US DoD conditions use of surgical masks-gloves

By Monitoring Desk
Friday – April 10, 2020
WASHINGTON, DC (United States): All individuals on United States (US) department of defence (DoD) property, installations and facilities are required to wear “cloth face coverings” when they cannot maintain 6 feet of social distance in public areas or work centres, the medical personal protective equipment (PPE) such as N-95 respirators or “surgical masks” will not be issued for this purpose as these items are reserved, due to increasing medical care requirements for COVID-19 patients, the US DoD under secretary of defence for personnel and readiness Matthew P. Donovan, on Thursday, made public the supplement 7 to the force health protection guidance, released for the DoD personnel, earlier on Wednesday.

According to the official statement, supplement 7 provides guidance on cloth face coverings and updates the guidance on PPE and non-pharmaceutical interventions, insists on following the guidelines to prioritise and optimise the use of PPE in current supply constrained US environment.

The DoD continues to rapidly adapt its response to the coronavirus disease 2019 (COVID-19) pandemic to protect the force and ensure the continuation of DoD missions.

The memorandum rescinds reference, and replaces it with the guidance on cloth face coverings and updated guidance on PPE and non-pharmaceutical interventions (NPIs).

The respirators, including N-95 respirators, are not recommended for use outside of healthcare, discrete COVID-19 support missions, and other specifically authorised settings. N-95 respirators must be fit-tested on the user to provide optimal protection.

“Surgical masks,” are intended to reduce the spread of viruses when worn by patients and healthcare workers.

“Gloves,” gowns, and eye protection, should be used primarily for patient care (e.g., en route care during patient transport). Between patient encounters, non-disposable eye protection must be cleaned and disinfected, and gloves and gowns must be changed at prescribed intervals.

To optimise the supply and use of PPE, components should follow centres for disease control and prevention (CDC)-published strategies.

As a source control, on a COVID-19 patient or person under investigation (PUI), the “surgical masks” can be used.

As a healthcare delivery, military treatment facility patient care requirements, emergency medical services, ancillary healthcare providers (e.g., dental, veterinary), N-95 respirators/“surgical masks,” eye protection, gowns and “gloves” can be used.

On discrete COVID-19 support missions, COVID-19 patient or PUI transport, quarantine and PUI support, mortuary affairs teams, N-95 respirators/“surgical masks,” eye protection, gowns and “gloves” can be used.

A “cloth face covering” shall extend above the nose without interfering with eyewear, and below the chin to cover the mouth and nostrils completely. It shall fit snugly but comfortably against the sides of the face and be secured (e.g., by being tied in place or with ear-loops).

Cloth face coverings shall be laundered regularly to maintain good hygiene. The military departments will issue guidance on uniform wear for service members. Pending that guidance, service members will wear cloth face coverings in neutral colours.

We know how a significant portion of individuals with COVID-19 are asymptomatic and can transmit the virus before showing symptoms.

As a result, the CDC now recommends wearing “cloth face coverings” in public setting where social distancing is difficult to maintain (e.g., grocery stores and workplaces). “Cloth face coverings” will slow the spread of COVID-19 by reducing transmission from people who do not realise they are infected.

Exceptions to this requirement, for reasons such as impracticality, health or other bases, may be approved by commanders, supervisors, and contracting officers, as appropriate.

Exceptions should be documented in writing and a copy provided to the recipient and the next higher level of command or supervision. Upon request, individuals will lower face coverings at security checkpoints to allow their identities to be verified.

Components will comply with applicable labour obligations (to the extent such obligations do not conflict with the agency’s ability to conduct operations during this emergency).

Increased risk in performance of official duties, commanders in consultation with their public health emergency officers, may include special public facing duties and incorporate CDC considerations for other special groups, the “gloves,” cloth face and covering can be used.

“Cloth face coverings” and PPE are part of a larger strategy for using NPIs to limit transmission of COVID-19.

It is important to continue consistently practicing of: frequent hand sanitisation using soap and water or hand sanitiser, properly covering coughs and sneezes, social distancing, staying home when sick, and use of telecommunications in place of face-to-face interactions, frequently cleaning and disinfecting common touch points, including gym, equipment, keyboards, laptops, door handles, etc.

Proper and consistent use of “cloth face coverings,” PPE, and NPIs reduce risk to DoD personnel and communities.