Coronavirus: When to use personal protective equipment

CORONAVIRUS

On 21 March 2020, Uganda's Ministry of Health (MoH) confirmed the first case of COVID-19 and on 23 March 2020 announced confirmation of 8 new cases.

By 24 March, the COVID-19 pandemic had affected 382,420 people with 16,569 deaths in 195 countries and territories of the world and continued to expand. As we walk around Uganda now, many people seem to feel that they need to be using personal protective equipment (PPE) to protect themselves against the Coronavirus Disease (COVID-19).

PPE includes items such as medical gloves, medical face masks, N95-respirator masks, goggles, face shields, gowns, and aprons. As this pandemic evolves, let's remember that when we, the public, use PPE and do not need it, we make it unavailable for the persons that need it the most.

Medical staff use PPE for two reasons: to protect their patients from becoming exposed to any spots on the doctor's clothes or hands that may have been contaminated from another patient, and to protect themselves from becoming infected by germs their patient has.

Based on the available evidence, the COVID-19 virus is thought to be primarily transmitted between people through close contact and droplets that come out of the mouth when a person sneezes or coughs.

The droplets can get into the mouth, nose, or eyes of an uninfected person and cause infection. The virus can also survive on surfaces for a period of time; how long is unknown so far.

Health care workers are at high risk for COVID-19 infections, as well as many other infections they can catch from their patients. Our healthcare workers are the ones who keep us alive when we are sick. Let's discuss the PPE needs in health care settings and communities facing a COVID-19 outbreak.

WHO NEEDS PPE?
Frontline health workers or other persons actively involved in COVID-19 work such as screening or triage of patients, collection of specimens like the nose or throat swabs from suspected COVID-19 patients, or caring for patients suspected/confirmed to be infected.

Healthcare workers and other persons taking temperatures and travel history at points of entry should wear face masks and gloves. Persons involved in cleaning COVID-19 patients' rooms need face masks, gowns, heavy-duty gloves, goggles or face shields (if there is a risk of splash from organic materials or chemicals), and boots or closed shoes.

The only time the public should be wearing face masks is if they themselves are sick, or if they are caring for someone who is sick. Persons with respiratory illnesses like flu/cough and ones suspected or confirmed to be infected with COVID-19 should use face masks if they can so that they do not cough on others and get droplets on those people.

 



Examples of Personal Protective Equipment for use in health care settings for COVID-19

WHO DOESN'T need PPE?
Persons who have no respiratory symptoms like cough and who are not near a person who is infected with COVID-19.  Instead, these persons should observe social distancing, hand hygiene, and be alert to notify health authorities should they or someone they know develop symptoms.

I recently saw a toilet paper hawker on the streets of Kampala wearing an expensive N95-respirator type of mask. This kind of waste is a burden on the health system for no good reason. In addition, this creates a false sense of security that can lead to the neglect of other essential and effective preventive measures.

WHY IS THIS IMPORTANT?
According to the World Health Organization, the current global stockpile of PPE is insufficient, particularly for face masks and N95 respirators. This increasing global demand is partly driven by the number of COVID-19 cases but also by misinformation, misuse, panic buying, and hoarding.

The capacity to expand PPE production or importation is still limited, especially in developing economies like Uganda. The current demand for respirators and masks cannot be met even now and is made more difficult if the widespread, inappropriate use of PPE continues by persons in the public who do not need it.

In the past seven weeks, Uganda's MoH has issued and implemented measures to protect the public from COVID-19.

These include messaging about signs and symptoms and how to notify health officials, preventive measures such as avoiding touching your eyes, nose, and mouth, observing coughing etiquette, hand washing, use of alcohol-based hand rub, and social distancing.

Observe these important measures to keep yourself and your family safe. Do not put our healthcare workers at risk of infection and make them unable to care for patients who need them most.  

The writer is a Field Epidemiology Fellow in the Uganda Public Health Fellowship Program, Ministry of Health