SARS-CoV-2, surgeons and surgical masks

The exact risk association of coronavirus disease 2019(COVID-19)for surgeons is not quantified which may be affected by their risk of exposure and individual factors.The objective of this review is to quantify the risk of COVID-19 among surgeons,and explore whether facemask can minimise the risk of COVID-19 among surgeons.A systematised review was carried out by searching MEDLINE to locate items on severe acute respiratory syndrome coronavirus 2 or COVID-19 in relation to health care workers(HCWs)especially those work in surgical specialities including surgical nurses and intensivists.Additionally,systematic reviews that assessed the effectiveness of facemask against viral respiratory infections,including COVID-19,among HCWs were identified.Data from identified articles were abstracted,synthesised and summarised.Fourteen primary studies that provided data on severe acute respiratory syndrome coronavirus 2 infection or experience among surgeons and 11 systematic reviews that provided evidence of the effectiveness of facemask(and other personal protective equipment)were summarised.Although the risk of COVID-19 could not be quantified precisely among surgeons,about 14%of HCWs including surgeons had COVID-19,there could be variations depending on settings.Facemask was found to be somewhat protective against COVID-19,but the HCWs’compliance was highly variable ranging from zero to 100%.Echoing surgical societies’guidelines we continue to recommend facemask use among surgeons to prevent COVID-19.

Efficacy of SARS-CoV-2 detection from used surgical masks compared with standard detection method

The real‐time reverse transcription‐polymerase chain reaction(RT‐PCR)test is the gold standard for severe acute respiratory syndrome coronavirus 2(SARS‐CoV‐2)detection.Proper specimen collection and obtaining a sufficient specimen are the most essential steps for laboratory diagnosis.The nasopharyngeal(NP)swab is recommended as the reference collection method.However,NP swab collection is invasive and uncomfortable for patients and poses some risk to healthcare workers.This study aimed to compare the efficacy of SARS‐CoV‐2 RNA detection from surgical masks with the NP swab method using RT‐PCR testing.Of 269 patients,RT‐PCR RNA from NP swabs was detected among 82 patients(30.5%)and was undetected among 187 patients(69.5%).All patients were tested for SARS‐CoV‐2 RNA from surgical masks.SARS‐CoV‐2 RNA was detected in 25/82(30.5%)surgical mask filters,while undetected among 57(69.5%).For the surgical mask with an average use time of 7.05 h,the sensitivity was 30.5%,the specificity was 100.0%,with positive predictive value of 100.0%and negative predictive value of 76.2%.Therefore,surgical masks could be an alternative non‐invasive specimen source for SARS‐CoV‐2 RT‐PCR testing.The results of our study suggest that the test could be employed after wearing surgical masks for at least 8‐12 h,with increased sensitivity when used for more than 12 h.

The Infection Control Measures Taken in MRI Examination During the COVID-19 Pandemic Prevention and Control Period

Objective:To optimize the magnetic resonance imaging(MRI)detection process in view of the COVID-19 pandemic,standardize and strengthen the infection control and management MRI rooms.Methods:According to the Technical Guide for COVID-19 Prevention and Control in Medical Institutions(3rd Edition),with reference to the current COVID-19 infection control plan,there are three aspects involved in the planning of MRI examination:MRI room management,medical staff management and protection,and patient management,especially the use of full plastic nose strip medical masks.Infection prevention measures are formulated,scientific prevention and control are made,and accurate policies are implemented.Results:MRI examination was carried out according to the infection control and management of MRI room plan during the epidemic,so as to ensure the safety of examination,the safety of patients and the safety of medical staff and no cross infection in hospital.Conclusion:The implementation of proper infection prevention measures during MRI examination in light of COVID-19 ensures that patients wear medical surgical masks with full plastic nose strips throughout the process to avoid cross-infection,ensure the safety of doctors and patients,and maintain the health of the population.

To mask or not to mask:Modeling the potential for face mask use by the general public to curtail the COVID-19 pandemic

Face mask use by the general public for limiting the spread of the COVID-19 pandemic is controversial,though increasingly recommended,and the potential of this intervention is not well understood.We develop a compartmental model for assessing the communitywide impact of mask use by the general,asymptomatic public,a portion of which may be asymptomatically infectious.Model simulations,using data relevant to COVID-19 dynamics in the US states of New York and Washington,suggest that broad adoption of even relatively ineffective face masks may meaningfully reduce community transmission of COVID-19 and decrease peak hospitalizations and deaths.Moreover,mask use decreases the effective transmission rate in nearly linear proportion to the product of mask effectiveness(as a fraction of potentially infectious contacts blocked)and coverage rate(as a fraction of the general population),while the impact on epidemiologic outcomes(death,hospitalizations)is highly nonlinear,indicating masks could synergize with other nonpharmaceutical measures.Notably,masks are found to be useful with respect to both preventing illness in healthy persons and preventing asymptomatic transmission.Hypothetical mask adoption scenarios,for Washington and New York state,suggest that immediate near universal(80%)adoption of moderately(50%)effective masks could prevent on the order of 17e45%of projected deaths over two months in New York,while decreasing the peak daily death rate by 34e58%,absent other changes in epidemic dynamics.Even very weak masks(20%effective)can still be useful if the underlying transmission rate is relatively low or decreasing:InWashington,where baseline transmission is much less intense,80%adoption of such masks could reduce mortality by 24e65%(and peak deaths 15e69%),compared to 2e9%mortality reduction in New York(peak death reduction 9e18%).Our results suggest use of face masks by the general public is potentially of high value in curtailing community transmission and the burden of the pandemic.The community-wide benefits are likely to be greatest when face masks are used in conjunction with other non-pharmaceutical practices(such as social-distancing),and when adoption is nearly universal(nation-wide)and compliance is high.