Innovations in COVID Series – Personal Protective Equipment

by | Apr 24, 2020

Author: Jennifer Gilbertson – Norwegian Red Cross
Illustrations: DesignIt

Because of the ongoing COVID-19 crisis all over the world is facing a lack of PPE, especially face masks and face shields. I had little idea and thought some why we can’t make face shield? I went shopping for some items and made face shields. Just checked. Really. It is very good. It protects my full face. Now I am using this for face contact and aerosol procedures with my nursing staff.

Volunteer Story from Qatar Red Crescent Society Prepare face shield by myself (PPE)


From volunteers working in their communities to clinicians caring for patients, one of the first global needs that arose during the COVID-19 pandemic was a shortage of personal protective equipment (PPE).

This need is not new, and as the RCRC we have seen our staff diligently working at all different levels to address supply shortages in our programming.

We would like to highlight four different challenges linked to the global PPE shortage, and different opportunities and innovations popping up to address these needs.

Local Fabrication of PPE

The Challenge:

While international bodies are working together to coordinate the resupply of essential PPE to National Societies, there is a shortage in local markets of supplies. Black markets are taking advantage of this opportunity and charging exorbitant prices for small quantities of equipment.

The Response:

While locally manufactured masks are not a replacement of critical PPE used by health workers, where facemasks are not available some countries are recommending the use of homemade masks. It is important to note that in a healthcare worker context, cloth face masks may be more dangerous than no face masks. Several National Societies are mobilizing their volunteers and their networks in the production of essential PPE, including face shields and masks.

One example of this is the Malaysian Red Crescent Society (MRCS), who has been organizing local mask production by their volunteers. These masks are distributed to vulnerable communities, such as the homeless, migrant workers, refugees, and the elderly, along with other essential hygiene commodities. MRCS is also using volunteers to produce face shields to support front-line health workers while they are waiting for a resupply of commercial medical face shields. In the span of 6 days, volunteers were able to produce around 30,000 face shields.

In Malaysia they’ve also scaled up production by working with prisons to engage prisoners in the production of equipment and collaborating with universities to use their engineering labs for PPE production. The National Society’s #responsMalaysia campaign has gained a lot of attention in the country, and they’ve received hundreds of thousands of donated PPE from local companies and organizations.

Similar stories of mobilization and coordination to meet local needs are popping up all over the globe, from Thailand where the Thai Red Cross Society has organized volunteers from 76 provinces to produce face masks, to Kazakhstan where nine regional branches have produced and distributed 2600 masks. National Societies, such as the Latvian Red Cross, are also working hand-in-hand with governments to negotiate and encourage local companies to produce masks and gowns, which can help boost local economies.

The importance of local manufacturing is that individuals and companies cannot develop PPE at a large scale and cannot always channel goods to the beneficiaries. Local champions in National societies can be the channel to meet local needs.

For branches and National Societies looking to respond to their local shortages, we have collected several resources for you:

 

Simple Mask DIY Guides:
    1. IFRC Minimum Standards & Cloth Mask Guidance
    2. IFRC Instructions for Production
    3. org Facemask Pattern
    4. Smart Air Guide on choosing materials for masks

Other PPE Equipment:

    1. Open Source COVID19 Medical Supplies Facebook Group
    2. ProjectN95 – Vetting products and sources of PPE
    3. Prusa Face Shield – 3D printed face shield developed with Czech MoH
    4. Helpful Engineering – Volunteer run incubator which designed the Origami Face Shield which can be downloaded for local production.
    5. VOC COV OCOV Mask – Durable mask produced in a French academia and industry collective.

Proper use of PPE

The Challenge:

Misuse of PPE can be harmful to the wearer and to those receiving treatment. Improper donning, use, and doffing of gear can result in the spread of COVID-19. In addition, use of the incorrect gear can contribute to unnecessary shortages and give the false impression of protection. We’ve heard didactic reports of vulnerable people using coffee filters as masks.

Health facilities are responsible for training workers on proper techniques for using PPE, but what do we do for our health delegates and volunteers working on the front lines in their communities?

The Response:

Online trainings have been created to train on proper infection prevention and control during COVID-19. One example of this is “Coronavirus: Basic knowledge and prevention measures for responders” online course on the Learning Platform.

The Spanish Red Cross, who created the course, attempts to offer basic information on COVID-19 for volunteers and employees of Red Cross and Red Crescent Societies to know how to take appropriate measures to prevent the spread of COVID-19 and to apply prevention measures in response.

The course, available in English, French and Spanish, includes proper selection and use of PPE, and includes a 5-minute YouTube video for putting on and removal of PPE.

 

 

 

Companies are also producing virtual courses for training those working on the front lines. In Laerdal Medical’s COVID resource page, the company published an open electronic course on PPE technique and launched several peer-to-peer training scenarios on PPE.

IFRC has also published guidance on the use of PPE depending on the activity. This guidance builds upon WHO recommended and includes ambulances, burial workers, quarantine workers, community-based surveillance, and more.

Treatment of PPE

The Challenge:

While most PPE is designed to be single use, during supply chain shortages some health workers and volunteers are reusing PPE. This increasing risk of infection transmission between patients and to the wearer themselves.

The Opportunity:

The CDC has shared that decontamination through heating may allow some PPE to come back into use. Innovation teams have been building solutions to allow reprocessing of PPE through heat treatment.

 


A recent hackathon hosted by the Johns Hopkins Center for Bioengineering Innovation and Design awarded a top prize to a team who proposed developing a convective heat treatment for decontaminating N95.


 

A recent hackathon hosted by the Johns Hopkins Center for Bioengineering Innovation and Design awarded a top prize to a team who proposed developing a convective heat treatment for decontaminating N95.

Other innovators from Michigan Tech University have built mobile thermal units out of a shipping container. During the West Africa Ebola crisis of 2014, one of the innovations which was developed and commercialized was Kinnos.

Winner of the USAID Fighting Ebola Grand Challenge, Kinnos’ Highlight products colorize disinfectants to make surface disinfection visible. We have seen National Societies, such as the Ethiopian Red Cross and Kenyan Red Cross Societies, work with their government to provide public disinfection services.

Jennifer Gilbertson
Norwegian Red Cross
April 24, 2020

Stories supporting the COVID-19 response across the network

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