New interim recommendations for the use of personal protective equipment when caring for patients with confirmed or suspected COVID-19

As we learn more about the Omicron variant of concern (VOC), Public Health Ontario (PHO) has released a technical brief with new recommendations for the use of personal protective equipment (PPE) when caring for patients with confirmed or suspected COVID-19 in health care settings. These settings include acute care, hospital and pre-hospital care, long-term care, primary care, ambulatory care clinics and community care.

These interim recommendations incorporate currently available evidence and are in response to the recent surge in the number of new reported cases of COVID-19 that are likely driven by the spread of the Omicron VOC, and will be re-evaluated as more information emerges.

Recommendations
In addition to other layers of protection, interim PPE recommendations include a fit-tested, seal-checked N95 respirator (or equivalent), eye protection, gown, and gloves. Other appropriate PPE includes a well-fitted medical mask, or non-fit tested respirator, eye protection, gown and gloves. Fit tested N95 respirators (or equivalent) should be used when aerosol-generating medical procedures are performed on patients with suspect or confirmed COVID 19 infections.

Health Care Workers (HCWs) are at risk of COVID-19 infection from exposures in the workplace as well as in the community. That is why public health measures, particularly vaccination, as well as physical distancing, masking, getting tested, and staying home when sick, are important to prevent COVID-19 transmission both in the community and in health care settings. Enhancing vaccine effectiveness with a third dose will likely offer significant added protection against Omicron and is strongly recommended for all health care workers.

These recommendations are aimed at providing HCWs with increased protection against COVID-19 and protecting the capacity of our health care system, including hospitals and other health care settings.

Omicron Variant
Evidence indicates that the Omicron variant is significantly more transmissible than previous variants of concern, and current COVID-19 vaccines may provide less protection against it. More study is needed to determine if this VOC causes more severe illness.

Directive 5
The Ministry of Health’s Directive 5 remains the prevailing directive for the provision of PPE at this time. PHO does not develop or approve public health policy or directives, including directives issued by the Chief Medical Officer of Health (CMOH) in accordance with the Health Protection and Promotion Act.