Gloves and Masks — Who Should Wear Them and Why

Over the past few months, as the coronavirus crisis has unfolded around the globe, one usually uncontentious element of viral protection has become highly controversial. The subject of personal protective equipment (PPE), in particular masks, gloves, gowns, and face shields in healthcare settings, is now hotly debated by health authorities, hospitals, medical professionals, and politicians alike. No one seems able to come to a definitive conclusion on who should wear them and for which reasons.

Today, depending on your particular location, you might be mandated by law to wear masks whenever you leave the house. On the other hand, in certain places, you might be advised not to purchase PPE in order to ensure healthcare facilities do not run short of stock. People are confused, and with good reason.

So, who should wear PPE? And what is the current guidance for Australia? Here, we take a look at the subject of personal protective equipment in healthcare and why there is so much confusion on when and where it should be used.

Who Should Wear Masks?

There are a number of issues surrounding the subject of protective masks, and to make matters more complicated, two of the most recognisable global health bodies, the WHO and the CDC, disagree. The WHO currently states that:

“If you are healthy, you only need to wear a mask if you are taking care of a person with COVID-19.” and that you should “wear a mask if you are coughing or sneezing.”

However, the CDC has recently revised its guidance on mask wearing, now suggesting:

“…wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.”

Among the reasons for the conflicting advice, from both these two bodies and various other outlets, is the types of mask used and their efficacy. The use of N95 respirators is now widely recommended for healthcare workers in high-risk environments, with proper fit testing and fit checking required to ensure a tight seal, as these masks are proven to protect against airborne particles. Fit tests should be performed yearly or when facial features change​.

Additionally, when it comes to more advanced masks such as N95 respirators used in healthcare, not only are fit tests required to ensure a proper seal is formed, but supply/demand issues mean that this type of mask should be reserved for healthcare professionals. The use of PPE such as safety face shields may be seen in supermarkets and other customer-facing environments, such as pharmacies, but again, these should be reserved for frontline and healthcare workers.

Currently, there is no official guidance from the Australian government on wearing masks in public, however, this doesn’t rule out a u-turn in the coming weeks, with many other countries changing their advice as the crisis grows. If you want to err on the side of caution, then you can make a perfectly serviceable mask at home, or purchase one here.

Who Should Wear Gloves?

When it comes to protective gloves, the advice is a little clearer. Gloves do not, and never should, replace comprehensive hand hygiene. In fact, in most cases, washing your hands regularly and thoroughly is preferable to wearing any kind of sanitary glove, since wearing them may lead to people becoming less prudent with hand hygiene.  

In hospitals and healthcare environments, gloves are used for specific purposes and then disposed of immediately. The potential for the misuse of gloves by the general public, is one of the reasons that they are unlikely to be mandatory, and over reliance on this type of PPE can lead to shortages elsewhere. Exceptions include those in food preparation, or for anyone who has any kind of open wound.

Again, there is no advice from the Australian government on glove wearing outside of the healthcare sector, and stockpiling gloves could have a knock-on effect on the healthcare sector’s ability to effectively equip those most at risk.

The bottom line is, unless you are obligated to wear masks and gloves by law or according to health & safety advice, then its probably better not to. However, for more information on whether this advice changes in Australia, stay tuned to the Medshop blog.  

 

Author: Carolyn Cumper's career spans from being a Patrol Officer in Rhodesia to a Paediatric Nurse in the UK, and later a Deputy Hospice Manager in Australia. Her diverse journey includes roles in law enforcement, healthcare, and business, culminating in her significant contributions to Medshop.