = 2015-01-19 keywords = PPE; care summary = To prevent the spread of infection and injury, emergency nurses must be well prepared to appropriately select and use personal protective equipment (PPE). 5 Recently the CDC issued revised standards for EVD precautions, which include detailed guidance on the types of PPE required during patient care and strategies for ensuring safe practice. 6 Because of the complex and detailed nature of the guidance on caring for a patient with known or suspected EVD, emergency nurses should seek information about precautions and PPE standards directly from the CDC Web page at http://www.cdc.gov/vhf/ebola/hcp/index.html. Examples of strategies that can be used to prevent injury include strict adherence to infection control precautions, hands-on and in situ training, and staffing that supports safe care. 7 The CDC recommends that health care providers receive repeated training and demonstrate competency in performing all Ebola-related infection control practices and procedures, including donning and doffing proper PPE before engaging in patient care activities. doi = 10.1016/j.jen.2014.11.011 id = cord-324654-nnojaupv author = Vordos, Nick title = How 3D Printing and Social Media Tackles the PPE Shortage during Covid – 19 Pandemic date = 2020-06-07 keywords = PPE; medium summary = During the recent Covid-19 pandemic, additive Technology and Social Media were used to tackle the shortage of Personal Protective Equipment. They explore how 3D printed designs were utilized to address the Covid-19 pandemic, as well how the QALY model can be applied in this case to measure the effects of the use of PPE. The ultimate goal of the article is to highlight the use of Social Media and additive technology in general from common users, to address the lack of basic personal protective equipment or even parts of machinery used by health professionals. Patients using PPE gained quality of life compared to health worker professionals from Europe or US, without the usage of PPEs. This study examined the way individual social media users and 3D printer owners tackle the PPE shortage during a pandemic. doi = 10.1016/j.ssci.2020.104870 id = cord-313528-rp15vi1o author = Wallace, Douglas W. title = An adapted emergency department triage algorithm for the COVID‐19 pandemic date = 2020-08-10 keywords = COVID-19; PPE; patient summary = The novel coronavirus disease 2019 (COVID‐19) pandemic, with its public health implications, high case fatality rate, and strain on hospital resources, will continue to challenge clinicians and researchers alike for months to come. The authors describe an adapted COVID‐19 pandemic triage algorithm for emergency departments (EDs) guided by the best available evidence and responses to prior pandemics, with recommendations for clinician PPE use for each level of encounter in the setting of an ongoing PPE shortage. 3 Hospitals across the United States have adapted to the COVID-19 pandemic by limiting nonessential patient interaction and transforming their emergency departments (EDs) to treat patients who are both critically ill and highly contagious. It is the authors'' hope that use of this triage algorithm and PPE recommendations will aid frontline emergency clinicians in the ongoing response to COVID-19. doi = 10.1002/emp2.12210 id = cord-349740-xed4aybr author = Wang, Yulong title = Recommendations of protective measures for orthopedic surgeons during COVID-19 pandemic date = 2020-06-10 keywords = COVID-19; PPE; patient; surgery summary = The appropriate protective measures for orthopedic surgeons and patients were reviewed (on-site first aid, emergency room, operating room, isolation wards, general ward, etc.) during the entire diagnosis and treatment process of traumatic patients. To avoid occupational transmission of COVID-19 to medical staff, appropriate protective measures taken by orthopedic surgeons during pandemic in different sites from pre-hospital, emergency diagnosis and treatment, emergency surgery, anesthesia, and perioperative management are of great importance. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work. Lessons learnt from our experience provide some recommendations of protective measures during the entire diagnosis and treatment process of traumatic patients and help others to manage orthopedic patients with COVID-19, to reduce the risk of cross-infection between patients and to protect healthcare workers during work. doi = 10.1007/s00167-020-06092-4 id = cord-028285-n4dommet author = Weilongorska, Natasha L. title = COVID-19: What are the challenges for NHS surgery? date = 2020-07-02 keywords = COVID-19; NHS; PPE; patient; surgery; surgical summary = doi = 10.1016/j.cpsurg.2020.100856 id = cord-322382-p46slvka author = Wesemann, Christian title = 3-D Printed Protective Equipment during COVID-19 Pandemic date = 2020-04-24 keywords = Easy; PPE; RC2 summary = Therefore, to provide HCWs with sufficient PPEs to increase facial protection, face shields could be 3-D printed. The increased space between the face and visor is sufficient for essential eye and mouth-nose protective equipment, but, at the same time, lateral protection against aerosols when using pre-fabricated DIN A4 foils is reduced. For effective and efficient manufacturing of the face shields presented in this study, fused deposition modeling (FDM) was preferred due to its increased printing capability and minimal post-processing requirements. Easy to use and self-sustaining face shield production using one''s own printing capabilities in combination with sufficiently available, commercial goods, such as the laser copy foils in the current study, can be considered to help protect HCWs from aerosol or accidental hand-to-face contamination during their daily clinical routines. 