CoVID19 and Improper Use of PPEs in Gilgit-Baltistan

By Dr. Maisoor Ahmed Nafees (PhD)

In the wake of COVID-19 and its subsequent implications, almost all human population round the globe became familiar with certain Personal Protective equipment (PPEs), and the most used and known one are gloves and masks. The question is the proper donning and doffing of these small but important lifesaving shields.

The current article is to highlight some important factors regarding proper donning and doffing of PPEs, specially masks and gloves to combat corona menace.

It is true that common man was not acquainted with proper use of PPEs as the subject was purely related to medical and scientific community. The need of abiding bio-safety and bio-security rules by health care professionals is always paramount and become indispensable during the current pandemic.

The negligence in proper donning and doffing along with irrelevant protective material is a precursor behind contracting and disseminating the deadly virus.

Here I will mention some undeniable facts peculiar to improper donning of PPEs by health care personnel which has led to some fatalities and severe complications of novel corona virus in GB alone.

The first COVID related death in GB was of Dr. Usama Riaz, whose footage gone viral while talking to media wearing an N-95 Mask. Although the kind of mask he donned has the capacity to restrict the said virus, but the improper fastening made him more vulnerable (see pic 1). One can vividly notice that only single strip is placed around face, whereas the second and lower one is free, making the mask a very loose grip with face, which is paving way for the pathogen from the suspected corona patients.

A paramedic working in a Quarantine center at Gilgit, who contracted the virus while dealing with corona positive patients and his video became viral on social media complaining of inadequate facilities at the isolation center, has shared a picture on social media wearing a displaced mask which is again not fully attached and airtight as it must be, also the googles and Tyvek suite is improperly fastened. (see pic 2).

A paramedic from Astore Hospital, who was tested positive for COVID -19, can be seen wearing the N-95 Mask, not properly fastened and over the googles creating an ample space for the pathogens.

Most of the technical people and scientific community is even unaware about the difference between face masks and head cover & booties (those wrapped around shoes). I have seen number of such individuals wearing head cover and booties instead of  face masks.

Same carelessness is practiced while donning and doffing of gloves. The improper use is a further source of perpetuation of corona virus.

Recently, during a visit to one of the leading government hospitals of Gilgit, I was shocked to notice an official of the setup with all PPEs mandatory to deal COVID-19 patients, but after doffing disposable gloves, he tried to inflate the gloves keeping them closer to mouth, as he was airing a balloon. The idea was to make it more comfortable to wear next time. This behavior is unacceptable and ends all precautionary measures in fiasco.

In addition to above mentioned sagas, everybody can notice wearing of ordinary fabric masks by security personnel at check posts, which are just dust proof and not to restrict pathogens. Still most of the people use damaged and overly soiled masks and gloves, exposing themselves and others to risk.

Above are some pictorial evidences to show the non-compliance of the proper protocols of donning and doffing of PPEs whether unintentionally or not properly educated with biosafety protocols.

It is pertinent to mention here that the Pakistan Biological Safety Association (PBSA) has arranged numerous workshop and training sessions in collaboration with Biological Sciences department, Karakorum international University, in the preceding years for health care professionals, paramedics, lab managers and lab technologist, officers from Agriculture and livestock department. The main aim of these training sessions were to acquaint the participants about basic rules and protocols of Biosafety and biosecurity, of which proper donning and doffing was a major area of concern with practical demos. The triviality and cumbersome in taking permission from concerned quarters by lab personnel and paramedics to attend the training sessions is a dilemma.

It is recommended to don and doff N-95 masks/surgical mask according to the needs and not for prolong use, re-use, as both of them are disposable. Improper donning and doffing imply some risk of contamination. Proper donning and doffing procedure must be fallowed. In case of gloves the well-known breaking method (developed by Sean Kaufman) must be fallowed.

It is pleaded and wished that proper biosafety and biosecurity trainings be arranged with refresher courses to cope with such pandemics and while scanning suspected individuals and treating patients.

The KIU has already included a course of biosafety, biosecurity and lab techniques for the students graduating in the field of life sciences, making them fully aware with full time lab demos and practical’s.

Here I quote some useful links pertaining to proper use of PPEs.

• Rational use of personal protective equipment (PPE) for corona virus disease (COVID-19)

WHO interim guidance, 19 March, 2020

• org.pk/events/videos-of-webinars-waste – management-and –use-of-masks/

Dr. Dr. Maisoor Ahmed Nafees is an Assistant Professor and Administrator of Water Quality Lab and the Department of Biological Sciences, KIU. He is also a lifetime member of PBSA.