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COVID-19 Crisis Prompting Innovation in Addressing Personal Protective Equipment Shortage

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COVID-19 Crisis Prompting Innovation in Addressing Personal Protective Equipment Shortage General Section Perspective COVID-19 crisis prompting innovation in addressing personal protective equipment shortage Kripa Rajak Medical Student (formerly), Patan Hospital, Patan Academy of Health Sciences, Lalitpur, Kathmandu, Nepal ISSN: 2091-2749 (Print) 2091-2757 (Online) Abstract Correspondence Coronavirus disease 2019 (COVID-19) has swept across the globe 2091-2757 (Online) Dr. Kripa Rajak overwhelming health care systems and disrupting supply chain of Patan Hospital personal protective equipment (PPE) like gloves, surgical face masks, Academy of Health Sciences, goggles, face shields, N95 respirators and gowns. Surging demand, panic Lalitpur, Nepal Email: [email protected] buying, hoarding, and misuse of PPE has led to substantial jump in its demand. Despite the terrible impact of COVID-19, if there’s any silver lining to this crisis, it is the rapidity at which communities are moving Peer Reviewers toward innovation in not just medicine and remote work but also in ways Asst. Prof. Dr. Ashis Shrestha to mitigate the growing PPE shortages. Patan Academy of Health Sciences Keyword: Centres for Disease Control and Prevention (CDC), facemasks, personal protective equipment (PPE) Asst. Prof. Dr. Sumana Bajrachraya Patan Academy of Health Sciences Submitted 25 Apr 2020 Accepted 27 Apr 2020 How to cite this article Kripa Rajak. COVID-19 crisis prompting innovation in addressing personal protective equipment shortage. Journal of Patan Academy of Health Sciences. 2020Apr;7(1):69-72. DOI: https://doi.org/10.3126/jpahs. v7i1.28867 69 Journal of Patan Academy of Health Sciences. 2020Apr;7(1):69-72. Kripa Rajak: COVID19 prompting innovations The world is battling coronavirus 2019 exposures are anticipated, including surgical (COVID-19) pandemic, a human tragedy. It has procedures.2 Conserving resources by overwhelmed health care system globally, and removing all facemasks from public areas, now has fatigued the global production availing masks to symptomatic patients, capacity of personal protective equipment emergency departments and implementing (PPE). Surging demand, panic buying, extended use is recommended by CDC during hoarding, and misuse of PPE has triggered the periods of expected facemask shortages.2 dramatic rise in demand for gloves, surgical It is recommended by CDC to cancel face masks, goggles, face shields, N95 nonemergency procedures, outpatient respirators and gowns, prompting significant encounters and implement re-use of price gouging, production backlogs and facemasks in the setting of known shortages.2 disruption of supply chains worldwide.1 When no facemasks are available, it Pandemics in the past have shaped human recommends excluding clinicians at higher risk history, propelling public-health innovations. (old age, comorbidities, pregnant) and This contagion, like all other, has ignited a designating the ones who have recovered wave of innovation in approaching the ways from infection to treat patients with COVID-19 to mitigate PPE deficit globally and locally. infection. Homemade mask can be used if necessary.2 In response to the pandemic, Centres for Disease Control and Prevention (CDC) has Global Innovations- To address the identified different levels of operational impending global PPE shortage, Journal of status to optimize the supply of face masks.2 American Medical Association (JAMA) issued a call for creative solutions from health care In regular practice, facemasks should be used professionals (HCPs) around the world, which to protect against splashes and sprays when has generated several inputs, Table 1.3 Table 1. Possible solutions for PPE conservation and management (adapted from3) Possible solutions for PPE conservation and management Import from international suppliers Reclaim by public and private buybacks Reuse by disinfection Repurpose prefabricated devices (snorkel, scuba, sports eye protector, motorcycle helmets with visor) Reduce non-essential services Reduce patient contact Alter staffing Use of nonhuman services like drones, robots Employ immune workers Use government solutions Stratify use by risk profiling An Israeli start-up developed washable masks integrity of PPE remain.5 Homemade masks embedded with antimicrobial agents that made from t-shirts blocked approximately could prove more effective than disposable 50% of 0.02-1 micron particles, compared masks.4 Sterilization of N95 with ultraviolet with up to 90% blocked by standard surgical irradiation inactivates coronaviruses, without masks.6 Both masks reduced the number of adversely affecting their fit and filtration.5 microorganisms expelled, but the surgical Other agents ranging from ethylene oxide, masks were two times more effective in gamma irradiation, ozone, and alcohol have blocking transmission than the homemade been identified but uncertainty about the masks.6 effects of these sterilizing agents on structural 70 Journal of Patan Academy of Health Sciences. 