What is PPE? Everything You Need to Know About Personal Protective Equipment

While it used to be mostly for healthcare workers, many Americans now keep masks and gloves on hand.

PPE: It's an acronym that became very familiar to us when the COVID-19 pandemic began. An abbreviation for personal protective equipment, it's one crucial way to keep safe during an infectious outbreak. Healthcare workers have always worn masks, protective clothing, eye protection, and gloves for infection control, but now, many of us keep a supply on hand, given the unpredictability of the virus.

PPE works as a barrier between an individual's skin, mouth, nose, or eyes and viral and bacterial infections. To be used in a medical setting, most PPE—medical gloves, gowns, and N95 respirators—is regulated by the Food and Drug Administration (FDA) and must meet its requirements.

"When used properly and with other infection control practices such as hand-washing, using alcohol-based hand sanitizers, and covering coughs and sneezes, (PPE) minimizes the spread of infection from one person to another," according to the FDA.

PPE also varies situationally, per the FDA. For example, the gear needed to treat patients with the flu varies from that used for those infected with Ebola. When treating patients with COVID-19, which is spread primarily by close contact, healthcare workers wear a full battery of protection:

  • Gloves
  • Medical masks
  • Respirators (N95 or FFP2 standard, or equivalent)
  • Eye protection
  • Gowns
  • Aprons
  • Boots or closed-toe work shoes

"Doctors cannot do (physical distancing) when seeing patients," said Lauren Pischel, MD, infectious disease fellow at Yale School of Medicine, explaining why doctors and nurses need PPE (whether there's a pandemic or not). "They need to be close to patients for often prolonged periods of time, whether that is to take a history of what a patient's symptoms are, do a physical exam to look for clues about what is going, or do a procedure."

Certain procedures also necessitate a greater need for PPE, said Dr. Pischel, such as intubation, the process of inserting a tube through a patient's mouth and into their airway, and nebulizer treatments, which deliver medicated mist into the lungs. "These procedures create a large amount of virus in the air, so anyone around would need to wear PPE." But really, Dr. Pischel pointed out that "anyone who is entering into a patient's room with known COVID-19," is in need of the recommended protective gear.

What PPE Is Recommended for Public Use?

As states' mask mandates have come and gone and come again, the CDC has developed guidelines for people to use to help determine if and when a mask is necessary. These take into account the degree of virus circulating in the environment, the number of people you may be around, and the level of risk for you and others with whom you'll be in proximity.

While masks were always the primary recommendation for the public during the pandemic, some people took to wearing gloves as well. However, the only time the CDC recommended wearing gloves for non-healthcare workers was for cleaning and disinfecting your home. Gloves pick up germs just as your bare hands do, so if you're wearing the same gloves while out in public at several locations, you're simply collecting and transporting those germs around. Some stores even started posting signs in their windows warning customers to not wear gloves in their establishments.

Gloves also have to be removed correctly to avoid transferring the germs to your hands. The CDC provides detailed instructions to healthcare workers for removing PPE, including gloves, for good reason. In a 2019 American Journal of Infection Control study examining healthcare workers' glove removal techniques (technically called "doffing"), researchers found that 37% of healthcare personnel contaminated their skin while removing their gloves. But when using the CDC's recommended techniques, contamination decreased significantly.

Instead of covering your hands, keep them extra clean. Regular and thorough washing is always a good idea, no matter what the level of COVID-19 is at any particular time or place.

Can PPE Be Reused or Shared?

PPE is for personal use. With few exceptions, "most PPE is designed to be used only one time and by one person prior to disposal," according to the FDA. Therefore, washing and reusing or sharing equipment with other users is not intended—or recommended.

However, scientists are researching ways to sanitize PPE for reuse. For example, in one 2021 study published online by Cambridge University Press, Yale Medicine doctors found that many N95 masks could be reprocessed using vaporized hydrogen peroxide to sterilize them for reuse. In short, they were able to clean a room full of N95s all at once using a system normally used to fumigate hospital rooms after patients with C. diff infection are discharged. The results were replicated three times.

Before this study, there had been data that showed that N95 respirators could be sanitized without damaging their ability to act as high-efficiency filters, but there had never been evidence that this was effective for viruses on a respirator, said Patrick Kenney, MD, one of the study's authors and medical director of the supply chain for Yale Medicine and Yale New Haven Health. "We inoculated N95s with three different viruses that are a reasonable proxy for SARS-CoV-2 and then reprocessed them. A highly sensitive test showed no evidence of residual virus."

In another 2021 study published in the journal Pathogens, researchers used an ozone-based dry sanitizer device to disinfect items contaminated with SARS-CoV-2, the virus that causes COVID-19. The researchers felt that the specific device they used for the study was "suitable for rapid decontamination of SARS-CoV-2- from worn items, frequently touched items, and PPE including N95 FFRs, face shields, and other personal items."

Is PPE Readily Available?

When the pandemic first began, most would not have predicted that PPE would have gone into short supply. But when panic set in around the world, people started stockpiling gloves, masks, respirators (and hand sanitizer), leaving those on the front lines struggling to find the proper safety gear to wear while treating patients.

Because the supply chain was not prepared for such a dramatic increase in PPE purchasing, supplies at the beginning of the pandemic did, indeed, dwindle. But some United States companies quickly came to the rescue in various ways. From snowboard manufacturers and fashion designers to whisky distillers and auto manufacturers, companies found ways to get more PPE and disinfectants made and distributed.

Now, many types of masks are available for purchase in stores and online.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

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