PPE for SARS-Cov-2 and the utility of single-use aprons

Since the initial outbreak of SARS-Cov-2 in late 2019, there have been many infection prevention and control (IPC) measures and protocols implemented, citing protection from the virus for clinicians and patients alike. For many frontline workers, often inquisitive as to the rationale behind some of these measures, the evidence-base referenced by in-house officials is often a third-party recommendation, based upon previous similar outbreaks or poorly researched ‘best-practice’. Mistrust in apron use, general fatigue of compliance over time and personal experiences of individual wearers can all affect their usage.

The author carried out a literature review using multiple sources, including medical journals and national guidelines found via database searches, such as Medline, CINAHL and Google Scholar. Keywords used were COVID-19, PPE, Aprons, Aerosols, Transmission and AGP (aerosol-generating procedure). There were a few themes found during this review, such as clothing as a mode of transmission, classification of an AGP, viral load and a need for further up-to-date research in key areas. This brief comment based on the author's review of the literature surrounding SARS-Cov-2 (the virus responsible for COVID-19) focuses on the evidence base for donning single-use plastic aprons as well as other forms of personal protective equipment (PPE) and relevant IPC measures. In examining the benefits and disadvantages of single-use plastic aprons and other COVID-19 PPE by looking into how the virus transmits and infects, as well as the potential efficacy with which aprons impact on the ‘chain of infection’, the author suggests that the wearing of plastic aprons with COVID-19 positive patients may be unjustified, provided the patient is wearing a facemask.