2020Apr;7(1):69-72. Kripa Rajak: COVID19 prompting innovations Innovations to preserve PPE by minimizing needed to ensure the handiness of protective human contact have been developed. For gears. First, with no sign of pandemic coming instance, an automatic mask vending to a close, I believe Nepal government should machines is rolled out in Taiwan to abate the encourage local entrepreneurs to set up new need for workforce.7 China and Spain have production facilities for protective gears by deployed drones to transport medical offering them incentives because there is a supplies like test kits between hospitals and global shortage and the demand will continue to tell people to stay indoors. China has to escalate down the line. A national stockpile robots on the roads and subway system to is needed to tackle future outbreaks or a detect people with fever. In hospital they help potential second wave of COVID-19. in monitoring infected patients, delivering medical supplies and disinfecting wards. Second, hand washing remains one of the few Robots were also used for delivering groceries weapons in the virus-killing arsenal and and pharmacies.8 minimizing the need of PPE. I think, government should contract with local There are also examples of how remote distilleries and companies in the nation to technologies are addressing challenges of PPE ramp up domestic production to distribute shortages. Contact-tracing technology using free soap and hand sanitizer. smart phones is being used in many countries to identify sick people, isolate them, and then Third, public use of masks helps prevent virus identifying and quarantining people they spread but a big public run on surgical masks came into contact with to break disease could make an already critical unavailability of transmission chains.9 Telemedicine is being masks for doctors and nurses even worse. In utilized for consultation as medical my opinion, government should reinforce the professionals need to stay disease-free and CDC’s guideline on using homemade masks preserve PPE.10 like scarves and bandanas that cover entire front and sides of the face. Local innovations- Besides global evidences on managing PPE shortages, some ideas bred Fourth, telemedicine already in use in Nepal locally to address this issue is praiseworthy. can be deployed to filter out potential COVID- Bheri Hospital in Nepalgunj is making gown 19 cases remotely, assess the condition of from thin plastic, goggles from transparent infected people under isolation and provide stationery and helmet from elastic apparel remote consultations for non-COVID-19 material. Other hospitals in the region have patients, limiting the patient displacement to adopted this design to manufacture gears in hospitals. local garment factory.11 Similarly, Mahabir Pun, a Nepali activist, has Conclusion leveraged his social media account to call for tailors and garment shops to collaborate in COVID-19 pandemic is an unprecedented mass production of protective gears.11 To crisis and several measures of innovations in raise awareness about hygiene, All Nepal public health areas have emerged. Football Association has released a video in which players address the population.12 All these efforts lessen the use of gloves, face Acknowledgement masks, goggles, face shields, N95 respirators I would like to thank Dr. Calvin Ghimire for and gowns. revisions in my article. My perspective- The initiatives from government and citizens provide critical Conflict of Interest assistance, but I think additional steps are None 71 Journal of Patan Academy of Health Sciences. 2020Apr;7(1):69-72. Kripa Rajak: COVID19 prompting innovations Funding 6. Davies A, Thompson KA, Giri K, Kafatos G, None Walker J, Bennett A. Testing the efficacy of homemade masks: would they protect in an influenza pandemic? Disaster Med Public Reference Health Prep. 2013;7(4):413-8. DOI PubMed GoogleScholar Weblink 7. Euronews. Face masks distributed via 1. World Health Organisation. Shortage of vending machines in Taiwan. Euronews personal protective equipment endangering [internet]. 2020. health workers worldwide. World Health Weblink Organisation [internet]. 2020 Mar 3. 8. Demaitre E. COVID-19 pandemic prompts Weblink more robot usage worldwide. The Robot 2. Centres for Disease Control and Prevention. Report [internet]. 2020 Mar 18; COVID-19. Strategies for optimizing the supply of Weblink facemasks. Centres for Disease Control and 9. Hartman M. Contact-tracing technology: a Prevention[internet]. 2020 Mar 17; Corona key to reopening. John Hopkins Bloomberg Disease 2019 (COVID-19). Weblink School of Public
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