This recently updated guidance from the U.S. Centers for Disease Control and Prevention (CDC) recommends that all U.S. healthcare facilities begin using contingency strategies for personal protective equipment (PPE).

The previous version of this guidance provided optimization strategies for various individual types of resources (e.g., facemasks, N95 respirators, ventilators), but did not direct recommendations at all U.S. healthcare facilities. The updated guidance recommends that all facilities:

• Maximize engineering controls (e.g., barriers, ventilation) and administrative controls (e.g., work practices) to minimize patient contacts
• Cancel all elective and non-urgent procedures and appointments
• Reserve PPE for healthcare personnel and use other barriers such as tissues for source control (i.e., for infected persons to prevent transmission)
• Use re-usable PPE
• Use PPE that is beyond manufacturer-designated shelf life for training purposes
• Consider allowing healthcare personnel to use some PPE beyond a single patient contact.

The updated guidance also notes that facilities experiencing PPE shortages may need to consider crisis capacity strategies and should engage in careful planning for implementation. These strategies may include:

• Using PPE beyond manufacturer-designated shelf life for patient care activities
• Prioritizing PPE use for selected care activities (e.g., reserving respirators for aerosol-generating procedures or care of patients with airborne transmitted disease risks)
• Using alternatives if no commercial PPE is available and if the alternatives will reduce personnel exposure and are safe for patient care.