3-D printing of the frame of a face shield was possible using open-source data and biodegradable material. doi = 10.3390/ma13081997 id = cord-269826-l44xbgok author = Wills, Timothy T. title = Utilization of an Orthopedic Hood as Personal Protective Equipment for Intubation of Coronavirus Patients: a Brief Technical Report date = 2020-06-02 keywords = COVID-19; PPE summary = title: Utilization of an Orthopedic Hood as Personal Protective Equipment for Intubation of Coronavirus Patients: a Brief Technical Report Personal protective equipment (PPE) has been tailored accordingly, but as of April 2020, close to 10 000 health care workers in the United States have contracted COVID-19 despite wearing recommended PPE. In this brief technical report, we describe the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission. CONCLUSION: Modification of existing PPE may provide protection for health care workers during high-risk aerosolizing procedures such as endotracheal intubation. We describe in a brief technical report the integration of an orthopedic hood cover as an item for full barrier protection against COVID-19 transmission during endotracheal intubation. The addition of an orthopedic hood covering to standard PPE may provide protection for health care workers during highrisk aerosolizing procedures such as endotracheal intubation. doi = 10.1177/2151459320930554 id = cord-332932-mq36xpai author = Wood, David A. title = Safe Reintroduction of Cardiovascular Services during the COVID-19 Pandemic: Guidance from North American Society Leadership date = 2020-05-04 keywords = COVID-19; PPE summary = In this consensus report, we harmonize recommendations from North American cardiovascular societies and provide guidance on the safe reintroduction of invasive cardiovascular procedures and diagnostic tests after the initial peak of the COVID-19 pandemic. As discussed below, COVID-19 testing of potential patients and health care workers (HCW), as well as personal protective equipment (PPE), must also be carefully monitored to minimize the risk of shortages as the pandemic escalates and abates. 2) COVID-19 Screening: Encourage routine screening of all patients prior to any cardiovascular procedure or test to ensure the safety of HCWs. This testing may include nasopharyngeal swabs and saliva or rapid antibody tests and should be guided by local institutional infectious disease experts and closely coordinated with regional public health officials. It provides an ethical framework with appropriate safeguards for the gradual reintroduction of invasive cardiovascular procedures and diagnostics tests after the initial peak of the COVID-19 pandemic. doi = 10.1016/j.jacc.2020.04.063 id = cord-332083-135iic7m author = Xia, Wei title = The Physical and Psychological Effects of Personal Protective Equipment on Health Care Workers in Wuhan, China: A Cross-Sectional Survey Study date = 2020-09-29 keywords = China; HCW; PPE summary = INTRODUCTION: The purpose of this study was to rapidly quantify the safety measures regarding donning and doffing personal protective equipment, complaints of discomfort caused by wearing personal protective equipment, and the psychological perceptions of health care workers in hospitals in Wuhan, China, responding to the outbreak. Detailed donning and doffing procedures are described in the Supplementary Figure The purpose of this study was to rapidly quantify the safety measures of donning and doffing PPE, complaints of discomfort caused by wearing PPE, and the psychological perceptions of HCWs in hospitals in Wuhan, China, responding to the COVID-19 outbreak. Because our participants were all HCWs in Wuhan hospitals, we divided their demographic information as follows: the demographic variables included sex (male or female); age (20-30 years, 30-40 years, 40-50 years, and >50 years); occupation (physician, nurse, pharmacist, medical technician, or other); workplace (a designated hospital for patients critically ill with severe COVID-19; an undesignated hospital for patients uninfected with COVID-19; and Fangcang Hospital for patients with mild symptoms of COVID-19); and department (general isolation ward, intensive care unit [ICU], emergency department for patients with fevers, and other). doi = 10.1016/j.jen.2020.08.004 id = cord-297863-ou432md0 author = Ye, Lei title = Infection