Background Healthcare workers (HCWs) employed personal protective equipment (PPE) during the COVID-19 pandemic, crucial to protecting themselves from infection. To highlight the efficacy of PPE in preventing environmental infection among HCWs, a systematic review was conducted in line with PRISMA guidance. Methods A search of the PubMed and Web of Science databases was conducted from January 2019 to April 2021 using pre-defined search terms. Articles were screened by three researchers. The approved papers were read in full and included in this review if relevance was mutually agreed upon. Data were extracted by study design and types of PPEs. Results 47 of 108 identified studies met the inclusion criteria, with seven reviews and meta-analyses, seven cohort, nine case-control, fifteen cross-sectional studies, four before and after, four case series, and one modeling studies. Wearing PPE offered COVID-19 protection in HCWs but required adequate training. Wearing surgical masks provided improved protection over cloth masks, while the benefit of powered air-purifying respirators is less clear, as are individual gowns, gloves, and/or face shields. Conclusions Wearing PPE, especially facial masks, is necessary among HCWs, while training in proper use of PPE is also important to prevent COVID-19 infection. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00131.

Dear Editor, The recent spread of coronavirus disease (COVID-19) represents an important public health problem worldwide and the potential for transmission by asymptomatic patients represents a major issue [1]. The global COVID-19 pandemic led many governments from different nations to adopt protective and strict measures to reduce its spread. As a consequence, a significant downsizing of non-urgent treatments is occurring in all medical fields including ophthalmology [2]. The final decision on what ocular disease to define as urgency is left to the ophthalmologist’s judgment. Of course, many retinal disorders including retinal detachment (RD), ocular trauma, and vitreous bleeding or neovascular age-related macular degeneration in monocular patients are considered non-deferrable conditions. In order to provide continuity of care, and to reduce the risk of contamination, series of protection measures have been proposed [3–5]. Particularly, Korobelnik et al. recently provided guidance for anti-vascular endothelial growth factor (VEGF) intravitreal injection procedures during the COVID19 pandemic [3]. Personal protective equipment including gloves, masks (e.g., N95), goggles and face shields, and slitlamp breath shields are mandatory [3]. Regarding the operating theater measures, reducing the surgical volume, minimizing staff presence, and reducing the time for each intervention have been also proposed (Fig. 1a) [6]. To achieve a reduction in the length of surgery, The Royal College of Ophthalmology recommended the most experienced surgeons to perform surgical procedures, thus excluding training surgeons (with possible repercussion on their training courses) [7]. We hereby propose a series of additional measures that could help the vitreoretinal (VR) surgeons in performing the surgery and follow the patient with the minimum risk of contamination. First of all, the creation of a deferrable/nondeferrable VR patient list should be considered for a correct management of a Vitreoretina Unit during the COVID-19 pandemic. For all patients undergoing VR surgery, a combined surgery including phacoemulsification should be taken into account in all patients already presenting lens opacities. A deferred phaco surgery in the next weeks/months would in fact expose the patient to further avoidable risks of exposure. The same applies for intravitreal injections of both steroid and antiVEFG at the end of the surgery whenever required. Three-dimensional (3D) heads-up display surgical visualization is an evolving technology demonstrating comparable efficacy to the standard operating microscope for macular surgery [8]. The use of 3D heads-up display systems in the COVID era can help in increasing the distance between surgeon and patient and also in improving ergonomics (Fig. 1b). The choice of the endotamponade preferring air and silicon oil in eligible cases could minimize the number of follow-up visits required. Specifically, air is nowadays considered effective as gas tamponade in macular hole, pucker, and even in some retinal detachment surgeries, with less risks of intraocular pressure elevation in the postoperative course (that may require additional visits) [9, 10]. Moreover, different types of silicon oil allow the surgeon to choose the appropriate endotamponade for every single case, with a higher stabilization of the retina in the postoperative period [11]. This may further reduce the number of conventional follow-up visits for operated patients. In selected cases, scleral buckling for RD could be eligible as a time-saving and fast recovery surgery. Nevertheless, despite the advantages of the ab-externo technique, VR surgeon has to cope with the disadvantages of using an indirect This article is part of a topical collection entitled Perspectives on COVID19.

