#Universal #Masking in #Hospitals in the #Covid19 Era (N Engl J Med., summary)

[Source: The New England Journal of Medicine, full page: (LINK). Summary, edited.]

Universal Masking in Hospitals in the Covid-19 Era

Michael Klompas, M.D., M.P.H., Charles A. Morris, M.D., M.P.H., Julia Sinclair, M.B.A., Madelyn Pearson, D.N.P., R.N., and Erica S. Shenoy, M.D., Ph.D.


As the SARS-CoV-2 pandemic continues to explode, hospital systems are scrambling to intensify their measures for protecting patients and health care workers from the virus. An increasing number of frontline providers are wondering whether this effort should include universal use of masks by all health care workers. Universal masking is already standard practice in Hong Kong, Singapore, and other parts of Asia and has recently been adopted by a handful of U.S. hospitals.


Keywords: SARS-CoV-2; COVID-19; Psychology; HCWs; PPE; Facemasks.


#Assessment of #Proficiency of #N95 #Mask #Donning Among the General #Public in #Singapore (JAMA Netw Open, summary)

[Source: JAMA Network Open, full page: (LINK). Summary, edited.]

Assessment of Proficiency of N95 Mask Donning Among the General Public in Singapore

Wesley Yeung, MBBS1,2; Kennedy Ng, MBBS3; J. M. Nigel Fong, MBBS4; et al. Judy Sng, MBBS5; Bee Choo Tai, PhD5; Sin Eng Chia, MBBS5

Author Affiliations: 1 University Medicine Cluster, National University Hospital, Singapore; 2 Laboratory for Computational Physiology, Harvard-MIT Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge; 3 Division of Medical Oncology, National Cancer Centre Singapore, Singapore; 4 Division of Medicine, Singapore General Hospital, Singapore; 5 Saw Swee Hock School of Public Health, National University of Singapore, Singapore

JAMA Netw Open. 2020;3(5):e209670. doi:10.1001/jamanetworkopen.2020.9670



With the advent of the coronavirus disease 2019 (COVID-19) pandemic, mask-wearing  among the general public has become commonplace, leading to a worldwide shortage.1  However, there is little data on mask-wearing proficiency in the general public. A single  study performed in the US after Hurricane Katrina, when individuals donned masks for  mold remediation, found that only 24% of participants demonstrated proper technique.2  Incorrectly worn masks may not confer effective protection against COVID-19. We  conducted this cross-sectional study to evaluate the proficiency of members of the  Singapore public in wearing N95 masks, which the local government distributed to  households in 2014 as part of an emergency preparedness program3 targeted at episodes  of haze. The duck-bill foldable N95 mask (3M VFlex 9105) was selected for ease  of mailing and was distributed along with pictorial instructions.


Keywords: SARS-CoV-2; COVID-19; PPE; Facemasks; Singapore.


#PPE needs in the #USA during the #COVID19 pandemic (Lancet, summary)

[Source: Lancet, full page: (LINK). Summary, edited.]

Personal protective equipment needs in the USA during the COVID-19 pandemic

Suhas Gondi, Adam L Beckman, Nicholas Deveau, Ali S Raja, Megan L Ranney, Rachel Popkin, Shuhan He

Published: May 14, 2020 | DOI: https://doi.org/10.1016/S0140-6736(20)31038-2


Personal protective equipment (PPE) shortages (eg, masks, gloves, gowns) endanger  patients and health-care workers alike during the coronavirus disease 2019 (COVID-19)  pandemic.1 Policymakers and experts have called for donations of existing PPE,  increased production by manufacturers, and novel fabrication strategies, such as 3D  printing of masks.2,  3  However, even as PPE sources are identified, a critical  information challenge remains: tracking evolving PPE needs and matching them with  existing or emerging PPE stockpiles. Although anecdotes of PPE shortages dominate the  media, and epicentres of the pandemic, like New York City, NY, USA, have articulated  clear needs, the national distribution of PPE shortages has not been examined. A  quantitative, real-time snapshot of the PPE needs across the USA is needed.


Keywords: SARS-CoV-2; COVID-19; PPE; USA.


