Prevention of COVID-19 Infection with Personal Protective Equipment
Noriko Shimasaki*, and Hideaki Morikawa**
*Influenza Virus Research Center, National Institute of Infectious Diseases (NIID)
4-7-1 Gakuen, Musashimurayama, Tokyo 208-0011, Japan
**Faculty of Textile Science and Technology, Shinshu University, Nagano, Japan
A new infectious disease caused by a novel coronavirus (COVID-19) has spread rapidly worldwide in 2020. The COVID-19 pandemic in Japan can be viewed as an urban disaster because transmission of this respiratory disease tends to occur in densely populated areas. A scientific understanding of the pathogen itself, the cause of the disaster (infectious disease), as well as infection control measures, are important to implement robust and appropriate countermeasures. This review discribes the features, especially the modes of transmission, of COVID-19 and the principles by which infection control is possible using one of the most effective infection control measures – personal protective equipment (PPE). Because COVID-19 is often transmitted to others by asymptomatic individuals through droplets, even those who are unaware of their infection should wear masks to prevent the spread of droplets that may contain the virus and effectively control the spread of disease. However, given the worldwide competition for masks and the urgent requirement of effective controls, it is necessary to conduct further research to establish a system that can supply adequate numbers of masks to regions where many people are infected in the country, with no shortage of masks, in order to make the country more resilient to disasters caused by infectious diseases in the future.
-  N. Zhu et al., “A Novel Coronavirus from Patients with Pneumonia in China, 2019,” N. Engl. J. Med., Vol.382, No.8, pp. 727-733, doi: 10.1056/NEJMoa2001017, 2020.
-  Q. Li et al., “Early Transmission Dynamics in Wuhan, China, of Novel Coronavirus-Infected Pneumonia,” N. Engl. J. Med., Vol.382, No.13, pp. 1199-1207, doi: 10.1056/NEJMoa2001316, 2020.
-  “WHO Director-General’s opening remarks at the media briefing on COVID-19 – 11 March 2020,” https://www.who.int/dg/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19-11-march-2020 [accessed March 15, 2020]
-  WHO, “Coronavirus disease (COVID-19) situation reports as of 04 October 2020,” October 5, 2020, https://www.who.int/docs/default-source/coronaviruse/situation-reports/20201005-weekly-epi-update-8.pdf [accessed October 5, 2020]
-  S. Shinoda, “COVID-19 and other pandemics as urban disasters,” J. Antibact. Antifung. Agent., Vol.48, No.9, pp. 449-457, 2020 (in Japanese).
-  Toyokeizai online, “Coronavirus Disease (COVID-19) Situation Report in Japan,” https://toyokeizai.net/sp/visual/tko/covid19/en.html [accessed October 26, 2020]
-  Statistics Bureau of Japan, https://www.stat.go.jp/data/nihon/02.html (in Japanese) [accessed October 26, 2020]
-  Geospatial Information Authority of Japan, https://www.gsi.go.jp/KOKUJYOHO/MENCHO/backnumber/GSI-menseki20200701.pdf (in Japanese) [accessed October 26, 2020]
-  A. Yuko and E. Maiko, “Japan declares coronavirus state of emergency,” Japan NHK WORLD-JAPAN News, April 7, 2020, https://www3.nhk.or.jp/nhkworld/en/news/backstories/1014/ [accessed October 5, 2020]
-  Ministry of Health, Labor and Welfare of Japan, “Prevention for COVID-19,” https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000121431_00094.html#yobou (in Japanese) [accessed October 26, 2020]
-  Centers for Disease Control and Prevention, “Standard Precautions,” https://www.cdc.gov/oralhealth/infectioncontrol/summary-infection-prevention-practices/standard-precautions.html [accessed August 30, 2020]
-  D. A. Solomon, A. C. Sherman, and S. Kanjilal, “Influenza in the COVID-19 Era,” JAMA, Vol.324, No.13, doi: 10.1001/jama.2020.14661, 2020.
-  X. He et al., “Temporal dynamics in viral shedding and transmissibility of COVID-19,” Nat. Med., Vol.26, No.5, pp. 672-675, 2020.
-  W. Sungnak et al., “SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes,” Nat. Med., Vol.26, pp. 681-687, 2020.
-  M. Hoffmann et al., “SARS-CoV-2 cell entry depends on ACE2 and TMPRESS2 and is blocked by a clinically proven protease inhibitor,” Cell, Vol.181, pp. 271-280, 2020.
