Challenges and solutions for addressing critical shortage of supply chain for personal and protective equipment (PPE) arising from Coronavirus disease (COVID19) pandemic – Case study from the Republic of Ireland

• Published in: The Science of the total environment Vol. 725; p. 138532
• Main Authors: Rowan, Neil J., Laffey, John G.
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 10.07.2020; The Authors. Published by Elsevier B.V
• Subjects: Betacoronavirus; case studies; Coronavirus Infections; COVID-19; COVID19; disinfection; health care workers; health services; Healthcare workers; hospitals; Humans; hydrogen peroxide; Ireland; Irish Republic; mortality; Orthocoronavirinae; pandemic; Pandemics; pathogens; planning; Pneumonia, Viral; PPE; public health; Resource utilization; respiratory tract diseases; safety equipment; SARS-CoV-2; Sterilization; supply chain; Sustainability; thermosensitivity; ultraviolet radiation; United States; vaccines; Ireland; Irish Republic; United States; Resource utilization; Healthcare workers; COVID19; PPE; Sustainability; Sterilization
• ISSN: 0048-9697; 1879-1026; 1879-1026
• DOI: 10.1016/j.scitotenv.2020.138532

Coronavirus (COVID-19) is highly infectious agent that causes fatal respiratory illnesses, which is of great global public health concern. Currently, there is no effective vaccine for tackling this COVID19 pandemic where disease countermeasures rely upon preventing or slowing person-to-person transmission. Specifically, there is increasing efforts to prevent or reduce transmission to front-line healthcare workers (HCW). However, there is growing international concern regarding the shortage in supply chain of critical one-time-use personal and protective equipment (PPE). PPE are heat sensitive and are not, by their manufacturer's design, intended for reprocessing. Most conventional sterilization technologies used in hospitals, or in terminal medical device sterilization providers, cannot effectively reprocess PPE due to the nature and severity of sterilization modalities. Contingency planning for PPE stock shortage is important. Solutions in the Republic of Ireland include use of smart communication channels to improve supply chain, bespoke production of PPE to meets gaps, along with least preferred option, use of sterilization or high-level disinfection for PPE reprocessing. Reprocessing PPE must consider material composition, functionality post treatment, along with appropriate disinfection. Following original manufacturer of PPE and regulatory guidance is important. Technologies deployed in the US, and for deployment in the Republic of Ireland, are eco-friendly, namely vaporised hydrogen peroxide (VH2O2), such as for filtering facepiece respirators and UV irradiation and High-level liquid disinfection (Actichlor+) is also been pursed in Ireland. Safeguarding supply chain of PPE will sustain vital healthcare provision and will help reduce mortality. [Display omitted] •There is pressing need to find solutions for reprocessing of PPE for COVID19•Reprocessing of PPE is challenging as made for one-time-use•Most sterilization technologies are not suitable for PPE reprocessing•Use of vaporised hydrogen peroxide and UV irradiation may prove effective for PPE