Mandeep Singh
Dr. Mandeep Singh, anesthesiologist, UHN, and Lead Investigator of the study that confirmed PPE is protective against respiratory viruses such as COVID-19. (Photo: UHN)

A study which reviewed the data of nearly 200,000 healthcare workers confirmed that personal protective equipment (PPE) is protective against infection during waves of respiratory virus pandemics, such as we've seen with COVID-19, SARS, MERS, H5N1, and H1N1.

For those people who are still afraid that masks, gowns, and gloves are not enough, a systematic review and meta-analysis of 54 studies found that the safety measures taken at Canadian hospitals such as UHN are indeed protective.

"Where we need the most protection, we have it, and it's working," says Dr. Mandeep Singh, anesthesiologist, UHN, and Lead Investigator of the study. "At the start of the COVID-19 pandemic, anesthesiologists found themselves at the frontline and potentially the highest risk due to their expertise in airway management, and aerosol generating procedures (AGMP).

"We were fortunate to bring together a team of specialists to review what had been done in the past, to inform our actions."

One year into the COVID-19 pandemic, much is still unknown about the virus that has caused a worldwide lockdown. However, we do know it is highly contagious and particularly deadly to the elderly and those with underlying health conditions, and, at the beginning, we saw how the virus infected healthcare workers who got sick and died in places such as China, Italy, and New York State.

As the virus spread, Canadians were lucky to have had a few weeks to prepare themselves for what was to come.     

"We were aware of the example of what people were experiencing elsewhere," says Dr. Alon Vaisman, infectious disease specialist, Infection Prevention and Control (IPAC), UHN, and one of the authors of the study.

"We had a bit of a window before it hit us." 

The multi-disciplinary team consisted of anesthesiologists, IPAC specialists, and research methodologists from UHN, who know better than most that PPE was, and continues to be, at the heart of the fear stalking healthcare workers in this pandemic. So, they did what scientists do, they asked questions, looked at the data, and examined the quality of the 54 published studies in question and were satisfied to report that where PPE is used properly, it works.

The study looked at risk factors for healthcare workers, such as where are they working, what kinds of patients are they seeing, frontline versus second line positions, and asked who is most at risk and what can be done to protect them? No one was surprised to discover that those performing aerosol generating medical procedures (AGMP) and frontline workers were at higher risk. Fortunately, the data also confirmed that the use of N95 respirators were protective in these areas.

The multi-disciplinary team that undertook the study wanted to provide answers to their colleagues, patients, and families. With so little concrete information at the beginning of the crisis, it was anticipated that healthcare workers were afraid of the unknown.

"Understandably, there was an initial wave of concern leading to the perception that we could be better protected," says Dr. Vaisman. "This study shows we are in fact properly protected, and I hope this brings some comfort to all our healthcare workers."


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