Potential Role of Personal Protective Equipment Use in the Protection Against COVID-19 Infection Among Health Care Workers

  1. Wei Wang
  2. Yuan-Zeng Min
  3. Chun-Mei Yang
  4. Hai-Ou Hong
  5. Tian Xue
  6. Yong Gao
  7. Tengchuan Jin
  8. Zhao-Hui Lu
  9. Liang-Ming Zhang
  10. Xueying Zheng
  11. Sihui Luo
  12. Wei Bao
  13. Jian-Ping Weng

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Abstract

The coronavirus disease 2019 (COVID-19) pandemic has posed a major challenge for protecting health care workers (HCWs) against the infection. Use of personal protective equipment (PPE) in health care workplace is recommended as a high priority. In order to investigate the relationship between PPE use and the number of COVID-19 cases among HCWs, we conducted a molecular epidemiological study among 142 HCWs who were dispatched from Hefei to work in Wuhan and 284 HCWs who remained in Hefei, China; both provided care for patients with COVID-19. Nucleic acid testing and SARS-CoV-2 specific antibody (IgM, IgG, IgA) detection were performed to confirm SARS-CoV-2 infection among those HCWs. We also extracted publicly released data on daily number of COVID-19 cases among HCWs, daily number of HCWs who were dispatched to Hubei province since January 24, and daily production of PPE in China and daily demand and supply of PPE in Hubei province. Our laboratory testing confirmed that none of the 142 HCWs who were dispatched to work in Wuhan and 284 HCWs who remained in Hefei were infected by SARS-CoV-2. Consistent with these findings, as of April 15, 2020, none of the 42,600 HCWs who were successively dispatched to Hubei province since January 24, 2020 was reported to have COVID-19. These HCWs were provided with adequate supply of PPE as committed by their original institutions or provinces. In contrast, during the early phase of COVID-19 epidemic in Hubei province, a substantial shortage of PPE and an increasing number of COVID-19 infection among HCWs were reported. With the continuing increase in domestic production of PPE in China, the PPE supply started to meet and then exceed the demand. This coincided with a subsequent reduction in the number of reported COVID-19 cases among HCWs. In conclusion, our findings indicate that COVID-19 infection among HCWs could be completely prevented. Appropriate and adequate PPE might play a crucial role in protecting HCWs against COVID-19 infection.

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  1. ScreenIT

    SciScore for 10.1101/2020.04.24.20070169: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The study protocol was approved by the Institutional Review Board at the University of Science and Technology of China (USTC).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    We used SPSS (version 19.0) for all the analyses.
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    This study has several limitations. First, like other observational studies, the present study could not establish causality between PPE use and the successful prevention of COVID-19 infection among HCWs. Due to ethical consideration, it is impossible to conduct experimental studies to compare infections between HCWs wearing and not wearing PPE. Only historical data of different periods could be used to test our hypothesis. Second, PPE consists of various items such as protective clothing, N95 masks, surgical masks, gloves, and goggles, etc. This study only presents the data of medical protective clothing because protective clothing is representative of PPE production and supply in China. Third, we were not able to test all the 42,600 HCWs who were dispatched to Hubei province. Finally, we did not have information about the HCWs’ personal prevention awareness and adherence at individual level which may also influence the infection among HCWs. In conclusion, our laboratory-confirmed findings of zero infection indicate that COVID-19 infection among HCWs could be completely prevented. Appropriate and adequate PPE might play a crucial role in protecting HCWs against COVID-19 infection. Therefore, it is critical and urgent to ensure sufficient PPE in health care workplace to protect HCWs from COVID-19 infection while they are fighting against the pandemic.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  2. Version published to 10.1101/2020.04.24.20070169v1 on medRxiv