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It Isn’t Over: Moving Forward Safely in a COVID-19 World

While PPE suppliers and others have stepped up to meet urgent demands, novel strategies are still needed to minimize risks to healthcare workers.

COVID-19 has hit the U.S. healthcare industry like a category five hurricane—an unexpected, widespread disaster that has taken lives and drained critical resources. One area hit particularly hard is the supply chain, with healthcare institutions scrambling to secure the supplies their providers need to protect themselves and their patients from this rapidly spreading illness.

Personal protective equipment (PPE), including masks and gowns, is a frontline defense against COVID-19 for healthcare workers, who can’t adhere to social distancing guidelines when providing hands-on patient care. While traditional PPE suppliers have significantly boosted production of their products and the U.S. government has called on companies from outside of the industry to redirect staff and factory lines to the manufacture of PPE, the demand continues to outpace product delivery. 

As state governments begin to relax restrictions intended to slow the spread of COVID-19 and companies start opening their doors, it’s easy to feel a false sense of security that as a nation we have outsmarted and subdued the virus. But in reality, the fight is just beginning: COVID-19 is a long-term reality, and we are likely to see a resurgence as we emerge from our homes and attempt to restart our lives after a national pause. Although prevention and treatment strategies for COVID-19 will eventually become available, they may not eradicate the risk of infection.

As a result, more people will get sick, and healthcare workers will continue to be the first line of defense. The strain on PPE resources will increase in the short term as hospitals and other healthcare facilities resume elective surgical procedures, annual primary care appointments, and other types of care that have been delayed because of the pandemic. Active infection with capacity for transmission has been observed in asymptomatic individuals, making PPE at these visits particularly critical. Hospitals, outpatient clinics, and other care settings (e.g., long-term care facilities, prisons, homeless shelters), government agencies (e.g., CDC, HHS, FDA), and PPE manufacturers all have a responsibility to provide healthcare practitioners with the products and information they need to protect themselves from COVID-19 exposure during the course of delivering patient care.  

These stakeholders must collaborate not only to boost the production of current PPE, but also to develop new PPE solutions that provide protection in a wider range of healthcare delivery settings. For example, areas of current supply shortages and exposure risk and opportunities for improvement include:

  • Reusable versus disposable PPE: One of the greatest challenges facing healthcare—and one that will continue to grow—is simply not having enough PPE to protect healthcare workers. Today most of the PPE supply, particularly gowns and gloves, are designed for single-use only. Developing PPE manufactured from materials that can be decontaminated and reused should be a priority.
  • Active defense PPE: Most PPE today is passive defense, i.e., designed to prevent viral transmission. For example, an N95 respirator filtration mask worn correctly can capture 95 percent of particles 0.3 microns or larger from filtered air. That remaining 5 percent of airborne particles still presents a risk. A mask that not only blocks but also inactivates pathogens before reaching the wearer would combine both active and passive defense mechanisms for greater protection. 
  • Donning and doffing PPE: Putting on PPE before caring for a COVID-19 patient (donning), then removing it after care has been delivered (doffing), is complex and time consuming, and it is a potential source of exposure to the wearer while removing contaminated PPE. Healthcare workers responsible for taking care of a growing population of COVID-19 patients don’t have time to spare. The development of safer and more efficient PPE use practices will reduce risk. 

While states are easing restrictions and re-opening businesses and gathering spaces and people are beginning to resume more normal activities, COVID-19 remains a serious threat. 

Nobody recognizes this more than the healthcare providers who continue to care for infected patients as they attempt to shield themselves and their families from contracting the virus. They are still experiencing the risks firsthand and the strain on the healthcare supply chain’s resources as they ration PPE so there is enough for everyone on the frontlines of care. 

Although government agencies, healthcare organizations, and manufacturers are working diligently to replenish the supply chain with PPE and ease the burden, a recurrent national surge of infections could overwhelm such efforts. In addition, we encourage these entities to develop novel PPE strategies that minimize the risk to healthcare workers and the limitations of current approaches.

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