Between Issues

Lessons from the Covid era: Is it time for PPE upgrades?

December 18, 2023

Felipe Urdaneta, MD, FASA

Nurses Putting on PPE

To the Editor:

The COVID-19 pandemic has undeniably transformed our approach to infection control practices and highlighted the profound impact on the public and healthcare workforce. As we move beyond this unprecedented event, we must reflect on the lessons we have gleaned from the experience. In May 2023, the U.S. government officially ended the Public Health Emergency.1,2 Still, the possibility of future pandemics looms on the horizon, with some experts estimating an approximately 2% chance per year of the next major outbreak (2.5-3.3). Based on this, there is a 47-57% chance of another global pandemic in the next 25 years.3 Hence, we must prioritize preparedness to safeguard ourselves and our communities. Throughout the COVID-19 crisis, we witnessed how vulnerable populations, such as older adults, those with obesity, and the immunosuppressed, suffered disproportionately in terms of morbidity and mortality. The availability and successful implementation of vaccination campaigns played a critical role in shaping the pandemic’s course, affecting incidence, prognosis, hospitalization rates, and overall mortality.4,5

Healthcare workers faced immense risks during the pandemic, as they were constantly on the frontline. Acknowledging the potential risk of a future outbreak primarily affecting the respiratory tract and spreading through droplets and airborne transmission is crucial. Proper preparation to protect healthcare workers is paramount to ensure an effective response.

During the early stages of the Covid-19 crisis, significant attention was given to the availability and supplies of personal protective equipment (PPE), respirators, and ICU beds. The Anesthesia Patient Safety Foundation (APSF) played a significant role in disseminating information and providing healthcare workers worldwide with essential training on respiratory equipment and PPE usage.6,7

While strides were made in addressing PPE shortages, we must not overlook the shortcomings in current PPE systems and gear. Many find them uncomfortable, and donning and doffing can be time-consuming and prone to errors. Additionally, these protective measures limit maneuverability, are prone to fogging, and hinder effective communications, impacting patient and healthcare workers safety.8

The APSF, as a prestigious organization, is uniquely positioned to lead and collaborate with other institutions to propose innovative designs for the next generation of PPE. Beyond addressing issues of supply and demand, the APSF can offer recommendations for improved design and materials, enhancing the overall safety and comfort of healthcare professionals who will require prolonged use of protective equipment.


Felipe Urdaneta, MD, FASA is a Clinical Professor of Anesthesiology at University of Florida, College of Medicine and serves as assistant editor for the APSF Newsletter.

He is a consultant for Medtronic.


  1. Looi M-K. What could the next pandemic be? BMJ. 2023;381:p909. doi:10.1136/bmj.p909
  2. Services USHaH. COVID-19 Public Health Emergency (PHE). Accessed June 16, 2023.
  3. Center for Global Development (CGD). The Next Pandemic Could Come Soon and Be Deadlier. Accessed June 23, 2023.
  4. Services UDoHH. Covid Vaccines. June15-2023;
  5. USAFacts. U.S Coronaviris Vaccine Tracker. 2023. Accessed June 15, 2023.
  7. APSF A, AAAA, AANA. The Use of Personal Protective Equipment by Anesthesia Professionals during the COVID-19 Pandemic. Accessed June 20, 2023.
  8. Hampton T, Crunkhorn R, Lowe N, et al. The negative impact of wearing personal protective equipment on communication during coronavirus disease 2019. J Laryngol Otol. Jul 2020;134(7):577-581. doi:10.1017/s0022215120001437