prevention and control in nursing severe coronavirus disease (COVID-19) patients during the pandemic date = 2020-06-12 keywords = PPE summary = doi = 10.1186/s13054-020-03076-1 id = cord-337499-jzpgtkai author = Yong Choi, Sung title = Safe surgical tracheostomy during the COVID-19 pandemic: A protocol based on experiences with Middle East Respiratory Syndrome and COVID-19 outbreaks in South Korea date = 2020-06-17 keywords = ICU; MERS; PPE; covid-19 summary = title: Safe surgical tracheostomy during the COVID-19 pandemic: A protocol based on experiences with Middle East Respiratory Syndrome and COVID-19 outbreaks in South Korea RESULTS: Compared with previous guidelines, our protocol consisted of enhanced PPE, simplified procedures (no limitation in the use of electrocautery and wound suction, no stay suture, and delayed cannula change) and a validated screening strategy for healthcare workers. In contrast, the surgical tracheostomy for the COVID-19 patient was performed by one dedicated head and neck surgeon and ICU medical staff (two intensivists and one senior nurse), who worked only in the negative pressure room for COVID-19, and assisted with all procedures (Supplementary Figure 1) . The first cannula change for the COVID-19 patient was performed by the same surgeon with enhanced PPE at 13 days because that patient had three consecutive negative SARS-CoV-2 PCR tests 11 days after tracheostomy. doi = 10.1016/j.oraloncology.2020.104861 id = cord-348614-im7qtr9k author = Yánez Benítez, Carlos title = International cooperation group of emergency surgery during the COVID-19 pandemic date = 2020-10-13 keywords = COVID-19; PPE; emergency; surgical summary = These COVID-19 dedicated protocols addressed surgical team organization, operating room (OR) preparation, rational use of personal protective equipment (PPE), considerations on anesthesiology, and intraoperative management of emergency surgical pathology. Continuity performing their regular tasks was reported by 73 (54%) of the respondents, in contrast with the rest, whose newly assigned duties were to the emergency department COVID-19 triage (25%), the intensive care unit (ICU) activities (13%), or had to manage mechanically ventilated patients in the surgical ward (7%). About half (51%) of the respondents had not received training in the use of PPE for airborne infectious risk while performing emergency surgical procedures before the pandemic, and roughly over one-third (37%) had it during the studied period. This study provides an international snapshot of the level of adoption of the guidance for surgical team organization, adequacy of PPE availability and usage, OR preparation, anesthesiologic considerations, and intraoperative management of emergency surgical cases during 2 weeks of the COVID-19 pandemic. doi = 10.1007/s00068-020-01521-y id = cord-332815-1w1ikj7q author = Zhan, Mingkun title = Lesson Learned from China Regarding Use of Personal Protective Equipment date = 2020-08-11 keywords = China; PPE summary = METHODS: Based on their prior experience with the 2003 SARS epidemic, health authorities in China recognized the need for personal protective equipment (PPE). Existing PPE and protocols were limited and reflected early experience with SARS; however, as additional PPE supplies became available, designated COVID-19 hospitals in Hubei Province adopted the World Health Organization guidelines for Ebola to create a protocol specific for treating patients with COVID-19. The paper focuses primarily on the use of PPE to help prevent transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to HCWs. The aim is to provide more detail regarding level-3 protection protocols used at designated COVID-19 hospitals in Hubei Province to prevent the spread of the virus to HCWs. The methods to protect HCWs, designated as level-3 protection in China, included a personal protection protocol for proper use of PPE with coveralls and procedures for changes to the flow of patients and personnel through the designated COVID-19 hospitals. doi = 10.1016/j.ajic.2020.08.007 id = cord-316126-j51dik7f author = Zhang, X. Sophie title = SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles date = 2020-10-28 keywords = COVID-19; CoV-2; N95; PPE; SARS; mask; study; transmission summary = title: SARS-CoV-2 and Health Care Worker Protection in Low-Risk Settings: a Review of Modes of Transmission and a Novel Airborne Model Involving Inhalable Particles Since the beginning of the COVID-19 pandemic, there has been intense debate over SARS-CoV-2''s mode of transmission and appropriate personal protective equipment for health care workers in low-risk settings. This review attempts to summarize current cumulative data on SARS-CoV-2''s modes of transmission and identify gaps in research while offering preliminary answers to the question on everyone''s mind: is the airborne route significant and should we modify our COVID-19 PPE recommendations for frontline workers in low-risk settings? Given that substantial disagreement persists on the importance of natural