PPE as a system: reading the 2014 Ebola guidance update
An original historical explanation of how evidence review, procurement, training and implementation connect when protective-equipment guidance changes.
Place the update in its outbreak context
The October 2014 WHO item describes a formal review of protective-equipment guidance during an Ebola response. Its stated purposes include clarification of options and support for procurement. It is a historical account of professional guidance being reviewed, rather than a current set of instructions for someone choosing or using equipment.
The important distinction is between the publication of guidance and the wider system in which it is implemented. A document can identify an intended standard, but its practical use depends on additional arrangements. Understanding that distinction makes an equipment story more informative than a list of individual products.
Follow the interfaces between decisions
Procurement, availability, training and working procedures have to connect. A reader evaluating implementation can ask whether the relevant service has the arrangements needed to apply its chosen guidance. That is an operational assessment, not a judgement that a particular item alone guarantees protection.
A change can also require more than replacing stock. The people responsible need to know which version is in use and how the service manages the transition. Otherwise an older document and a newer procedure can be discussed as if they were the same standard. A dated guidance announcement is one reference point in that process, not evidence of every later implementation decision.
Keep the educational scope clear
This article explains how to read a guidance update. It does not reproduce technical specifications, prescribe equipment combinations or provide a sequence for putting on or removing PPE. Those tasks belong to the relevant current professional procedures and training.
The unchanged 2014 source wording remains in a dated archive disclosure on this page. Our original comparison below focuses on the evidence and implementation questions a public reader can reasonably follow. It helps visitors understand why guidance can evolve and why the success of a response cannot be inferred solely from the existence of a published equipment standard.
A guidance update has several interfaces
| Interface | Question for an implementation review | Insufficient conclusion |
|---|---|---|
| Evidence to guidance | What issue and version did the review address? | The headline alone settles every setting |
| Guidance to service | How are procurement and training connected? | An item’s availability guarantees protection |
| Service to evaluation | What implementation evidence was recorded? | A document proves every procedure was followed |
Source snapshot · feed date 31 October 2014
WHO updates personal protective equipment guidelines for Ebola response
As part of WHO’s commitment to safety and protection of healthcare workers and patients from transmission of Ebola virus disease, WHO has conducted a formal review of personal protective equipment (PPE) guidelines for healthcare workers and is updating its guidelines in context of the current outbreak.
About the PPE guidelines
These updated guidelines aim to clarify and standardize safe and effective PPE options to protect health care workers and patients, as well as provide information for procurement of PPE stock in the current Ebola outbreak. The guidelines are based on a review of evidence of PPE use during care of suspected and confirmed Ebola virus disease patients.
The Guidelines Development Group convened by WHO included participation of a wide range of experts from developed and developing countries, and international organizations including the United States Centers for Disease Control and Prevention, Médecins Sans Frontières, the Infection Control Africa Network and others.
“These guidelines hold an important role in clarifying effective personal protective equipment options that protect the safety of healthcare workers and patients from Ebola virus disease transmission,” says Edward Kelley, WHO Director for Service Delivery and Safety. “Paramount to the guidelines’ effectiveness is the inclusion of mandatory training on the putting on, taking off and decontaminating of PPE, followed by mentoring for all users before engaging in any clinical care.”
Guidelines were developed from an accelerated development process that meets WHO’s standards for scientific rigour and serves as a complement to the Interim infection prevention and control guidance for care of patients with suspected or confirmed filovirus haemorrhagic fever in health-care settings, with focus on Ebola, published by WHO in August 2014.
Use of the personal protective equipment
Experts agreed that it was most important to have PPE that protects the mucosae – mouth, nose and eyes – from contaminated droplets and fluids. Given that hands are known to transmit pathogens to other parts of the body, as well as to other individuals, hand hygiene and gloves are essential, both to protect the health worker and to prevent transmission to others. Face cover, protective foot wear, gowns or coveralls, and head cover were also considered essential to prevent transmission to healthcare workers.
"Although PPE is the most visible control used to prevent transmission, it is effective only if applied together with other controls including facilities for barrier nursing and work organization, water and sanitation, hand hygiene, and waste management," says Marie-Paule Kieny, Assistant Director-General of Health Systems and Innovation. Benefits derived from PPE depend not only on choice of PPE, but also adherence to protocol on use of the equipment.
A fundamental principle guiding the selection of different types of PPE was the effort to strike a balance between the best possible protection against infection while allowing health workers to provide the best possible care to patients with maximum ease, dexterity, comfort and minimal heat-associated stress.
In this situation where evidence is still being collected, to see what works best and on an effective sustainable basis, it was considered prudent to provide options for selecting PPE. In most cases, there was no evidence to show that any one of the options recommended is superior to other options available for healthcare worker safety.
Further work is needed to gather scientific experience and data from the field in systematic studies, in order to understand why some health workers are infected in the current outbreak and to increase effective clinical care. WHO is committed to working with international partners on these issues to build this evidence base.
WHO media contacts
Tarik Jasarevic Communications Officer Telephone: +41 22 791 50 99 Mobile: +41 79 367 62 14 Email: jasarevict@who.int
Ebola disease — sources, context and outbreak reporting
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Read the disease guide →Sources & Verification
World Health Organization (WHO). RSS content used with permission. Formatting adapted for Worldwide Outbreak.
- WHO updates personal protective equipment guidelines for Ebola response Verify original (opens in a new tab)
- WHO — Ebola PPE guidance publication context Verify original (opens in a new tab)
Feed retrieved 24 Oct 2026, 14:09 UTC. Story date follows the dated WHO article address; the feed timestamp is 2 Jun 2018.
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