Use of personal protective equipment against coronavirus disease 2019 by healthcare professionals in Wuhan, China: cross sectional study

Min Liu, Shou-Zhen Cheng, Ke-Wei Xu, Yang Yang, Qing-Tang Zhu, Hui Zhang, Da-Ya Yang, Shuyuan Cheng, Han Xiao, Ji-Wen Wang, He-Rui Yao, Yu-Tian Cong, Yu-Qi Zhou, Sui Peng, Ming Kuang, Fan-Fan Hou, KK Cheng, Hai-Peng Xiao

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Abstract

Objective: To examine the protective effects of appropriate personal protective equipment for frontline healthcare professionals who provided care for patients with coronavirus disease 2019 (covid-19).

Design: Cross sectional study.

Setting: Four hospitals in Wuhan, China.

Participants: 420 healthcare professionals (116 doctors and 304 nurses) who were deployed to Wuhan by two affiliated hospitals of Sun Yat-sen University and Nanfang Hospital of Southern Medical University for 6-8 weeks from 24 January to 7 April 2020. These study participants were provided with appropriate personal protective equipment to deliver healthcare to patients admitted to hospital with covid-19 and were involved in aerosol generating procedures. 77 healthcare professionals with no exposure history to covid-19 and 80 patients who had recovered from covid-19 were recruited to verify the accuracy of antibody testing.

Main outcome measures: Covid-19 related symptoms (fever, cough, and dyspnoea) and evidence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, defined as a positive test for virus specific nucleic acids in nasopharyngeal swabs, or a positive test for IgM or IgG antibodies in the serum samples.

Results: The average age of study participants was 35.8 years and 68.1% (286/420) were women. These study participants worked 4-6 hour shifts for an average of 5.4 days a week; they worked an average of 16.2 hours each week in intensive care units. All 420 study participants had direct contact with patients with covid-19 and performed at least one aerosol generating procedure. During the deployment period in Wuhan, none of the study participants reported covid-19 related symptoms. When the participants returned home, they all tested negative for SARS-CoV-2 specific nucleic acids and IgM or IgG antibodies (95% confidence interval 0.0 to 0.7%).

Conclusion: Before a safe and effective vaccine becomes available, healthcare professionals remain susceptible to covid-19. Despite being at high risk of exposure, study participants were appropriately protected and did not contract infection or develop protective immunity against SARS-CoV-2. Healthcare systems must give priority to the procurement and distribution of personal protective equipment, and provide adequate training to healthcare professionals in its use.
Original languageEnglish
Article numberm2195
Number of pages6
JournalBMJ
Volume369
DOIs
Publication statusPublished - 10 Jun 2020

Keywords

  • Adult
  • Betacoronavirus
  • China
  • Coronavirus Infections/diagnosis
  • Cross-Sectional Studies
  • Female
  • Health Personnel
  • Humans
  • Infection Control/instrumentation
  • Infectious Disease Transmission, Patient-to-Professional/prevention & control
  • Intensive Care Units
  • Male
  • Middle Aged
  • Occupational Exposure/prevention & control
  • Pandemics/prevention & control
  • Personal Protective Equipment/supply & distribution
  • Pneumonia, Viral/diagnosis

ASJC Scopus subject areas

  • Medicine(all)

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