-  Ministry of Health, Labor and Welfare of Japan, “New Coronavirus Infection (COVID-19) Treatment Guide,” 2nd Edition, May 18, 2020, https://www.mhlw.go.jp/content/000631552.pdf (in Japanese) [accessed June 30, 2020]
-  D. Brahim Belhaouari et al., “The Strengths of Scanning Electron Microscopy in Deciphering SARS-CoV-2 Infectious Cycle,” Front Microbiol., Vol.11, doi: 10.3389/fmicb.2020.02014, 2020.
-  K. Shinya, M. Ebina, S. Yamada, M. Ono, N. Kasai, and Y. Kawaoka, “Avian flu: influenza virus receptors in the human airway,” Nature, Vol.440, pp. 435-436, 2006.
-  ”Orthomyxoviruses,” D. M. Knipe and P. M. Howley (Eds.), “Fields Virology,” 5th edition, pp. 1692-1740, Lippincott Williams & Wilkins, 2007.
-  Centers for Disease Control and Prevention, “Key Facts About Influenza (Flu),” https://www.cdc.gov/flu/about/keyfacts.htm [accessed on September 10, 2020]
-  G. R. Johnson et al., “Modality of human expired aerosol size distributions,” J. of Aerosol Science, Vol.42, Vol.12, pp. 839-851, 2011.
-  H. Qian and X. Zheng, “Ventilation control for airborne transmission of human exhaled bio-aerosols in buildings,” J. Thorac. Dis., Vol.10, Suppl.19, pp. S2295-S2304, 2018.
-  M. Nicas et al., “Toward understanding the risk of secondary airborne infection: emission of respirable pathogens,” J. of Occupational and Environmental Hygiene, Vol.2, No.3, pp. 143-154, 2005.
-  W. C. Hinds, “Aerosol Technology,” Second Edition, John Wiley & Sons Inc., pp. 15-74,459, 1999.
-  Ministry of Foreign Affairs of Japan, “Overseas Safety Web Site Infectious Disease (SARS, Avian Flu, etc.),” https://www.anzen.mofa.go.jp/sars/k_1_3.html (in Japanese) [accessed December 25, 2019]
-  E. Hatagishi et al., “Establishment and clinical applications of a portable system for capturing influenza viruses released through coughing,” PLoS One, Vol.9, doi: 10.1371/journal.pone.0103560, 2014.
-  S. Murakami, S. Kato, and J. Zeng, “Combined simulation of airflow, radiation and moisture transport for heat release from a human body,” Building and Environment, Vol.35, No.6, pp. 489-500, 2000.
-  Ministry of Health, Labour and Welfare, “Influenza Q&A,” https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou01/qa.html (in Japanese) [accessed December 2, 2019]
-  Ministry of Health, Labour and Welfare, “2019 winter influenza season’s comprehensive measures,” https://www.mhlw.go.jp/bunya/kenkou/influenza/index.html (in Japanese) [accessed December 2, 2019]
-  A. Davies, K. A. Thompson, K. Giri, G. Kafatos, J. Walker, and A. Bennett, “Testing the efficacy of homemade masks: would they protect in an influenza pandemic?,” Disaster Med Public Health Prep., Vol.7, No.4, pp. 413-418, 2013.
-  A. Rodriguez-Palacios, F. Cominelli, A. R. Basson, T. T. Pizarro, and S. Ilic, “Textile Masks and Surface Covers – A Spray Simulation Method and a “Universal Droplet Reduction Model” Against Respiratory Pandemics,” Front Med (Lausanne), Vol.7, e260, 2020.
-  J. Yan et al., “Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community,” Proc. Natl. Acad. Sci. USA, Vol.115, No.5, pp. 1081-1086, 2018.
-  D. K. Milton, M. P. Fabian, B. J. Cowling, M. L. Grantham, and J. J. McDevitt, “Influenza virus aerosols in human exhaled breath: particle size, culturability, and effect of surgical masks,” PLoS Pathog., Vol.9, No.3, e1003205, 2013.
-  N. H. L. Leung et al., “Respiratory virus shedding in exhaled breath and efficacy of face masks,” Nat. Med., Vol.26, No.5, pp. 676-680, 2020.