aerosol generation by COVID-19 patients, and consequently, the necessary level of respiratory protection in non-AGP contexts, our review will focus on transmission and PPE in low-risk health care settings. doi = 10.1128/cmr.00184-20 id = cord-274477-jkjyh4cs author = Zhang, Zhiruo title = Protecting healthcare personnel from 2019-nCoV infection risks: lessons and suggestions date = 2020-03-23 keywords = HCP; PPE summary = The outbreak of a novel Coronavirus disease (COVID-19, caused by the 2019-nCoV infection) in December 2019 is one of the most severe public health emergencies since the founding of People''s Republic of China in 1949. Healthcare personnel (HCP) nationwide are facing heavy workloads and high risk of infection, especially those who care for patients at the epicenter of the outbreak, Hubei Province. Based on literature search and interviews with some HCP working at Wuhan, capital city of Hubei, we have summarized some of the effective measures taken to reduce infection among HCP, and also made suggestions for improving occupational safety during an infectious disease outbreak. The local outbreak of novel coronavirus epidemic (COVID-19, caused by the 2019-nCoV infection) in Wuhan, Hubei Province of China, last December has rapidly spread nationwide with a cumulative number of 80 026 laboratory-confirmed cases and 2912 deaths as of March 1, 2020 [1] . doi = 10.1007/s11684-020-0765-x id = cord-309956-topo2bc6 author = Zheng, Kenneth I. title = COVID-19 Cross-Infection and Pressured Ulceration Among Healthcare Workers: Are We Really Protected by Respirators? date = 2020-09-10 keywords = PPE; respirator summary = The Occupational Safety and Health Administration respiratory protection regulations at 29 CFR 1910.134 mandated that HCWs be fit-tested and seal checked prior to the initial use of a respirator and whenever a different respirator face piece (size, style, model, or make) is used (4). While it is obvious that the use of respirators can cause discomfort and harm to HCWs, there is a need to evaluate adherence of protocol and to assess the risk of infection from skin lesions due to PPE. Nevertheless, it is recognized that HCWs in the current COVID-19 pandemic, through prolonged wearing of respirators, might be exposed to a higher risk of cross-infection and skin damage. It is necessary to improve the design of currently certified respirators in order to achieve better sealing capabilities and reduce pressure ulcerations. doi = 10.3389/fmed.2020.571493 id = cord-327595-00fxzyhq author = nan title = American Geriatrics Society (AGS) Policy Brief: COVID‐19 and Assisted Living Facilities date = 2020-05-14 keywords = PPE; care; covid-19 summary = This policy brief sets forth the American Geriatrics Society''s (AGS''s) recommendations to guide federal, state, and local governments when making decisions about care for older adults in assisted living facilities (ALFs) during the coronavirus disease 2019 (COVID‐19) pandemic. ALFs, other congregate living settings (eg, NHs, residential care facilities for older adults, continuing care retirement communities), and home healthcare agencies (eg, Visiting Nurse Association) must be included as priorities when estimating what is needed for the US coordinated response to COVID-19. For older adults residing in ALFs and other congregate living settings, screening for COVID-19 will be particularly important for protecting the health and safety of their communities. This includes the ability to isolate or cohort the resident(s) separately from the rest of the community and provide dedicated staff to meet increased care needs for people with COVID-19. doi = 10.1111/jgs.16510 id = cord-319567-4t5t8bcx author = Şentürk, Mert title = Thoracic Anesthesia of Patients with Suspected or Confirmed 2019 Novel Coronavirus Infection: Preliminary Recommendations for Airway Management by the EACTA Thoracic Subspecialty Committee date = 2020-04-11 keywords = PPE; airway; intubation; patient summary = Recognizing the unique risks of intubation and mechanical ventilation in these high-risk groups and the high potential of infection risk to healthcare workers, several useful reports, algorithms and society endorsed recommendations have emerged in the recent literature regarding the general airway and anesthesia management of these patients. Anaesthesia Subspecialty group has considered these challenges and developed a preliminary set of expert recommendations regarding the airway management and ventilation of COVID-19 thoracic patients. The group has considered a broad spectrum of issues regarding thoracic anesthesia in COVID-19 patients and decided to focus on overall approaches to general and specific aspects of airway management, preparation for anaesthesia, lung isolation/separation and ventilation.  Tracheal intubation in COVID-19 patients for thoracic surgery is a high-risk procedure for the anesthesia team because of the risks of aerosol transmission of the infection during placement of the airway device and check bronchoscopy. doi = 10.1053/j.jvca.2020.03.059