In a study published in Singapore, extensive environmental contamination with SARS-COV-2 was detected in the healthcare setting, but only 1 sample of 10 taken from PPE was positive (the front of 1 HCW’s shoe). 1 Notably, no AGPs were performed in this study. No contamination was found on N95 masks, goggles, or shoes of exposed HCWs. Previous studies have investigated contamination of PPE with SARS-COV-2. Full face visors were worn by all staff members, which may have blocked contamination of the underlying mask. No contamination of face masks worn by HCWs during care for known COVID-19 patients (whether worn during intubation or for routine patient care on a ward) was detected. SARS-COV-2 was not detected from any samples taken after decontamination using UVGI (Table (Table1 1). SARS-COV-2 was not detected on the masks of HCWs delivering routine care (ie, no AGPs performed) to COVID-19–positive patients (Table (Table1). Both masks tested negative after decontamination with UVGI. Both samples were taken from masks held to the side of a patient during endotracheal intubation (1 positive mask from each patient). Low levels of SARS-CoV-2 were detected from 2 of the 6 samples taken from 2 masks used as positive controls (Table (Table1). A lower CT value is generally associated with a higher viral load. For positive samples, the cycle threshold (CT) value (ie, the number of PCR cycles required before the result flags as positive) was recorded. Samples were analyzed by real-time PCR using an in-house assay. In total, 4 swabs and 2 samples of material were tested for each mask, yielding a total of 48 data points. The masks were decontaminated on the Antigermix AE1 Probe Disinfector using a 40-second cycle of ultraviolet germicidal irradiation (UVGI). A sample was then taken from the front of the mask using a hole punch for uniformity. Masks were sampled before and after decontamination as follows: 1 dry swab was used to swipe the outside surface including the outer filter and 1 dry swab was used to swipe the inside surface. One mask was worn by the clinician carrying out the intubation, and the other was worn by the assisting clinician. One mask was held immediately to the left of the patient at shoulder height, ~40 cm above the patient’s sternal notch with the outer filter pointing toward the patient (positive control). For each intubation, 3 exposed masks were analyzed. The remaining 6 masks were exposed during endotracheal intubation of 2 COVID-19–positive patients. ![]() Two masks were worn by HCWs during routine patient care on a normal shift on a ward of confirmed COVID-19 patients. In this study, we sampled 8 FFP3 masks (Aura, 3M, St Paul, MN) after exposure to COVID-19–positive patients. ![]() Endotracheal intubation is classed as an AGP. PHE recommends an FFP3 mask, eye protection, long-sleeved gown, and gloves for personnel at risk of exposure to AGPs. In hospitals, airborne transmission is possible in specific circumstances during aerosol-generating procedures (AGPs) when respiratory secretions are exposed to high pressure. ![]() Human transmission of SARS-CoV-2 is thought to occur predominately via close contact through droplets produced from the respiratory tract or fomites. Maintaining PPE supplies has become a priority for healthcare systems around the world. In the United Kingdom, healthcare workers (HCWs) are advised to wear PPE in line with Public Health England (PHE) guidance. In response to the COVID-19 global pandemic, countries have implemented strategies to limit the spread of disease. To the Editor-In response to the article published on contamination of personal protective equipment (PPE) by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), 1 we describe a small study investigating contamination and decontamination of filtering face piece 3 (FFP3) masks after exposure to SARS-CoV-2 in a variety of settings, including routine patient care and during endotracheal intubation.
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