-  X. Wang, E. G. Ferro, G. Zhou, D. Hashimoto, and D. L. Bhatt, “Association Between Universal Masking in a Health Care System and SARS-CoV-2 Positivity Among Health Care Workers,” JAMA, Vol.324, No.7, pp. 703-704, 2020.
-  WHO, “Advice on the use of masks in the context of COVID-19,” June 5, 2020, https://www.who.int/publications/i/item/advice-on-the-use-of-masks-in-the-community-during-home-care-and-in-healthcare-settings-in-the-context-of-the-novel-coronavirus-(2019-ncov)-outbreak [accessed June 7, 2020]
-  Ministry of Health, Labour and Welfare of Japan, “Expert Committee on Countermeasures to Combat Infectious Diseases of the Novel Coronavirus “Position on Countermeasures to Combat Infectious Diseases of the Novel Coronavirus”,” March 9, 2020, https://www.mhlw.go.jp/content/10900000/000606000.pdf (in Japanese) [accessed March 26, 2020]
-  Ministry of Health, Labour and Welfare of Japan and Office of Infectious Disease Crisis Management, Japan Medical Association, “Guide to Preventing Influenza Institutional Infection,” https://www.mhlw.go.jp/bunya/kenkou/kekkaku-kansenshou01/dl/tebiki25.pdf (in Japanese) [accessed on Dec 2, 2019]
-  Y. Qian, K. Willeke, S. A. Grinshpun, J. Donnelly, and C. C. Coffey, “Performance of N95 respirators: filtration efficiency for airborne microbial and inert particles,” Am. Ind. Hyg. Assoc. J., Vol.59, No.2, pp. 128-132, 1998.
-  K. Willeke and Y. Qian, “Tuberculosis control through respirator wear: performance of National Institute for Occupational Safety and Health-regulated respirators,” Am. J. Infect. Control., Vol.26, No.2, pp. 139-142, 1998.
-  E. Okazaki, Y. Moriyama, and H. Kobayashi, “Effect of Surgical Mask to Prevent Influenza Transmission,” J. of Healthcare-Associated Infection, Vol.10, pp. 9-17, 2017 (in Japanese).
-  C. R. MacIntyre et al., “The efficacy of medical masks and respirators against respiratory infection in healthcare workers,” Influenza and Other Respiratory Viruses, Vol.11, No.6, pp. 511-517, 2017.
-  M. Loeb et al., “Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial,” JAMA, Vol.302, No.17, pp. 1865-1871, 2009.
-  L. J. Radonovich Jr. et al., “N95 Respirators vs Medical Masks for Preventing Influenza Among Health Care Personnel: A Randomized Clinical Trial,” JAMA, Vol.322, No.9, pp. 824-833, 2019.
-  N. Shimasaki, A. Okaue, R. Kikuno, and K. Shinohara, “Comparison of the filter efficiency of medical nonwoven fabrics against three different microbe aerosols,” Biocontrol. Sci., Vol.23, pp. 61-69, 2018.
-  N. Shimasaki, Y. Nojima, A. Okaue, H. Takahashi, T. Kageyama, I. Hamamoto, and K. Shinohara, “A novel method of safely measuring influenza virus aerosol using antigen-capture enzyme-linked immunosorbent assay for the performance evaluation of protective clothing materials,” Biocontrol. Sci., Vol.21, pp. 81-89, 2016.
-  T. Nishida, N. Suzuki, Y. Ono, J. Shimizu, D. Nakamatsu, K. Matsumoto, and M. Yamamoto, “How to make an alternative plastic gown during the personal protective equipment shortage due to the COVID-19 pandemic,” Endoscopy, Vol.52, No.10, pp. E388-E389, doi: 10.1055/a-1197-5949, 2020.
-  A. W. H. Chin, J. T. S. Chu, M. R. A. Perera, K. P. Y. Hui, H. L. Yen, M. C. W. Chan, M. Peiris, L. L. M. Poon, “Stability of SARS-CoV-2 in different environmental conditions,” Lancet Microbe., Vol.1, No.1, e10, 2020.
-  N. Shimasaki, K. Shinohara, and H. Morikawa, “Performance of materials used for biological personal protective equipment against blood splash penetration,” Ind. Health., Vol.55, No.6, pp. 521-528, doi: 10.2486/indhealth.2017-0120, 2017.
This article is published under a Creative Commons Attribution-NoDerivatives 4.0 International License.