Availability and Crisis Standards of Care for Personal Protective Equipment During Fall 2020 of the COVID-19 Pandemic: A National Study by the APIC COVID-19 Task Force

Rebmann, Terri; Alvino, Rebecca T.; Holdsworth, Jill E.

BACKGROUND: The COVID-19 pandemic resulted in personal protective equipment (PPE) shortages in spring 2020, necessitating crisis protocols. METHODS: An online survey was administered to all Association for Professionals in Infection Control and Epidemiology members in October, 2020 to assess PPE availability and crisis standards utilized in fall, 2020. RESULTS: In total, 1,081 infection preventionists (IP) participated. A quarter lacked sufficient disinfection supplies, N95s, isolation gowns, and gloves; 10 – 20% lacked eye protection and hand hygiene supplies. Significantly more were reusing respirators than masks (65.6% vs 46.8%, respectively; p< .001); a third (32.0%, n=735) were re-using isolation gowns. About half (45.9%, n=496) were decontaminating respirators. Determinants of believing current PPE re-use protocols were safe and evidence-based included the IP being involved in developing COVID-19 protocols (both), having respirator reuse protocols that involve ≤ five reuses (both), using reusable respiratory protection (both), decontaminating respirators (perceived safe), and not reusing masks (perceived safe; p < .05 for all). CONCLUSIONS: Although most healthcare facilities had adequate PPE in fall 2020, PPE supply chains were still disrupted, resulting in the need to reuse or decontaminate PPE. Ongoing gaps in PPE access need to be addressed in order to minimize healthcare associated infections and occupational illness.