Hair today, gone tomorrow: How personal protective equipment guidance changed doctor's facial hair during the COVID-19 pandemic

A Close Shave: Balancing Religious Tolerance and Patient Care in the Age of COVID-19

In this essay we discuss an ethical dilemma that recently arose in our institution, involving healthcare workers who lamented the requirement to shave their facial hair as a condition to care for COVID-19 patients. The essay represents a genuine attempt to grapple with the dilemma sensibly and vigorously. We first provide a brief introduction, focusing on the tension between religious tolerance and the institutional obligation to optimize patient care and public health in the age of COVID-19. We then discuss the complex relationship between facial hair and cultural as well as religious factors throughout history. Next, we make a case, based on several principles in Islam jurisprudence, that Muslim healthcare professionals in our institution should be expected to shave their facial hair so they could care for COVID patients. We end with considering two alternative solutions that were offered in the literature.

Respiratory protection preparedness in critical care healthcare workers: An observational audit of facial hair at a major tertiary hospital in Australia

BACKGROUND

Facial hair under a tight fitting P2/N95 respirator diminishes respiratory protection. There is limited guidance with respect to the threshold to be clean shaven in readiness to wear N95 respirators.

METHODS

We performed a cross sectional audit in late August 2021 to observe whether staff had facial hair that could decrease respiratory protection of tight fitting respirators. The audit was conducted in three critical care areas at a major tertiary public hospital in Australia during a period of moderate-to-high community prevalence of COVID-19. All staff observed had previously successfully completed quantitative fit testing with a clean shaven face in the preceding 12 months.

RESULTS

110 consecutive male critical care staff were observed including thirty staff who were required to wear a N95/P2 respirator at the time. Forty - five percent of male staff observed were not clean shaven in the face seal zone of their respirators.

CONCLUSIONS

The readiness to wear a tight-fitting respirator and hence the need to be clean shaven, should be guided by both state and local COVID-19 risk ratings, as well as the specific respiratory biohazard risks present in the clinical area at that time. During periods of significant community transmission of COVID-19, critical care clinical staff should be clean shaven, so they are fit-for-purpose and ready to wear a tight fitting respirator at short notice. Respiratory protection preparedness in critical care healthcare workers: An observational audit of facial hair at a major tertiary hospital in Australia.