key: cord-0986724-us3jkm5h
authors: Zhao, Yi; Liang, Wenhua; Luo, Yan; Chen, Ying; Liang, Peng; Zhong, Ran; Chen, Ailan; He, Jianxing
title: Personal protective equipment protecting healthcare workers in the Chinese epicenter of COVID-19
date: 2020-07-23
journal: Clin Microbiol Infect
DOI: 10.1016/j.cmi.2020.07.029
sha: 31f06fe6eeb0160e3551f872e56fba7168d58281
doc_id: 986724
cord_uid: us3jkm5h

It is important to evaluate the efficacy and safety of personal protective equipment (PPE) protecting healthcare workers in the coronavirus disease 2019 (COVID-19) epidemic. We conducted a survey on PPE usage among healthcare workers who completed their healthcare service for COVID-19 patients in Hubei province (the Chinese epicenter of the epidemic). Efficacy and safety information about PPE were collected from 960 participants and summarized in this study.

Globally, healthcare workers (HCWs) have met an unprecedented challenge since the outbreak of coronavirus disease 2019 . HCWs made up 9.0% of confirmed cases in Italy [1] , and nearly 14.0% of confirmed cases in Spain [2] , in the first month of their respective outbreaks. Reasons for the rapid surge in HCW cases may partially be the lack of effective protection measures. Personal protective equipment (PPE) has been recommended for HCWs [3] and it is important to evaluate its efficacy on protecting this vulnerable population while combating COVID-19.

We conducted a cross-sectional survey (Supplementary Table 1 All participants had three consecutive RT-PCR tests (7 days apart) and 672 (70.0%) also tested for anti-SARS-CoV-2 IgG and IgM (30.0% of participants were not required to take this test, thus their results are unknown) before ending quarantine. All results were negative. (Table 1) . Evidence from the comparison of HCWs with any adverse events vs those without any adverse events showed that older age (33 vs 31 median years, P=0.016) and more consecutive days using PPE (40 vs 35 median days, P=0.001) were associated with a greater risk of adverse events (Supplementary Table 3 ). HCWs had an increased risk of adverse events from Group 3 (2.6%), Group 2 (34.7%) to Group 1 (62.6%) with P<0.05 between any two groups. Both doctors (30.2%) and nurses (66.5%) had greater risks of adverse events compared with other types of HCWs (3.3%, both P<0.05).

The present study focuses on efficacy and safety of PPE for HCWs in the Chinese epicenter of COVID-19, which we believe is critical to forming appropriate responses to this and future epidemics. Healthcare workers (HCWs) were stratified into "Group 1" (n=573, mainly working in intensive care unit, laboratory, testing room, and operating room), "Group 2" (n=346, mainly working in fever outpatient department, general patient room, Fangcang shelter hospital, emergency department, cleaning area, imaging examination area, and transfer vehicle), and "Group 3" (n=41, mainly working in general outpatient department, community, pharmacy, and administrative area). The usage frequency of PPE were scored "Score 4"=always (more than 95% of the time); "Score 3"=most of the time (50% or more but not 100%); "Score 2"=occasionally (20% to under 50%); and "Score 1"=rarely (less than 20%).

Mean rank was calculated via Kruskal-Wallis test to compare the usage frequency of each PPE among groups. **Adjust p-value < 0.001, * adjust p-value < 0.05. PPE=personal protective equipment. Mean rank ** * ** ** ** ** * * ** **

High proportion of healthcare workers with COVID-19 in Italy is a stark warning to the world: protecting nurses and their colleagues must be the number one priority

Virus knocks thousands of health workers out of action in Europe. The New York Times

World Health Organization. Rational use of personal protective equipment (PPE) for coronavirus disease (COVID-19): Interim Guidance

Risk assessment and management of exposure of health care workers in the context of COVID-19: Interim Guidance

None.