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Shortages of personal protective equipment during the coronavirus disease 2019 (COVID-19) pandemic have led to the extended use or reuse of single-use respirators and surgical masks by frontline healthcare workers. The evidence base underpinning such practices warrants examination.
Objectives:
To synthesize current guidance and systematic review evidence on extended use, reuse, or reprocessing of single-use surgical masks or filtering face-piece respirators.
Data sources:
We used the World Health Organization, the European Centre for Disease Prevention and Control, the US Centers for Disease Control and Prevention, and Public Health England websites to identify guidance. We used Medline, PubMed, Epistemonikos, Cochrane Database, and preprint servers for systematic reviews.
Methods:
Two reviewers conducted screening and data extraction. The quality of included systematic reviews was appraised using AMSTAR-2. Findings were narratively synthesized.
Results:
In total, 6 guidance documents were identified. Levels of detail and consistency across documents varied. They included 4 high-quality systematic reviews: 3 focused on reprocessing (decontamination) of N95 respirators and 1 focused on reprocessing of surgical masks. Vaporized hydrogen peroxide and ultraviolet germicidal irradiation were highlighted as the most promising reprocessing methods, but evidence on the relative efficacy and safety of different methods was limited. We found no well-established methods for reprocessing respirators at scale.
Conclusions:
Evidence on the impact of extended use and reuse of surgical masks and respirators is limited, and gaps and inconsistencies exist in current guidance. Where extended use or reuse is being practiced, healthcare organizations should ensure that policies and systems are in place to ensure these practices are carried out safely and in line with available guidance.
This volume endeavors to explain the most important developments in philosophy since the end of the Second World War. Yet even when we restrict our focus primarily to those insights and movements that most profoundly shaped the English-speaking philosophical world (as we reluctantly found it necessary to do), it still remains the case that no one – and no one volume (not even a volume like ours, filled with more than fifty chapters from a diverse range of leading philosophers) – can tell this whole story. This is not only because there is no one single overarching story to tell, but also because the overlapping and sometimes conflicting stories that together constitute this complex history are still being written – here in this book, for example. Two of the reasons for the history of philosophy’s necessary incompleteness came to the fore of (what we risk calling) the general self-understanding of Western philosophy during this historical period. These interconnected philosophical reasons (or self-realizations) merit emphasis here, especially because they remain subtle undercurrents throughout the book.
Almost everyone who studies the philosophical issues surrounding “the analytic/Continental divide” now recognizes that the supposed dichotomy between “analytic” and “Continental” philosophy is itself deeply problematic philosophically.1 I’ll drop the quotes before they become tedious, but I do want to insist that, as Bernard Williams (2006) famously pointed out, cross-classifying the main division within contemporary Western philosophy in the mixed, geographical-cum-methodological terms analytic and Continental is rather like trying to sort cars into two (would-be) mutually exclusive groups, those “with an automatic transmission,” on the one hand, and those “made in Germany,” on the other.2