Our sister site Ecouterre reported earlier this month that the U.S. government is offering up to $1 million to anyone who can come up with a more effective Personal Protective Equipment (PPE) design to better protect healthcare workers from the Ebola virus. But given that even in an experimental lab setting it has still been possible for workers to contract the virus through workplace accidents, where exactly are the flaws in the current protective measures?

Ebola suit 1

While the first cases of Ebola contamination amongst healthcare workers on U.S. soil may have been the result of unpreparedness, a very high number of healthcare workers in the field in West Africa are also being contaminated, despite knowing exactly what they are dealing with. Guidelines for the level of protection required vary from institution to institution, and on 20 October, 2014 the Centers for Disease Control and Prevention (CDC) tightened its guidance for U.S. based healthcare workers in an effort to ensure there was no ambiguity.

Related: WHO: World’s Worst Ebola Outbreak Could Affect 20,000 People or More

Issues with the current PPE suits largely revolve around how bulky and exhausting they are to wear, particularly in the tropical heat. In West Africa, health workers are reportedly working in 45-minute shifts to mitigate the risk of heat stroke. The suits come in various grades depending upon how permeable they are, but the trouble is breathability decreases along with permeability. A build up of sweat and steam inside the suits can make visibility difficult due to condensation on the goggles or mask, and thick or multilayered gloves reduce nimbleness and the sense of touch, which can lead to accidents. Needlestick incidents can also occur if the gloves make it difficult to follow a one-handed recapping protocol. Healthcare workers must undergo a decontamination process before they can begin to remove the suits, being sprayed with chlorinated water to kill off any lingering viruses. A buddy system is also used to ensure the suit is removed as safely as possible.

Ideally, improvements in suit design would make them cooler to wear, but there are many aspects of working in the field in Africa that make some options impractical. Facilities for keeping enough decontaminated cooling vests for all workers to use in 45-minute shifts, for example, simply aren’t an option. As reported by Fast Company, suit manufacturers also tend to specialize, and as yet no one specializes in full-body – boots, gloves and all – suits that are manufactured on the scale required. Healthcare workers currently tape up joins at the ankles, wrists and neck, which increases the time taken to put on and remove the suits and retains the risk of an unsealed entry point. But economy of scale seems to be the main challenge. What commercial manufacturer of protective gear can leap to produce the number of suits now required by the outbreak, or that may be be required over the coming months? With Tyvek suits selling for around $10, $1 million might not be enough of a commercial incentive.

Via Fast Company

Photos by Athalia Christie/CDC Global via Flickr