Personal Protective Equipment for COVID-19: A Comprehensive Review

Abstract

A century after the great Spanish flu wiped millions of people off the face of earth, the world is at loggerheads with yet another pandemic: the coronavirus disease 2019 or COVID-19. According to the World Health Organization (WHO), the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the COVID-19 infection. It is a single-stranded RNA virus in the coronavirus family (Coronaviridae) named from morphology. The SARS-CoV-2 infects human respiratory epithelial cells a thousand times more than the previous coronavirus strains and does so by interacting with human angiotensin-converting enzyme 2 (ACE2) receptors. The transmission modes include contact droplets from infected individuals, airborne transmission or indirect contacts on infected surfaces. The best way of prevention is hand and respiratory hygiene practice. As such, the transmission may be wholly or partially arrested by the universal adoption of personal protective equipment (PPE). PPE include N95 respirator masks or surgical masks, eye protectors or face shields, alcohol-based sanitizers, protective gowns, surgical caps and rubber boots. All the medical devices intended for specific PPE types must meet the standards of the Food and Drugs Administration (FDA). The WHO has exceedingly recommended the use of face masks by the general populace living in the affected areas. Model simulations in the United States using COVID-19 relevant data have shown that even simple cloth masks can impede the spread of this virus and thus prevent community transmission. Various studies have attested to the fact that the use of face masks in conjunction with other practices like hand hygiene and social distancing can cause considerable benefits to the whole community. While wearing a proper elastomeric respirator, selecting the proper eye gear with the correct positioning of protection is also required along with face shields. Mass masking is only beneficial when the majority of the population-akin wears masks to herd immunity after vaccination. Amidst the spread of this pandemic, there has been increasing emphasis by medical specialists on the use of alcohol-based hand sanitizers and soaps for keeping the hands germ-free. Gloves as protective equipment are advised to be worn mostly by medical personnel for invasive procedures. They need to be changed after each episode of treatment or between caring for two different patients. Sustainability of PPE is also a budding trend. At present, PPE manufacturing resources are derived from polyester, polyamide, polyethylene and other polymers. In the near future, biopolymers like natural fibres for disposable PPE manufacture may overrule the market. In essence, masking and gloving can be considered to keep the harm at source, whereas sanitizing falls under mitigative strategies aimed at killing the virus. It may also be remembered that gloves are not substitutes for hand sanitizing, and sanitizers are still encouraged before and after wearing gloves. Patient care measures need to be optimized irrespective of conventional, contingency and crisis circumstances. These measures include personal protective equipment (PPE), administrative and engineering controls to be implemented in general spread of infection and regulation strategies in healthcare management. © 2022, Springer Nature Switzerland AG.