#SARS-CoV-2-specific #antibody #detection in #HCWs in #Germany with direct contact to #COVID19 patients (J Clin Virol., abstract)

[Source: Journal of Clinical Virology, full page: (LINK). Abstract, edited.]

Journal of Clinical Virology | Available online 13 May 2020, 104437 | In Press, Journal Pre-proof | Short communication

SARS-CoV-2-specific antibody detection in healthcare workers in Germany with direct contact to COVID-19 patients

Johannes Korth a, Benjamin Wilde a, Sebastian Dolff b, Olympia E. Anastasiou c, Adalbert Krawczyk b, Michael Jahn a, Sebastian Cordes d, Birgit Ross e, Stefan Esser f, Monika Lindemann g, Andreas Kribben a, Ulf Dittmer c, Oliver Witzke b, Anke Herrmann c

a Department of Nephrology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; b Department of Infectious Diseases, West German Centre of Infectious Diseases, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; c Institute for Virology, University Hospital Essen, University of Duisburg-Essen, Virchowstr. 179, 45147 Essen, Germany; d Department of Pneumology, University Hospital Essen, University Hospital Essen, Tüschener Weg 40, 45239 Essen, Germany; e Hospital Hygiene, University Hospital Essen, University Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany; f Clinic of Dermatology, University Hospital Essen, University of Duisburg-Essen, Hufelandstr. 55, 45147 Essen, Germany;  g Institute for Transfusion Medicine, University Hospital Essen, University of Duisburg-Essen, 45147 Essen, Germany

Received 5 May 2020, Accepted 10 May 2020, Available online 13 May 2020.

DOI: https://doi.org/10.1016/j.jcv.2020.104437



  • The average SARS-CoV-2 seroprevalence in healthcare workers of a a tertiary hospital, University Hospital Essen, Germany was 1.6% in the period between March to April 2020.
  • The local hygiene standards seem to be effective to prevent patient-to-staff virus transmission at the designated COVID-19 units wards.




The novel coronavirus SARS-CoV-2 is associated with a severe respiratory manifestation, COVID-19, and presents a challenge for healthcare systems worldwide. Healthcare workers are a vulnerable cohort for SARS-CoV-2 infection due to frequent and close contact to patients with COVID-19.

Study design

Serum samples from 316 healthcare workers of the University Hospital Essen, Germany were tested for SARS-CoV-2-IgG antibodies. A questionnaire was used to collect demographic and clinical data. Healthcare workers were grouped depending on the frequency of contact to COVID-19 patients in high-risk-group (n = 244) with daily contact to known or suspected SARS-CoV-2 positive patients, intermediated-risk-group (n = 37) with daily contact to patients without known or suspected SARS-CoV-2 infection at admission and low-risk-group (n = 35) without patient contact.


In 5 of 316 (1.6%) healthcare workers SARS-CoV-2-IgG antibodies could be detected. The seroprevalence was higher in the intermediate-risk-group vs. high-risk-group vs. 2/37 (5.4%) vs. (3/244 (1.2%), p = 0.13). Four of the five subject were tested negative for SARS-CoV-2 via PCR. One (20%) subject was not tested via PCR since he was asymptomatic.


The overall seroprevalence of SARS-CoV-2 in healthcare workers of a tertiary hospital in Germany is low (1.6%). The data indicate that the local hygiene standard might be effective.

Keywords: SARS-CoV-2; COVID-19; Serology; Seroprevalence; HCWs; PPE; Germany.


#Epidemiology of and #Risk #Factors for #Coronavirus Infection in #HCWs: A Living Rapid Review (Ann Intern Med., abstract)

[Source: Annals of Internal Medicine, full page: (LINK). Abstract, edited.]

Epidemiology of and Risk Factors for Coronavirus Infection in Health Care Workers: A Living Rapid Review

Roger Chou, MD; Tracy Dana, MLS; David I. Buckley, MD, MPH; Shelley Selph, MD, MPH; Rongwei Fu, PhD; Annette M. Totten, PhD




Health care workers (HCWs) are at risk for severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection.


To examine the burden of SARS-CoV-2, SARS-CoV-1, and Middle Eastern respiratory syndrome (MERS)-CoV on HCWs and risk factors for infection, using rapid and living review methods.

