FFP3, FFP2, N95, surgical masks and respirators: what should we be wearing for ophthalmic surgery in the COVID-19 pandem
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EDITORIAL
FFP3, FFP2, N95, surgical masks and respirators: what should we be wearing for ophthalmic surgery in the COVID-19 pandemic? Kenneth K. W. Li 1,2 & Antonia M. Joussen 3 & Joseph K. C. Kwan 4 & David H. W. Steel 5,6 Received: 8 May 2020 / Revised: 8 May 2020 / Accepted: 12 May 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
This is a fearful time and wearing appropriate personal protective equipment (PPE) has become a topic we all need to be experts in. It has become particularly relevant with the worldwide shortages that have become daily headlines. Elective surgery has been delayed until the current crisis has settled and in most affected countries ophthalmic surgeons are now performing only emergency or urgent surgery. Vitreoretinal surgery in particular, however, still carries on due to the numerous conditions we treat which are time critical. Recently, it has been recommended by the Royal College of Ophthalmologists (RCOphth) and the British and Eire Association of Vitreoretinal Surgeons (BEAVRS) that we use filtering face-piece (FFP)3 masks during vitrectomy surgery in all patients, in addition to eye protection related to the potential for aerosol production [1]. This has been backed by the American Society of Retinal Specialists (ASRS) [2]. Whilst much is still unknown regarding transmission of the SARS-CoV-2 coronavirus, it is interesting to review some of the factors behind this recommendation. This article is part of the topical collection Perspectives on COVID-19. * Joseph K. C. Kwan [email protected] * David H. W. Steel [email protected] 1
Department of Ophthalmology, United Christian Hospital, Hospital Authority, Kwun Tong, Hong Kong SAR
2
Department of Ophthalmology, Tseung Kwan O Hospital, Hospital Authority, Tseung Kwan O, Hong Kong SAR
3
Department of Ophthalmology, Charité University Medicine Berlin, Berlin, Germany
4
Division of Environmental and Sustainability, Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong SAR
5
Sunderland Eye Infirmary, Sunderland, UK
6
Bioscience Institute, Newcastle University, Newcastle, UK
Standard disposable surgical face masks have been the rule in most of our theatres for years [3]. Their function has thought to be two-way but primarily to prevent the passage of germs from the surgeon’s nose and mouth into the patient’s wound. The evidence in terms of reducing infection rates is surprisingly unclear; however, with COVID-19, we are perhaps more concerned with transmission to the surgeon [4]. Current data suggest person-to-person transmission most commonly happens during close exposure to a person infected with SARS-CoV-2. It is important to remember that recent studies have shown that people with COVID-19 frequently do not report typical symptoms such as fever or respiratory symptoms, and go through a pre-symptomatic phase of several days when they are infectious. Infection is thought to occur primarily via respiratory droplets produced when the infected person speaks, coughs, or sneezes. Droplet
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