BACKGROUND
The coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is now a pandemic with devastating implications for populations, healthcare systems, and economies globally. Many healthcare workers (HCWs), including those in primary and community care settings, may be at increased risk of COVID-19 infection.1 COVID-19 is known to have three modes of transmission: contact (direct or via a fomite, that is, a contaminated surface or object), droplets (from the respiratory tract of an infected individual during coughing or sneezing transmitted onto a mucosal surface or conjunctiva of a susceptible individual), and aerosols (microbes within droplets that remain suspended in air for long periods).2,3 Personal protective equipment (PPE) reduces the transference of droplets or other body fluids onto HCWs’ skin and clothing or directly onto the mucous membranes of the eye or nasopharynx. PPE can also include respiratory protective equipment to protect against aerosol inhalation. Concerns have, however, been raised about PPE provision for preventing COVID-19 in primary and community care staff.4 This is a particularly pressing concern given the anxiety and stress of working in conditions that may pose a threat to health and which can negatively impact the productivity and care provided by HCWs.5 In this article we present findings from rapid reviews conducted regarding PPE for frontline primary care and community care staff, and what circumstances may potentially put HCWs at risk of contagion.
CURRENT GUIDANCE
Most guidance on PPE appears skewed to secondary care settings (emergency department or inpatient) and focuses mainly on ‘high-risk’ scenarios, for which full aerosol, droplet, and contact PPE (that is, disposable gloves, gown, eye protection, and respirator masks) are recommended. The highest number of contacts in many healthcare settings, however, will be within primary and community environments, including not just general practices but …
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