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Medics urged to ensure proper use of PPE

Tuesday, June 30, 2020

CONSULTANT anaesthesiologist at the St Ann's Bay Regional Hospital, Dr Peter Scarlett, says the correct use of personal protective equipment (PPE) by health professionals during the novel coronavirus pandemic is imperative to safeguarding their well-being.

Dr Scarlett explained that as a physician working in the operating theatre, he has concerns for his own safety. But he said that once the guidelines are followed, neither he nor his colleagues should have major challenges.

He pointed out that while there are concerns regarding infectious diseases generally, issues relating to COVID-19 would be the major cause of some uncertainty resonating among his peers.

“As a physician, I wouldn't say I have fears… but I have concerns because any sort of infectious disease is something that you have to take seriously,” Dr Scarlett said.

He noted that COVID-19 is new and that the level of concern has heightened because very little is known about it.

“I think what mitigates or prevents the concern from becoming fear is knowledge in the first instance, then acting on that knowledge. From early days, we heard how this virus is transmitted and what you need to do to protect yourself. We know that it is transmitted through droplets and possibly through aerosol; and to protect yourself you need the right PPE,” he said.

“Sadly, in many hospitals across the world, our colleagues, doctors and nurses, and hospital workers have become infected and it is largely because they never had the appropriate PPE even in the most developed countries,” he added.

Dr Scarlett explained how PPE protects those on the front line from being infected in different ways.

“If you're thinking about the respiratory tract, the first thing that you need to do is prevent yourself from getting that virus in your respiratory system through breathing, and that's the beauty about the mask,” he says.

The consultant anaesthesiologist indicatef that the N95 mask is a special respirator that filters up to 99.9 per cent of viral particles.

“So if I am wearing one, and I am interviewing or examining a COVID patient, I know that this will protect me from inhaling it by filtering out the virus,” he pointed out. Dr Scarlett noted, however, that this is only part of the required PPE, pointing out that the virus is spread by droplets.

Consequently, he said someone could cough during a procedure or on a surface which could result in other individuals coming in contact with their secretions.

Full protective equipment, therefore, includes wearing a waterproof gown to protect the body against the permeation of secretions. Gloves, a mask, and a face shield or goggles, are also used.

“Because if someone were to cough or sneeze, even if you have the mask on, the virus could get in your face or hair; so we wear hair covering as well,” Dr Scarlett said.

He noted that the greatest challenge is with persons who are asymptomatic, noting that there are different aspects to how to protect oneself if it is unknown whether the person is infected.

“In the first instance, all medical personnel should practise universal precautions. So when interacting with a patient, you should always put on gloves and practise proper hand hygiene before and after… wear a mask and pay attention to proper hand hygiene. So there are certain minimal precautions that should be taken,” Dr Scarlett emphasised.

He said that if this is done routinely, then the possibility of being infected by an asymptomatic carrier is significantly reduced.

Dr Scarlett pointed out, however, that although practising these procedures routinely should yield optimal results, there are instances where someone may still be a risk.

“One good example is that regular universal precaution does not include the special N95 mask. This mask is molded to your face so that when you breathe in, no air can come through the sides, it all comes through the filter,” he says while also indicating that the regular surgical mask filters approximately 75 per cent of particles.

Health personnel, he said, do special fitting sessions where users are exposed to tests to ensure the effectiveness of the PPE.

“They expose you to a particular aroma and if you can smell it, it means that your mask is not working. So everything comes through and it is filtered out, which is why you should not touch the front of the mask because viruses or bacteria would be trapped on the front but would not get through,” the medical practitioner further explained.

Dr Scarlett also pointed out that fundamentals of PPE use are also demonstrated during the sessions, including the correct donning (putting on) and doffing (removal) as well as the correct disposal.

Over the past few months, a number of donors have supplied the Ministry of Health and Wellness, through its Health and Wellness for Life Foundation, with PPE as the country deals with the novel coronavirus pandemic, to ensure that there is adequate protective gear for front line workers.

Managing director of Enviro Planners Limited, which recently donated 4,650 coveralls valued at approximately $4.5 million, Dr Timon Waugh, said his company was happy to play its part in supporting the ministry's efforts that will benefit the entire country.

In accepting the donation, Health Minister Christopher Tufton praised the entity for its philanthropic spirit and acknowledgement that the COVID-19 fight is a collective national imperative.

Similarly, the Jamaica Northeast Diaspora USA organisation recently handed over 500 KN95 masks to boost the ministry's capacity to meet the challenges that have been wrought by the pandemic.