key: cord-0727948-5g95n4gx
authors: Goldust, Mohamad; Kroumpouzos, George; Murrell, Dedee F.; Jafferany, Mohammad; Lotti, Torello; Wollina, Uwe; Shivakumar, Swathi
title: Use of Face Masks in Dermatology Department During the COVID‐19 Outbreak
date: 2020-05-06
journal: Dermatol Ther
DOI: 10.1111/dth.13521
sha: e0bede72ab527d7a4f671b7faf12eaf606b434cc
doc_id: 727948
cord_uid: 5g95n4gx

nan

December 2019, has quickly spread throughout the world to reach pandemic proportions. The main reason for this is due to its high contagiousness, being present in respiratory droplets even in the initial incubation period (up to 14 days). 1-3 Therefore, a presumed to be healthy person, may be harboring the virus and spreading it to others even prior to onset of symptoms. This highlights the need to use personal protective equipment (PPE) and practice social distancing in order to control the alarming spread. 4, 5 In most countries, a complete lockdown was ordered by government authorities, keeping open only essential services like hospitals, pharmacies, groceries and automated teller machines. It is still a moral dilemma whether non-emergency services like Dermatology should remain open.

However, there are also emergencies in Dermatology Clinics. If kept open, utmost care needs to be taken so that we don't become vectors in the spread of this virus. 6 This article is protected by copyright. All rights reserved.

Current guidelines by World Health Organization (WHO) advice against community use of masks due to lack of evidence as well as gross shortage of masks. However, global use of masks may be the only way of control of spread of infection from asymptomatic carriers. 7 Most health care providers agree that wearing a self-made mask, or even a scarf covering the face and eye glasses, is better than not wearing any. It is especially necessary in a setting like dermatology outpatients where the number of cases is bigger and chances of cross-infection from physician to patient, or vice-versa, are high. 6 The outpatient case load can be reduced by limiting appointments to only emergency cases. Routine follow-up visits can be converted into virtual visits (teledermatology). All patients should be screened for symptoms of fever, cough, and sore throat, and referred to Fever Clinic or Infectious Disease specialist, if symptomatic. The remaining patients should be educated on maintaining social distance, observing hand hygiene and should be provided with surgical masks prior to an encounter. They should be advised to never take off the mask during the consult, except in instances where the physician needs to examine facial lesions. Doctors and nursing staff should be well protected with PPE, including masks, surgical caps, protective suits, and goggles. Surgical masks are to be worn by health care personnel at all times during a patient encounter. Their PPE should be taken off only at the end of their work hours, in a designated disposable area. 8 Measures to face the increased demand for masks include mass production and stockpiling, as was done successfully in Taiwan. As a response to the shortage of facemasks, posts of self-made masks, made of different materials, including a plastic transparent sheet that covers the eyes, This article is protected by copyright. All rights reserved.

have appeared in social media. Urgent research is needed to prolong the use of disposable masks and for invention of reusable masks. 9 A recent protocol was developed by researchers at Duke university where N95 masks could be resterilized. This could prove very valuable to help relieve the current global shortage of masks. 10 

The effect of quarantine and isolation for COVID-19 in general population and dermatologic treatments

COVID-19-New Insights on a Rapidly Changing Epidemic

This article is protected by copyright. All rights reserved

Solidarity and transparency against the COVID-19 pandemic

Priorities for global health community in COVID-19 pandemic

COVID-19 and SARS: differences and similarities

Dermatology practices as vectors for COVID-19 transmission: a call for immediate cessation of non-emergent dermatology visits

Mass masking in the COVID-19 epidemic: people need guidance. The Lancet

What are we doing in the dermatology outpatient department amidst the raging of the 2019 novel coronavirus?

Rational use of face masks in the COVID-19 pandemic

Duke Starts Novel Decontamination of N95 Masks to Help Relieve Shortages | Duke School of Medicine