COVID-19, Personal Protective Equipment, and Human Performance

Keith J. Ruskin, M.D.; Anna Clebone Ruskin, M.D.; Brian T. Musselman, C.As.P.; Jaime Rivas Harvey, C.As.P.; Thomas E. Nesthus, Ph.D.; Michael O'Connor, M.D.


Anesthesiology. 2021;134(4):518-525. 

In This Article


The COVID-19 pandemic reinforces the critical role that clinicians play in caring for patients and managing resources during local, regional, and global disasters. Clinicians are frequently on the front line of the response and are thus at an increased risk for infection. The personal protective equipment that is routinely used to protect clinicians imposes a variety of physiologic and psychologic stressors that may impair their performance. Modern medical personal protective equipment protects healthcare professionals but is often difficult to don and doff, is uncomfortable, and may impair a clinician's ability to care for his or her patients. This article offers immediate countermeasures that can help to mitigate these effects and provide some relief to clinicians who must wear personal protective equipment (Table 1).

Improving the design of personal protective equipment can help to preserve a clinician's performance, especially in circumstances where this equipment will be worn for a prolonged period of time. Health care systems, government agencies, and experts in human performance should therefore work together to set universal standards for equipment quality, requirements, fit, and training. Although this article has described physiologic and psychologic stressors in the context of the current pandemic, the principles described are similar whenever clinicians work in an environment to which they are not accustomed. Healthcare professionals can improve patient safety and protect themselves by understanding how they are affected by physiologic and psychologic stressors and then implementing the appropriate countermeasures.