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

• Published in: BMJ (Online) Vol. 369; p. m2195
• Main Authors: Liu, Min, Cheng, Shou-Zhen, Xu, Ke-Wei, Yang, Yang, Zhu, Qing-Tang, Zhang, Hui, Yang, Da-Ya, Cheng, Shu-Yuan, Xiao, Han, Wang, Ji-Wen, Yao, He-Rui, Cong, Yu-Tian, Zhou, Yu-Qi, Peng, Sui, Kuang, Ming, Hou, Fan-Fan, Cheng, KK, Xiao, Hai-Peng
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 10.06.2020; BMJ Publishing Group Ltd
• Subjects: Adult; Betacoronavirus; China; Clinical medicine; Coronaviridae; Coronavirus Infections - diagnosis; Coronavirus Infections - prevention & control; Coronaviruses; Cough; COVID-19; Cross-Sectional Studies; Disease control; Dyspnea; Epidemics; Female; Fever; Health Personnel; Hospitals; Humans; Immunoglobulin G; Immunoglobulin M; Infection Control - instrumentation; Infections; Infectious Disease Transmission, Patient-to-Professional - prevention & control; Intensive care; Intensive Care Units; Intubation; Male; Masks; Medical supplies; Middle Aged; Nucleic acids; Nurses; Nursing care; Occupational Exposure - prevention & control; Ostomy; Pandemics; Pandemics - prevention & control; Patients; Personal protective equipment; Personal Protective Equipment - supply & distribution; Physicians; Pneumonia, Viral - diagnosis; Pneumonia, Viral - prevention & control; Quarantine; Questionnaires; Respiration; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Testing laboratories; Training; China; Wuhan China
• ISSN: 1756-1833; 0959-8138; 1756-1833
• DOI: 10.1136/bmj.m2195

AbstractObjectiveTo examine the protective effects of appropriate personal protective equipment for frontline healthcare professionals who provided care for patients with coronavirus disease 2019 (covid-19).DesignCross sectional study.SettingFour hospitals in Wuhan, China.Participants420 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 measuresCovid-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.ResultsThe 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%).ConclusionBefore 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.