Data Sources:

Multiple electronic databases including the WHO Database of Publications on Coronavirus Disease and medRxiv preprint server (2003 through 27 March 2020, with ongoing surveillance through 24 April 2020), and reference lists.

Study Selection:

Studies published in any language reporting incidence of or outcomes associated with coronavirus infections in HCWs and studies on the association between risk factors (demographic characteristics, role, exposures, environmental and administrative factors, and personal protective equipment [PPE] use) and HCW infections. New evidence will be incorporated on an ongoing basis by using living review methods.

Data Extraction:

One reviewer abstracted data and assessed methodological limitations; verification was done by a second reviewer.

Data Synthesis:

64 studies met inclusion criteria; 43 studies addressed burden of HCW infections (15 on SARS-CoV-2), and 34 studies addressed risk factors (3 on SARS-CoV-2). Health care workers accounted for a significant proportion of coronavirus infections and may experience particularly high infection incidence after unprotected exposures. Illness severity was lower than in non-HCWs. Depression, anxiety, and psychological distress were common in HCWs during the coronavirus disease 2019 outbreak. The strongest evidence on risk factors was on PPE use and decreased infection risk. The association was most consistent for masks but was also observed for gloves, gowns, eye protection, and handwashing; evidence suggested a dose–response relationship. No study evaluated PPE reuse. Certain exposures (such as involvement in intubations, direct patient contact, or contact with bodily secretions) were associated with increased infection risk. Infection control training was associated with decreased risk.


There were few studies on risk factors for SARS-CoV-2, the studies had methodological limitations, and streamlined rapid review methods were used.


Health care workers experience significant burdens from coronavirus infections, including SARS-CoV-2. Use of PPE and infection control training are associated with decreased infection risk, and certain exposures are associated with increased risk.

Primary Funding Source: World Health Organization.

Keywords: SARS-CoV-2; COVID-19; HCWs; PPE.


#Protecting #HCWs from inhaled #SARS-CoV-2 virus (Occupat Med., summary)

[Source: Occupational Medicine, full page: (LINK). Summary, edited.]

Protecting healthcare workers from inhaled SARS-CoV-2 virus

John W Cherrie, Miranda Loh, Robert J Aitken

Occupational Medicine, kqaa077, https://doi.org/10.1093/occmed/kqaa077

Published: 30 April 2020

Issue Section: Editorial


The current Covid-19 emergency presents enormous challenges in the prevention of infection in healthcare workers. TV and media images of these workers show a huge variety of personal protective equipment (PPE) being used, in many cases being worn incorrectly by healthcare workers, compromising the effectiveness. The question is to what extent are these workers at risk of infection from inhaled virus particles and if they are at risk, how should they best be protected?


Keywords: SARS-CoV-2; COVID-19; HCWs; PPE.


Moving #PPE Into the #Community – Face #Shields and #Containment of #COVID19 (JAMA, summary)

[Source: JAMA, full page: (LINK). Summary, edited.]

Moving Personal Protective Equipment Into the CommunityFace Shields and Containment of COVID-19

Eli N. Perencevich, MD, MS1,2; Daniel J. Diekema, MD, MS2; Michael B. Edmond, MD, MPH, MPA2

Author Affiliations: 1 Center for Access & Delivery Research and Evaluation, Iowa City VA Health Care System, Iowa City, Iowa; 2 Carver College of Medicine, Department of Internal Medicine, The University of Iowa, Iowa City

JAMA. Published online April 29, 2020. doi:10.1001/jama.2020.7477


On March 19, 2020, California became the first state to issue a stay-at-home order in response to the evolving coronavirus disease 2019 (COVID-19) pandemic. It was quickly recognized that widespread diagnostic testing with contact tracing, used successfully in countries such as South Korea and Singapore, would not be available in time to significantly contain the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).1,2 Over the following month, additional nonpharmaceutical mitigation strategies, including school closures, bans on large in-person gatherings, and partial closures of restaurants and retail stores, were applied to “flatten the epidemic curve” and limit the peak effects of a surge of patients on health care systems. Yet, even as the benefits of mitigation bundles have not fully been realized, there are widespread calls to reopen businesses, given the immense economic and social consequences of extreme physical distancing strategies.


Keywords: SARS-CoV-2; COVID-19; USA; Society; PPE.