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What Physicians Need to Know to Protect Themselves Against COVID-19

Doctors and nurses in hospitals are accustomed to wearing various types of personal protective equipment (PPE), including facemasks and respirators, but the highly contagious nature of COVID-19 has raised concerns for far more types of healthcare workers, from family physicians to hospital janitorial staff.

As scientists attain more understanding of how the virus causing COVID-19 spreads from one person to another, recommendations for personal protection are changing. Another factor that will impact changes to recommendations is the amount of PPE that is available, which determines how practical it is to follow the guidance offered.

The Centers for Disease Control (CDC) has issued guidance for how to stay safe during the pandemic, and they have updated it as better information has become available, making it important to stay current on recommendations.

Working With the Shortage of Recommended Facemasks

While it wouldn’t normally hurt to err on the side of caution and have everyone wear an FDA-approved facemask, there is currently a concern about the availability of PPE, especially disposable facemasks, which are in high demand and limited supply.

When the concern of shortages became known, manufacturers of FDA-approved masks ramped up production as much as possible. Other businesses started to look for ways they could start making facemasks, though these are not the N95 masks that are ideal.

As more companies are starting to produce alternate masks, the supply of them is rising, so at least some form of face covering is generally available. New producers may not be matching the standards of masks that had been cleared by the FDA in the past, so it is important to be aware of the kind of mask being used and to follow manufacturer instructions for each particular type.

Updated CDC Recommendations

N-95 (or higher level) respirators are ideal for protecting physicians and other caregivers, but users need to be cleared medically for their use and the respirators must be fit tested. This makes it impossible for most clinics and long-term care facilities to properly implement use of them.

Facemasks are defined by CDC as the type of PPE often referred to as surgical masks or procedure masks. (Cloth face coverings are specifically excluded from the category as they are not known to protect the wearer.)

Because of the limited amount of PPE that is available, it should be reserved for healthcare staff, but cloth face coverings may help reduce the spread of the virus by limiting the volume of droplets and distance traveled when an infected person coughs, sneezes or talks.

If the supply of facemasks is not sufficient to provide them to patients and visitors, while ensuring there will be plenty for healthcare staff, medical facilities can provide cloth face covers to be worn on the premises. CDC has recommended that everyone wear cloth face covers when they are out in public and near other people, so it should not surprise anyone to be asked to wear some form of face covering.

Because people infected with the coronavirus may not show symptoms of COVID-19 for up to two weeks, patients and healthcare providers alike could be spreading the virus without any way to be aware of it. Therefore, part of the strategy for keeping healthcare providers and other patients safe is in the way visitors and patients are managed.

CDC also recommends screening everyone before they enter the facility for fever and other COVID-19 symptoms, though it is acknowledged that this will not detect the virus in anyone who is asymptomatic.

Further information can be found on the CDC website. The Interim Infection Prevention and Control Recommendations for Patients with Suspected or Confirmed Coronavirus Disease 2019 (COVID-19) in Healthcare Settings document is updated as new recommendations are made.

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