Review of Coveralls, Gowns, and their Use as Part of Personal Protective Equipment (PPE KIT) for Effective Protection of Healthcare Workers in India in COVID-19

Abstract

Healthcare Workers (HCWs) and public health professionals are playing a pivotal role in containing COVID-19. Personal Protective Equipment (PPEs) are a critical component in the hierarchy of primary infection controls to ‘break the chain of infection’ to protect patients, HCW’s, and public. As SARS-CoV-2 is highly contagious, and vaccine and prophylactics not yet available, understanding correct PPE usage is imperative. This study aims to: understand purpose, use, and quality standards of body-coveralls and gowns and how to use PPE’s for effective protection in COVID 19 in India. Types of PPE’s in healthcare, their purposes, materials used, and properties were reviewed. Gowns and Body-coveralls classification and standards in Europe, USA and India were studied.  While current stipulated test standards for coveralls in India are lower, as routine use of reusable gowns made of woven fabrics is more common in India, one could hypothesize that these coveralls provide a higher level of protection. As per current understanding of mode(s) of transmission of SARS-CoV-2 a properly fitted N95 respirator; goggles and splash resistant face shield; gloves; and single-use full body-coverall/gown preferably resistant to Synthetic Blood Penetration under pressure and made of non-woven Laminated SMS (Spunbond-Meltblown-Spunbond)_or Non Laminated SSMMS fabrics are advisable depending upon anticipated level of exposure. HCW’s should educated about transmission risks, correct principles of infection control, functional purpose of PPE’s and must be conscious that PPE’s alone will not protect them.  They must follow good practices of how to wear (don) and how to remove (doff) and ensure that they do not inadvertently contaminate their clothing/skin and self-inoculate.