Real-world assessment, relevance, and problems in use of personal protective equipment in clinical dermatology practice in a COVID referral tertiary hospital.

BACKGROUND: Doctors and healthcare workers (HCW) are at frontline in control of the pandemic caused by the novel coronavirus infection (COVID-19). The virus is transmitted by contact, droplet, and airborne transmission; hence, hand hygiene, social distancing, environmental disinfection, and use of appropriate personal protective equipment (PPE) form important components to protect HCWs from cross-infection. Appropriate use of PPE is of paramount importance not only to reduce the risk of transmission but also to maintain adequate stock for those who are dealing directly with COVID-19 patients. AIMS: In this article, we aim to provide the rationale for appropriate use of PPE in the dermatology setting in the current scenario. We have also discussed the scientific evidence for use of each component of protection and the practical problems faced in our COVID referral tertiary hospital. METHODS: Our review was based on articles that have studied or analyzed the efficacy of various protective measures being utilized by health workers against spread of COVID-19. This was done by carrying out a PUBMED search with terms "coronavirus, COVID-19, personal protective equipment (PPE), transmission, mask, face shields, goggles, gloves." We also scrutinized the various pragmatic issues being faced by doctors in our setup while using PPE. RESULTS: In order to maximize the appropriate use of PPE, the rationale for use needs to be understood and problems encountered in daily practice need to be addressed. CONCLUSION: Adherence to protective measures and use of PPE is of utmost importance for HCWs to prevent cross-infection in this pandemic. The use of PPE can limit transmission to a great extent, but appropriate use and avoiding misuse is equally important in the dermatology setting in order to avoid depletion of stock. It is also essential to consider various practical issues with use of PPE and device measures to avoid them so that breach in protocols can be prevented and spread of infection minimized.