• John B Lynch, Perica Davitkov, Deverick J Anderson, Adarsh Bhimraj, Vincent Chi-Chung Cheng, Judith Guzman-Cottrill, Jasmine Dhindsa, Abhijit Duggal, Mamta K Jain, Grace M Lee, Stephen Y Liang, Allison McGeer, Valery Lavergne, M Hassan Murad, Reem A Mustafa, Rebecca L Morgan, Yngve Falck-Ytter, and Shahnaz Sultan.
• Department of Medicine, Division of Allergy and Infectious Diseases, University of Washington, Seattle, Washington.
• Clin. Infect. Dis. 2020 Jul 27.

BackgroundSARS-CoV-2 is a highly transmissible virus that can infect health care personnel and patients in health care settings. Specific care activities, in particular aerosol-generating procedures, may have a higher risk of transmission. The rapid emergence and global spread of SARS-CoV-2 has created significant challenges in health care facilities, particularly with severe shortages of personal protective equipment (PPE) used to protect health care personnel (HCP). Evidence-based recommendations for what PPE to use in conventional, contingency, and crisis standards of care are needed. Where evidence is lacking, the development of specific research questions can help direct funders and investigators.ObjectiveDevelop evidence-based rapid guidelines intended to support HCP in their decisions about infection prevention when caring for patients with suspected or known COVID-19.MethodsIDSA formed a multidisciplinary guideline panel including front-line clinicians, infectious disease specialists, experts in infection control and guideline methodologists with representation from the disciplines of preventive care, public health, medical microbiology, pediatrics, critical care medicine and gastroenterology. The process followed a rapid recommendation checklist. The panel prioritized questions and outcomes. Then a systematic review of the peer-reviewed and grey literature was conducted. The Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach was used to assess the certainty of evidence and make recommendations.ResultsThe IDSA guideline panel agreed on eight recommendations and provided narrative summaries of other interventions undergoing evaluations.ConclusionsUsing a combination of direct and indirect evidence, the panel was able to provide recommendations for eight specific questions on the use of PPE for HCP providing care for patients with suspected or known COVID-19. Where evidence was lacking, attempts were made to provide potential avenues for investigation. There remain significant gaps in the understanding of the transmission dynamics of SARS-CoV-2 and PPE recommendations may need to be modified in response to new evidence.© The Author(s) 2020. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

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