Microneedles: An Emerging Vaccine Delivery Tool and a Prospective Solution to the Challenges of SARS-CoV-2 Mass Vaccination.

Vaccination is an effective measure to prevent infectious diseases. Protective immunity is induced when the immune system is exposed to a vaccine formulation with appropriate immunogenicity. However, traditional injection vaccination is always accompanied by fear and severe pain. As an emerging vaccine delivery tool, microneedles overcome the problems associated with routine needle vaccination, which can effectively deliver vaccines rich in antigen-presenting cells (APCs) to the epidermis and dermis painlessly, inducing a strong immune response. In addition, microneedles have the advantages of avoiding cold chain storage and have the flexibility of self-operation, which can solve the logistics and delivery obstacles of vaccines, covering the vaccination of the special population more easily and conveniently. Examples include people in rural areas with restricted vaccine storage facilities and medical professionals, elderly and disabled people with limited mobility, infants and young children afraid of pain. Currently, in the late stage of fighting against COVID-19, the main task is to increase the coverage of vaccines, especially for special populations. To address this challenge, microneedle-based vaccines have great potential to increase global vaccination rates and save many lives. This review describes the current progress of microneedles as a vaccine delivery system and its prospects in achieving mass vaccination against SARS-CoV-2.

Expert consensus on prevention and control of infection in makeshift hospitals

Makeshift hospitals have played an important role in responding to the spread of the epidemic caused by the Omicron coronavirus variant, one of the novel coronavirus(SARS-CoV-2) strains with significantly enhanced infectiousness. In order to prevent the patients, healthcare workers and other staff against from infection, Healthcare-associated Infection Management Committee of Chinese Hospital Association organized domestic experts to jointly formulate this consensus according to the comprehensive consideration of national guidelines as well as the actual characteristics and needs of makeshift hospitals. This consensus is mainly applicable for makeshift hospitals where a large number of asymptomatic and mild cases of novel coronavirus disease 2019(COVID-19) are treated. It provides guidance for the managers and staff to implement prevention and control work in line with local conditions in makeshift hospitals based on a perfect organizational structure and efficient working mechanism, the prevention and control work includes training and assessment of infection control knowledge and skills, flowing in and out of the makeshift hospitals for staff and materials, infection monitoring and feedback, implementation of infection prevention and control measures, requirements for infection management in key areas, occupational protection of staff and terminal disinfection, etc. Meanwhile, this consensus particularly emphasizes that the infection prevention and control in makeshift hospitals is a systematic project, which requires not only multi-system and multi-department collaboration, but also uniting in a concrete effort among leaders and staff. In accordance with the national guidelines and evidence-based experiences, it is very important to combine theory with practice for ensuring efficient operation and safety of makeshift hospitals.

Progress of fit testing of respirators

Respirators are important personal protective equipment to reduce the exposure of respiratory tract infections in health care workers (HCW). It is important to choose suitable respirators through fit testing and wear them correctly. This article introduced the classification of respirators and summarized the purposes, methods and requirements of fit testing, as well as the challenges when performing it. Users can choose the suitable respirators including powered air-purifying respirators and tight-fitting facepiece only when they passed fit testing. Qualitative fit testing (QLFT) and quantitative fit testing (QNFT) assays were two categories of fit testing and studies showed that the effect of QNFT in the detection of leaks was better than that of QLFT. Users should perform fit checking everytime in order to wear the respirator correctly although the respirators were screened by fit testing before. It was difficult to implement fit testing during the COVID-19 pandemic because of the shortage of respirator supply. But now domestic and foreign institutions have re-emphasized the supervision of respirator fit testing as the supply of respirators resumes. Although the fit testing of respirators needs the support of clinical technical systems and faces various cost challenges, it not only has high education value but also provides effective protection for the HCW in medical institutions.

Multicenter investigation of current status of use of personal protective equipment among healthcare workers during diagnosis and treatment of COVID-19

OBJECTIVE: To investigate the use of personal protective equipment (PPE) of healthcare workers (HCWs) in the room where confirmed COVID-19 patients are admitted and understand the current status of prevention. METHODS: The healthcare workers who from medical aid teams in Hubei in 30 hospitals were randomly selected by the trained staff for hospital infection prevention, the basic characteristics of the enrolled subjects and the use of PPE were recorded, and the questionnaires were filled out through questionnaire star. RESULTS: The survey found that all the healthcare workers received theoretical training and practical training on the use of PPE before entering the isolation ward, 95.56% (2 433) of them were inspected or supervised by someone when they put on or took off PPE. 86.57% (2 204) of the healthcare workers wore two layers of masks at the same time, most of whom (1621, 63.67%) wore medical surgical mask and respirator at the same time. 57.50% (1 464) of the healthcare workers used goggles or face shield, 42.50% (1 082) of whom used goggles and face shield at the same time. 95.25% (2 425) of the healthcare workers wore coverall and disposable gown at the same time. 96.62% (2 460) of the healthcare workers wore boot covers and shoe covers at the same time. The proportion of the healthcare workers who wore two-layer hats was the highest (70.54%), and the proportion of the healthcare workers who wore two-layer gloves was also the highest (57.31%). CONCLUSION The use of PPE of the HCWs who are from the medical aid teams has effectively prevented the COVID-19 infection, achieving a 'zero infection' among the 42.6 thousand HCWs. However, there are excessive use of PPE, and the rational use of PPE needs to be further standardized and explored.