Every time we enter a Covid affected person’s room, we first don gloves, and a disposable robe. Once we come out of the room, we take away that gear and put it in one of many many bulging disposal luggage lining the halls of our hospital. We undergo the identical course of for the subsequent affected person, as do well being care staff throughout the nation and around the globe. It will not be unusual for this to occur 30 instances a day for every affected person as nurses, physicians, aids, and others present care.

Multiply our actions by the hundreds of well being care staff who see sufferers on daily basis, and the almost 800 days since Covid-19 was declared a public well being emergency within the U.S. and around the globe, and the scope of the disposal downside turns into large.

Donning and doffing private protecting gear (PPE) made sense in early 2020, when Covid-19 started its relentless march across the globe. It was prudent to institute varied infection-control practices as a result of nobody knew then how SARS-CoV-2, the virus that causes Covid-19, was transmitted.


Because the pathogen unfold, well being care staff had been usually contaminated with it. In our well being care system, Northwell Well being, greater than 20 of our colleagues died of Covid-19 through the first three months of the pandemic. Frantic makes an attempt to acquire sufficient private care gear to guard front-line staff grew to become a significant accountability of well being methods throughout the nation.

Given all of the uncertainty about viral transmission, the Facilities for Illness Management and Prevention and the World Well being Group conservatively assumed the virus might be transmitted by droplets, aerosols, or direct contact. The transmission of pathogens unfold by droplets and aerosols will be prevented by utilizing masks and eye safety, which is what well being care staff have historically used when seeing sufferers who’ve or may need influenza. Robes, gloves, and different gear are wanted to forestall the transmission of pathogens unfold by direct contact.


Early within the pandemic, folks had been being urged to disinfect all the pieces they touched, together with their packages. Hand sanitizers are nonetheless current in nearly each public venue, together with colleges. New York Metropolis spent a whole lot of thousands and thousands of {dollars} disinfecting the subways every night time. Many different public venues nonetheless have particular cleansing protocols.

Present pointers from the CDC and WHO require well being care staff who present direct care to sufferers to put on masks, protecting eyewear or face shields, robes, and gloves. Many well being care staff have additionally requested to make use of scrubs, shoe covers, and bouffant hair coverings, objects that had been as soon as equipped solely to these working in working rooms.

Robes, coverings, and gloves are to get replaced between every affected person contact.

Nationwide information on the usage of private protecting gear are arduous to come back by. Our well being system alone, which is the most important supplier of well being care in New York State, used greater than 2.5 million isolation robes a month through the first wave of Covid-19 in March and April 2020. In the course of the Omicron wave of December and January, the quantity had dropped to about 800,000 per 30 days, however that’s nonetheless twice the amount used earlier than the pandemic. There have been additionally massive will increase in the usage of scrubs, gloves, and bouffants.

Comparable patterns have occurred in hospitals and nursing houses throughout the nation.

Well being care methods have spent billions of {dollars} buying private protecting gear. However there’s a hidden value that has largely gone unnoticed: All of these things are disposable, and medical waste will not be recycled. Disposing this gear is dear, and damages the surroundings. The Environmental Safety Company estimated that about 3 million tons of medical waste was generated yearly in the US alone previous to the pandemic. On February 1, 2022, the WHO issued a report on the necessity to take care of the important downside of medical waste and its antagonistic impression on the surroundings. It highlights the expense and local weather implications of the incineration of the principally plastic waste.

Given what is understood right this moment in regards to the transmission of SARS-CoV-2, the CDC and WHO have didn’t replace their two-year-old insurance policies on protecting private gear that add to the waste downside. Though the CDC pointers don’t carry the drive of legislation, states and medical facilities really feel an obligation to observe them.

Having taken care of a whole lot of Covid-19 sufferers, we’d don’t have any concern about coming into a affected person’s room with out an isolation robe, as a result of this an infection is transmitted by means of the air by way of droplets and aerosols, not by touching a contaminated floor. Though hand washing is at all times an vital a part of an infection prevention efforts, contamination of 1’s garments, hair and footwear have by no means been proven to be an issue.

It is mindless for well being care staff to robe up to enter the rooms of Covid-19 sufferers they usually have fleeting contact with.

The CDC additionally must dial again on its messaging that cleansing surfaces and utilizing hand sanitizer will lower the chance of Covid transmission, when there isn’t a proof to assist both.

As Covid strikes from a pandemic to an endemic an infection, you will need to talk precisely what actually is vital in stopping unfold. There isn’t any doubt that correct air flow, the usage of masks, and most significantly vaccines can stop unfold each inside and out of doors of hospital settings.

Utilizing pointless garb to interrupt a theoretical mechanism of unfold will not be value the fee and injury to the surroundings and erodes public confidence within the CDC and its experience.

Bruce Farber is an infectious illness doctor, chief of public well being and epidemiology at Northwell Well being, and chief of infectious ailments at North Shore College Hospital and LIJ Medical Middle. Aradhana Khameraj is a registered nurse and director of an infection prevention at North Shore College Hospital.