COVID-19 pandemic and personal protective equipment shortage: protective efficacy comparing masks and scientific methods for respirator reuse

Background and Aims The abrupt outbreak of COVID-19 and its rapid spread over many health care systems in the world led to personal protective equipment (PPE) shortening, which cannot be faced only by the reduction in their consumption nor by the expensive and time-requiring implementation of their production. It is thus necessary to promote PPE rational use, highlighting possible differences in terms of efficacy among them and promoting an effective technique to reuse them. Methods A literature search was performed on PubMed, Scopus, Cochrane database, and Google Scholar and from 25 top cited papers, 15 were selected for relevance and impact. Results Most studies on prior respiratory virus epidemic to date suggest surgical masks not to be inferior compared with N95 respirators in terms of protective efficacy among health care workers. The use of N95 respirators should be then limited in favor of high-risk situations. Concerning respirators reuse, highly energetic short-wave ultraviolet germicidal irradiation (UVGI) at 254 nm was proficiently applied to determine N95 respirators decontamination from viral respiratory agents, but it requires careful consideration of the type of respirator and of the biological target. Conclusions Rational use and successful reuse of respirators can help facing PPE shortening during a pandemic. Further evidences testing UVGI and other decontamination techniques are an unmet need. The definitive answer to pandemic issues can be found in artificial intelligence and deep learning: these groundbreaking modalities could help in identifying high-risk patients and in suggesting appropriate types and use of PPE.