Reviewed by Lauren M. DiBiase, MS, University of North Carolina Hospitals
Rebmann et al. summarize results of an online survey developed by members of the APIC COVID19 Task Force that was sent to all members of APIC in late March 2020. A Likert-type scale was used to assess participants’ current access to various types of personal protective equipment (PPE), and hand hygiene and disinfection supplies. More than 1200 participants completed the survey with infection preventionists making up the majority of respondents (87.3%, n=1,048). Participants reported running a bit low to almost being out of all types of PPE. Participants were more likely to report having sufficient gloves (63.4% had sufficient amount) compared to all other PPE types. Face shields and N95 respirators were the least available PPE types (only 13.6% and 18.2% had sufficient amounts, respectively; p < .001 for all comparisons). Half (52.0%, n=624) reported receiving PPE from local or state sources, 44% (n=528) from private donations, 30.7% (n=369) DIY, and 22.2% (n=267) from the SNS. Participants reported running a bit low to almost having sufficient amounts of hand hygiene products. Less than half (45.4%, n=545) reported having sufficient disinfection supplies. The findings of this study indicate that most US healthcare facilities lacked or at least believed they lacked sufficient infection prevention supplies during the first month of the COVID-19 pandemic. Perceived critical shortages were identified in N95 respirators, masks, face shields, goggles, isolation gowns, hand sanitizer, and disinfection supplies. It is notable that in this study, many US healthcare facilities had obtained supplemental PPE from outside sources yet still reported significant deficiencies in PPE availability. Although local, state, and federal stockpiles exist, they are intended to be supplemental and were not sufficient to aid in response to COVID-19. These gaps in stockpiling and planning need to be addressed before the next major pandemic wave or event; failure to do so will result in not protecting our healthcare personnel sufficiently causing excess healthcare associated infection and more occupational exposures and illness.
In light of PPE shortages during the COVID19 pandemic, there is a need to identify ways to safely re-use N95 respirators and possibly other protective equipment. G. Ibanez-Cervantes et al. examine the disinfection capacity of hydrogen peroxide plasma (HPP) against the SARS-CoV-2 virus and two members of the ESKAPE bacteria (Acinetobacter baumannii and Staphylococcus aureus) through a study of artificial contamination in situ of N95 masks. To examine disinfectant activity of HPP, five different dilutions of SARS-coV-2 were inoculated on N95 masks to simulate ‘real’ contamination of masks in healthcare personnel. Amplification of specific genes by real-time reverse transcription polymerase chain reaction (RT-PCR) of SARS-CoV-2 and microbiological culture of ESKAPE bacteria was performed before and after the disinfection process. All dilutions were detected by RT-PCR after inoculation, therefore the possible not detection of SARS-coV-2 can be attributed to HPP. SARS-CoV-2 was not detected in all assays and A. baumannii and S. aureus were not cultivable with inoculums of 102 to 106 CFU after disinfection tests of N95 masks with HPP. With these results, the researchers speculate that HPP significantly damaged the genetic material of SARSCoV-2 virus rendering it undetectable by RT-PCR. With these findings, the authors conclude that the use of hydrogen peroxide plasma under standard conditions of treatment of N95 masks, may be an alternative for disinfection and possibly for other protective devices in shortage situations. This study demonstrated one possible viable solution to alleviating the N95 shortage by utilizing a method that allows N95 reuse while preserving the physical characteristics of protection and avoiding the degradation of the materials with which they are made.
References:
Terri Rebmann PhD, RN, CIC, FAPIC , Angela Vassallo MPH, MS, CIC, FAPIC, Jill E. Holdsworth MS, CIC, FAPIC, NREMT, CRCST, Availability of Personal Protective Equipment and Infection Prevention Supplies During the First Month of the COVID-19 Pandemic: A National Study by the APIC COVID-19 Task Force, AJIC: American Journal of Infection Control (2020), DOI: https://doi.org/10.1016/j.ajic.2020.08.029
Ibáñez-Cervantes G, Bravata-Alcántara JC, Nájera-Cortés AS, Meneses-Cruz S, Delgado-Balbuena L, Cruz-Cruz C, Durán-Manuel EM, Cureño-Díaz MA, Gómez-Zamora E, Chávez-Ocaña S, Sosa-Hernández O, Aguilar-Rojas A, Bello-López JM. Disinfection of N95 masks artificially contaminated with SARS-CoV-2 and ESKAPE bacteria using hydrogen peroxide plasma: Impact on the reutilization of disposable devices. AJIC: American Journal of Infection Control 2020 Sep; 48(9):1037-1041, DOI: https://doi.org/10.1016/j.ajic.2020.06.216
