The rise and prevalence of the Coronavirus pandemic has created unparalleled demand for Personal Protective Equipment (PPE), globally. Though it is common knowledge that gowns play a pivotal role in protecting frontline healthcare workers, there is still uncertainty as to what practical role they play in halting the transmission of the virus. The following paper details how our products protect against Covid-19, and what other steps health clinicians may take to safeguard against occupational risks relating to the virus.
The novel coronavirus presented unknown territory when it began to spread in the early stages of 2020. While a number of coronavirus strains commonly circulate and cause illnesses such as the common cold, Covid-19 was an unknown quantity when it first began to attract the attention of scientists and healthcare specialists.
The World Health Organisation first coined the term Covid-19 in February of 2020, providing a name for the new virus which was spreading significantly in certain parts of the globe. The ‘19’ moniker came from the fact that the virus was first identified in Wuhan, in 2019.
Applying existing scientific insight to a new virus
As Coronavirus strains are extremely prevalent across all nations globally, scientists were able to make informed decisions early in the pandemic period, to provide guidance for clinicians in managing the spread. Along with the ‘catch it, bin it, kill it’ phrase which more usually has applied to seasonal influenza and other similar viruses, early guidance stressed the importance of providing hospital staff, dentists, GPs and healthcare providers with the right degree of PPE to prevent onward transmission of the disease, and inhibit its spread.
The Covid-19 virus is thought to be spread predominantly from one individual to another, through the respiratory droplets which people produce when they cough, shout, sneeze or talk. The droplets emitting from an infected person are then capable of landing in the mouth or nose of another individual, or potentially inhaled into the lungs of the non-infected person. Scientific research to date suggests that onward transmission of the disease is most likely in situations where people are in close contact with each other (within six feet or less).
When it comes to knowing how long the Covid-19 virus can exist on fabrics, there has not to date been any specific scientific study to determine this. However, by applying knowledge gleaned from other infections, it’s likely that the virus does not survive for as long on clothes and linens, as it may on hard surfaces.
Current guidance on using gowns in preference to aprons or no covering
Research to date suggests that healthcare workers in primary setting may be at greater risk of Covid-19 infection, than that present in general population and community settings. As the virus is transmitted through spreading droplets and fomites, gowns work in reducing the spread of droplets and/or bodily fluids to the skin of the healthcare practitioner and clothing. This then works to greatly reduce the possibility for secondary spreading to hands, and then onward to mucous membranes (the mouth or nasal passage for example).
The best possible form of protection is considered to be a gown, accompanied with a waterproof apron, to cover as much surface area of the clinician as possible without inhibiting their ability to conduct the requirements of their role.
NHS England recommends that lower-intensity settings (for example, in clinical consultations or for examinations conducted in either primary, or community, care), it is sufficient to deploy a face mask, gloves, eye protection and an apron. However, many healthcare practitioners have disputed the safety of this recommendation, and prefer to follow the guidance provided for other clinical environments.
Understanding the categories of risks for healthcare scenarios
The World Health Organisation (WHO) and Public Health England have provided policies emphasising the need to assess the risk of contagion for each distinct encounter, and deploy Personal protective Equipment according to this assessment.
The WHO distinguishes between four categories of risk, as follows:
- Standard precautions e.g. for staff conducting triage: hand hygiene + require any patient with suspected COVID-19 to wear a facemask
- ‘Contact and droplet precautions’ for suspected or confirmed case of COVID-19 not involving AGPs: requires hand hygiene, surgical mask, gown, goggles, gloves
- ‘Airborne precautions’ for suspected or confirmed case of COVID-19 requiring healthcare facility admission and AGP: requires hand hygiene, respirator mask, gown, goggles, gloves
- Collection of specimens for laboratory diagnosis: if undertaken via an AGP, requires hand hygiene, respirator mask, gown, goggles, gloves plus additional precautions.
The WHO’s guidance recommends that gowns should be deployed for all circumstances in preference over disposable aprons, other than in initial triage situations. To protect against both contact and droplet risks, they suggest that a clean, non-sterile, sleeveless gown and gloves is the best form of protection to inhibit the transmission of Covid-19.