Donning and doffing technique for coverall personal protective equipment, is it safe?

To the Editor—The sudden spread of coronavirus disease 2019 (COVID-19) increased the demand for personal protective equipment (PPE), resulting in shortages.1,2 An observational compliance study regarding specific precautions for COVID-19 patients showed that among improper PPE use, 193 of 322 (60.%) were classified as wasteful practices that contributed to the shortage of these products.3 The lack of gowns has ignited a search for alternative PPE such as coveralls. The World Health Organization (WHO) guideline did not recommend coveralls as alternative PPE.2 The Centers for Disease Control and Prevention mentioned coveralls as alternative PPE, but it did not recommend standardized donning and doffing techniques in the context of COVID-19.4 In this study, in a simulated healthcare environment, we proposed replacing the standard gown by a coverall PPE for healthcare professionals (HCPs) providing assistance to patients suspected or confirmed of COVID-19. Supplementary material To view supplementary material for this article, please visit https://doi.org/10.1017/ice.2020.1429 Acknowledgments We thank the Skills and Simulation Center of the Federal University of São Paulo, the Recommed Company, the healthcare professionals who volunteered in the study, and the following: