BACKGROUND
In 2014, the world witnessed the worst Ebola outbreak on record, with widespread disease in the West African countries of Guinea, Liberia, and Sierra Leone—infecting more than 28,000 people and killing more than 11,300 in the span of 2 years.1 It was the first Ebola outbreak to reach large city centers, where it spread rapidly. The disease particularly impacted health care workers because it is so highly infectious and difficult to defend against, placing additional pressure on already fragile health care systems. By August 2015, 880 health care workers had become infected, and 512—nearly 60%—of those workers had died.2
One of the greatest times of risk for health care workers occurs when they remove their personal protective equipment (PPE) and are exposed to the virus on the outer surfaces, especially during glove and gown removal (doffing). Compounding the danger is the complexity of the doffing protocols and of the multipiece PPE ensembles themselves.3 Every additional element and step in a multicomponent PPE ensemble, either in donning or doffing, adds an opportunity for error and increase in risk.
In October 2014, in response to these issues and to the United States Agency for International Development's (USAID's) Grand Challenge for Development to help health care workers respond to the epidemic, Johns Hopkins University's Center for Bioengineering Innovation and Design (CBID) and Jhpiego, an NGO affiliate of Johns Hopkins University, organized the “Johns Hopkins Emergency Ebola Design Challenge,” a hackathon-type event in which participants worked in teams to address specific issues with existing PPE ensembles. The event was also …