key: cord-0737802-d7zrvj8l
authors: Howell, Alan C.; Havens, Lisa; Swinford, Wes; Arroliga, Alejandro C.
title: Effectiveness of personal protective equipment—Yes, the buck and virus can stop here
date: 2021-02-19
journal: Infection control and hospital epidemiology
DOI: 10.1017/ice.2021.75
sha: ecfbe6d1a6116402a721d550df4add7417771263
doc_id: 737802
cord_uid: d7zrvj8l

We conducted an observational study of a multi-center healthcare system to determine the effectiveness of our infection control/PPE program during the care of COVID-19 patients. The COVID-19 conversion rate in the patient care setting was 0.70%. Comparatively, the conversion rate noted in the non-patient care/community setting was 15.17%.

During this same period, 7,486 employees reported community exposures. 3,990 of these employees were tested due to their described exposure and/or onset of COVID-19 symptoms. Moreover, 1,136 tested positive for SARS-CoV-2, for a conversion rate of 15.17% by encounter and 2.67% by total staff. The number of positive tests per month for employees with reported community exposure peaked in July (478 employees tested positive). June, July, and August accounted for ∼93% of the 1,136 positive tests collected from March through August.

A lack of adequate PPE, work overload, insufficient diagnostic testing, and exposure to infected patients are all factors linked to the risk of infection for healthcare personnel. 1 Our rate of work-related exposure compares favorably to the 6.3% rate noted at the Cleveland VA Medical Center. 1 The effectiveness of PPE is highly dependent upon appropriate staff training, adherence to strict hand hygiene, and appropriate human behavior. 2 This latter point carries significant importance regardless of whether HCP are carrying out their employment-related duties or are in the community. The fact that our conversion rate in the hospital setting was 0.70% versus 15.17% in the community supports this concept.

Importantly, no efforts are fail proof. As the pandemic continues, PPE and mask fatigue will set in. Hospital systems across the country are beginning to note evidence of this fact. 3 The next struggle will be to determine strategies to best combat "battle fatigue."

In summary, our experience with PPE, its availability, and our system approach (EHCCC) clearly demonstrate effectiveness. The risk community exposure poses to our finite number of HCP and patients remains.

What are the sources of exposure in healthcare personnel with coronavirus disease 2019 infection? AJIC 2020

Use of medical face masks versus particulate respirators as a component of personal protective equipment for healthcare workers in the context of the COVID-19 pandemic

Brigham and Women's Hospital website

Acknowledgments.Financial support. No financial support was provided relevant to this article.

All authors report no conflicts of interest relevant to this article.