Pathology can be described as a respiratory disease that often progressed into pneumonia with bilateral ground-glass opacities. Elderly patients and those with underlying conditions like hypertension, cardiovascular disease or diabetes, are more likely to develop serious complications like pneumonia secondary to COVID-19 including septicemia due to cytokine activity and fluid build-up in the lower lobe. Hospitalized COVID-19 patients are often in need of respiratory support.¹

Droplets are considered particles secreted from a patient’s respiratory tract that are no smaller than 5µm in diameter and travel shorter distances (defined as ≤ 3ft) because they cannot stay suspended in air for long periods of time. However, SARS-CoV while still classified as a droplet, is estimated to travel anywhere from 6ft. to 10ft. and can be impacted by environmental factors such as velocity and mechanism by which respiratory droplets are propelled from the source, the density of respiratory secretions, environmental factors such as temperature and humidity, and the ability of the pathogen to maintain infectivity over that distance² and therefore has the potential to become an aerosol or airborne.

This presents challenges to the assignment of isolation categories because of conflicting information and uncertainty about possible routes of transmission. Although SARS-CoV is transmitted primarily by contact and/or droplet routes, airborne transmission over a limited distance (e.g., within a room), has been suggested, though not proven.³

While The Vest® System therapy itself is not considered an AG procedure per CDC Infection Control Guidelines, because it is a cough inducing therapy, it is important to take necessary steps of donning and doffing PPE consistent with the above guidelines.² These take into consideration factors such as the pathogen characteristics and recommended level of PPE needed. 

Current CDC recommendations state that if bronchial hygiene therapies are necessary for patient care, they should ideally be performed with appropriate level of PPE and environmental conditions (i.e. AIIRs). Specifically, it is recommended that healthcare workers take precautions during cough inducing therapies, like The Vest® System’s HFCWO, by donning and doffing PPE in a manner that is consistent with Infection Prevention and Control practices. In addition, it is recommended to place a surgical mask over the patient’s nose and mouth or, in the event of a PPE shortage, provide tissues for the patient to cough into (i.e practice good cough etiquette). For more information on COVID-19 specific Infection Prevention Guidelines, please visit the CDC’s COVID-19 website.⁴