Table 1.

Summary of national guidance for whether chest compressions are considered an AGP and the PPE required for those conducting chest compressions in patients with COVID-19 as of 29th June 2020. The ten countries with the highest incidence of COVID-19 are arranged in descending order. Abbreviations used: COVID-19: coronavirus disease 2019; PPE: personal protective equipment; AGP: aerosol generating procedure.

Country	Confirmed cases	Deaths	Source of evidence	Are chest compressions considered an AGP	Recommended PPE for chest compressions
USA	2,549,069	125,803	Center for Disease Control and Prevention, citing the Tran et al meta-analysis.1 American Heart Association, which cites ILCOR publication.	Both the Center for Disease Control and Prevention and the American Heart Association considers the entirety of CPR as aerosol generating Chest compressions are not considered separately.	Full PPE prior to chest compressions Surgical gown, gloves, visors, and at least FFP-2 level respirator protection. No explicit statement about low level of evidence for chest compressions to be aerosol generating or not.
Brazil	1,344,143	57,622	There are no updated resuscitation guidelines made in relation to COVID-19.	N/A	Unspecified
Russia	640,256	9152	There are no updated resuscitation guidelines in relation to COVID-19; refers directly to the European Resuscitation Council guidance.	N/A	Unspecified
India	548,318	16,475	Indian Resuscitation Council suggested guidelines for comprehensive cardiopulmonary life support for suspected or confirmed coronavirus disease patients.	Considers the entirety of CPR as aerosol generating Chest compressions are not considered separately	Full PPE prior to chest compressions Surgical gown, gloves, visors, and at least FFP-2 level respirator protection
United Kingdom	312,653	43,634	Public Health England (PHE) Chest compressions are not aerosol generating. Resuscitation council (RCUK) chest compressions are aerosol generating.	There is disagreement between PHE and RCUK	PHE – No full PPE for chest compressions First responders can commence chest compressions/defibrillation without full PPE, until airways procedures are required No explicit statement about low level of evidence for chest compressions to be aerosol generating or not, despite an extra statement explaining that NERVTAG (advisory group to the UK government) saying that the “having reviewed all the evidence… does not support chest compressions being procedures that are associated with a significantly increased risk of transmission of acute respiratory infections” RCUK – Full PPE for chest compressions Surgical gown, gloves, visors, and at least FFP-2 level respirator protection No explicit statement about low level of evidence for chest compressions to be aerosol generating or not. However, additional statement on 28th April acknowledging the low level of evidence for chest compressions to be aerosol generating.
Peru	279,419	9317	There are no updated resuscitation guidelines made in relation to COVID-19.	N/A	Unspecified
Chile	271,982	5509	There are no updated resuscitation guidelines made in relation to COVID-19.	N/A	Unspecified
Spain	248,770	5280	Spanish Resuscitation Council which cites the ILCOR publication.	Considers chest compressions as aerosol generating but qualifies the evidence is weak.	Full PPE prior to chest compressions Surgical gown, gloves, visors, and at least FFP-2 level respirator protection. However, considering the weak evidence it may be reasonable to defibrillate prior without PPE.
Italy	240,310	34,738	Italian Resuscitation council which cites the WHO guidance.3	Considers the entirety of CPR as aerosol generating Chest compressions are not considered separately	Full PPE prior to chest compressions Surgical gown, gloves, visors, and at least FFP-2 level respirator protection. However, in the absence of appropriate PPE chest compressions should be performed.
Iran	222,669	10,508	There are no updated resuscitation guidelines made in relation to COVID-19.	N/A	Unspecified