Low-cost production of handrubs and face shields in developing countries fighting the COVID19 pandemic.

To the Editor(s):

The COVID-19 caused by the novel coronavirus now known as SARS-CoV-2 (severe acute respiratory syndrome coronavirus-2), has spread worldwide with its first reported case in late December 2019 in Wuhan city of China.

This rapidly growing pandemic has also affected many healthcare workers. A recent report from China classified an overall 14.8% of confirmed cases among health workers as severe or critical and 5 deaths were observed.

Presently, the clinical spectrum of the disease is being defined including the potential for asymptomatic spread. So far, no specific treatment and prevention strategies like targeted antiviral drugs and vaccines are available for COVID-19. Thus, we can only depend on the traditional public health outbreak response practices—isolation, quarantine, social distancing, and community containment.

Such times call for judicious and appropriate use of personal protective equipment (PPE)––gloves, masks, face shields, and handrubs among healthcare workers. In populous countries like India, judicious use of PPE can be a game-changer. Thus, the Infection Control Team at the JPNA Trauma Center, AIIMS, New Delhi has the taken measures such as in-house production of the WHO-recommended handrubs on a large scale and indigenous face shields to be used by the healthcare workers in the hospital (Fig 1 ).

Fig 1

(A) Indigenously prepared WHO-recommended alcohol based handrubs. (B) In-house low-cost face shields made in the laboratory using readily available raw materials.

The usefulness of both the in-house developed PPE has been tested by the treating clinicians at the Center. Both the formulations of handrubs––ethanol & isopropyl alcohol, have proved to be effective. The in-house made face shields were prepared using the readily available materials like foam, transparency sheets, and elastic bands. The cost of each face shield was just 15 Indian rupees INR. It took us approximately 2 minutes to make each face shields. The residents wore the face shield for almost 4 hours without discomfort. Such cost-effective measures towards preparedness to battle the pandemic could be taken by all healthcare facilities across the globe, to overcome the expected crises of PPE and halt the outbreak. With the expected shortage of masks, we are also looking at the option to make triple-layered masks using indigenous materials.