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Variation of National and International Guidelines on Respiratory Protection for Health Care Professionals During the COVID-19 Pandemic

Educational Objective
To identify the key insights or developments described in this article
1 Credit CME

Conflicting evidence surrounding SARS-CoV-2 transmission, particularly airborne transmission, may have contributed to heterogeneous recommendations for respiratory protection across countries and organizations.1 Variability among guidelines may generate confusion, anxiety, and mistrust among health care professionals (HCPs) regarding the ability of respiratory protection to prevent SARS-CoV-2 transmission. We assessed variation in international and national guidelines on respiratory protection for HCPs in hospital settings during the first year of the COVID-19 pandemic.

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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.

Article Information

Accepted for Publication: May 27, 2021.

Published: August 4, 2021. doi:10.1001/jamanetworkopen.2021.19257

Open Access: This is an open access article distributed under the terms of the CC-BY License. © 2021 Birgand G et al. JAMA Network Open.

Corresponding Author: Gabriel Birgand, PhD, National Institute for Health Research Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance at Imperial College London, Hammersmith Campus, Du Cane Road, London W12 0NN, UK (g.birgand@imperial.ac.uk).

Author Contributions: Dr Birgand had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.

Concept and design: Birgand, Mutters, Lucet.

Acquisition, analysis, or interpretation of data: Birgand, Mutters, Otter, Eichel, Lepelletier, Morgan.

Drafting of the manuscript: Birgand, Mutters, Morgan, Lucet.

Critical revision of the manuscript for important intellectual content: All authors.

Statistical analysis: Birgand.

Administrative, technical, or material support: Birgand, Otter, Eichel, Lepelletier, Morgan.

Supervision: Lucet.

Conflict of Interest Disclosures: Dr Birgand reported receiving grants from the UK Economic and Social Research Council outside the submitted work. Dr Otter reported receiving personal fees from Gama Healthcare outside the submitted work. Dr Morgan reported receiving grants from the US Department of Veterans Affairs, US Agency for Healthcare Research and Quality, and US Centers for Disease Control and Prevention and reimbursement for conference speaking or coordination from the Infectious Diseases Society of America, Society for Healthcare Epidemiology of America, and Lown Institute outside the submitted work. No other disclosures were reported.

Funding/Support: The study was supported by the UK Economic and Social Research Council as part of the Antimicrobial Cross Council initiative supported by the 7 UK research councils and the UK Global Challenges Research Fund.

Role of the Funder/Sponsor: The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Disclaimer: The views expressed are those of the authors and not necessarily those of the UK National Health Service, UK National Institute for Health Research, England Department of Health, or Public Health England.

Meeting Presentation: This study was presented at the virtual 31st European Congress of Clinical Microbiology and Infectious Diseases; July 9 through 12, 2021.

Additional Contributions: Nina Zhu, PhD (Imperial College London); Anne Savey, MD (Regional Centre for Infection control Auvergne Rhone Alpes); and Karine Blanckaert, MD (Regional Centre for Infection control Pays de la Loire) contributed to the review of guidelines.

AMA CME Accreditation Information

Credit Designation Statement: The American Medical Association designates this Journal-based CME activity activity for a maximum of 1.00  AMA PRA Category 1 Credit(s)™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to:

  • 1.00 Medical Knowledge MOC points in the American Board of Internal Medicine's (ABIM) Maintenance of Certification (MOC) program;;
  • 1.00 Self-Assessment points in the American Board of Otolaryngology – Head and Neck Surgery’s (ABOHNS) Continuing Certification program;
  • 1.00 MOC points in the American Board of Pediatrics’ (ABP) Maintenance of Certification (MOC) program;
  • 1.00 Lifelong Learning points in the American Board of Pathology’s (ABPath) Continuing Certification program; and
  • 1.00 credit toward the CME of the American Board of Surgery’s Continuous Certification program

It is the CME activity provider's responsibility to submit participant completion information to ACCME for the purpose of granting MOC credit.

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