The global pandemic of coronavirus disease-19, caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), is the latest hazard facing healthcare workers (HCW) including dental care workers (DCW). It is clear that the major mode of SARS-CoV-2 transmission is the airborne route, through inhalation of virus-infested aerosols and droplets. Several respiratory protection equipment (RPE), including masks, face shields/visors, and respirators, are available to obviate facial and conjunctival contamination by microbes. However, as their barrier value against microbial inhalation has not been evaluated, we systematically reviewed the data on the effectiveness and efficacy of facemasks and respirators, including protective eyewear, with particular emphasis on dental healthcare.PubMed, MEDLINE, the Cochrane Library, and Embase databases were searched between 01January 1990 and 15 May 2020.Of 310 identified English language records, 21 were included as per eligibility criteria. In clinical terms, wearing layered, face-fitting masks/respirators and protective-eyewear can limit the spread of infection among HCWs. Specifically, combined interventions such as a face mask and a face shield, better resist bioaerosol inhalation than either alone. The prolonged and over-extended use of surgical masks compromise their effectiveness.In general, RPE is effective as a barrier protection against aerosolized microbes in healthcare settings. But their filtration efficacy is compromised

The speed of the spread of coronavirus disease 2019 (COVID-19) has put enormous pressure on hospitals and other healthcare facilities. This, together with blockages in several countries, has hindered the availability and accessibility of the necessary personal protective equipment (PPE). To identify, systematically evaluate and summarize the available scientific evidence on the efficacy, safety, safe use and reuse of PPE for healthcare professionals, for preventing severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Systematic review of studies analyzing products for disinfecting and enabling reuse of PPE for coronavirus within the evidence-based health program of a federal university in São Paulo (SP), Brazil. A systematic search of the relevant literature was conducted in the PubMed, EMBASE, Cochrane Library, CINAHL, SCOPUS, Web of Science and LILACS databases, for articles published up to November 30, 2020. Ten studies were selected. These analyzed the use of N95, surgical and cotton masks, face shields, flexible enclosures with plastic covers or polycarbonate intubation boxes and plastic curtains; and also PPE disinfection using several substances. Combined use of a face shield with a N95 mask proved to be superior to other associations for protecting healthcare workers. Some products are useful for disinfecting PPE, such as 70% ethanol, 0.1% sodium hypochlorite and a mixture of quaternary ammonium and H2O2, and hydrogen peroxide. Ultraviolet light and dry heat at 70 °C can be used to decontaminate N95 masks. DOI: 10.17605/OSF.IO/4V5FD at the OPENSCIENCE Framework.

Mucocutaneous and transconjunctival exposure are important portals for the transmission of blood-borne infections to surgeons and health-care workers. Despite this knowledge, few surgeons or their assistants wear protective equipment for procedures perceived to be affiliated with less risk. This study investigates the potential risk of mucocutaneous and transconjunctival blood splash injury during common laparoscopic and endourologic procedures undertaken using standard video endoscopy equipment.Masks combined with eye shields were consecutively collected from the surgeon, surgical assistant, and theater nurse after a variety of endourologic procedures over a 4-month period. These were analyzed macroscopically for visible blood droplets. Modern forensic techniques were then instituted to assess for nonvisible blood exposure.Eye shields from 118 procedures performed by five surgeons were collected. Two hundred and thirty-six masks were examined for visible and visually enhanced evidence of blood contamination. In total, 48.5% of surgeons' masks, 29.5% of assisting surgeons' masks, and 31.8% of scrub nurse masks were positive for either visible or visually enhanced blood contamination. In terms of evidence of blood splash, 84.2% of laparoscopic nephrectomies, 66.7% of pyeloplasties, and 58.3% of flexible ureteroscopies tested positive.Splash injuries remain commonplace, even with the use of video endoscopy equipment. Therefore, all health-care workers should be encouraged to we

Abstract Background The use of respiratory devices can mitigate the spread of diseases such as COVID-19 in community settings. We aimed to determine the effectiveness of closed face shields with surgical face masks to prevent SARS-CoV-2 transmission in working adults during the COVID-19 pandemic in Bogotá, Colombia. Methods An open-label non-inferiority randomized controlled trial that randomly assigned participants to one of two groups: the intervention group was instructed to wear closed face shields with surgical face masks, and the active control group was instructed to wear only surgical face masks. The primary outcome was a positive reverse transcription polymerase chain reaction test, IgG/IgM antibody test for SARS-CoV-2 detection, or both during and at the end of the follow-up period of 21 days. The non-inferiority limit was established at − 5%. Results A total of 316 participants were randomized, 160 participants were assigned to the intervention group and 156 to the active control group. In total, 141 (88.1%) participants in the intervention group and 142 (91.0%) in the active control group completed the follow-up. Primary outcome: a positive SARS-CoV-2 test result was identified in one (0.71%) participant in the intervention group and three (2.1%) in the active control group. In the intention-to-treat analysis, the absolute risk difference was − 1.40% (95% CI [− 4.14%, 1.33%]), and in the per-protocol analysis, the risk difference was − 1.40% (95% CI [− 4.20, 1.40]