The Mobile Negative Pressure Unit Solution: Simple, Pragmatic and Doable
- Coronavirus infection is not binary, viral dose exposure could increase fatality
- Negative room pressure units prevent cross contamination of both workers and other patients
- Hospitals have existing negative pressure rooms, but not enough to meet demand
- Hospital resources can be augmented with mobile units without infrastructure changes
- Mobile units are assembled on truck fleets for easy deployment where they are needed most
- Mobile units could likely be created using existing low-tech components and materials not in scarcity
- Units are easy to scale, as they can be set up in parking lots or designated areas for coronavirus care
Infection is Not Binary: Viral Dose Exposure Could Increase Fatality
Research coming out of Denmark suggests that coronavirus infections may not be binary but rather dependent upon the dose of exposure. In other words, a low dose of exposure to the virus is less lethal than a high – or viral – dose.
This theory expands on research conducted by Danish scientist, Peter Aaby, related to the measles outbreak in Africa 40 years ago. At the time, the theory was that the high fatality rate on that continent had to do with malnourishment, but the explanation was much simpler – it had to do with the fact that families lived in very close quarters with children sharing beds and sleeping together. The more exposed a person was to the disease, the shorter the incubation time, and consequently, the less time available for the immune system to fight the virus.
As Aaby said in a recent news article: “In Sweden, six of the first ten dead Somalis were living together. In the United States there were four from the same family who died. It could indicate that mortality increases if the infection spreads in the home.”
His theory is further supported by Rudi Westendorp, a professor at the Department of Epidemiology at the Department of Public Health at the University of Copenhagen, “If you’re exposed to a larger dose of illness, you’re more likely to get sick.” There may be a difference between being infected by a passerby in the supermarket or a close family member with whom you have intensive contact for a long time. The latter will involve a harder – and potentially more fatal – version of the coronavirus.
This theory might also explain why so many frontline healthcare workers have contracted the virus. Almost 10 percent of the cases in Italy are healthcare workers.
Mobile Negative Room Pressure Units
Negative room pressure is an isolation technique used in hospitals and medical centers to prevent cross-contamination from room to room. It includes a ventilation that generates “negative pressure” (pressure lower than the surroundings) to allow air to flow into the isolation room but not escape from the room, as air will naturally flow from areas with higher pressure to areas with lower pressure, thereby preventing contaminated air from escaping the room. This technique is used to isolate patients with airborne contagious diseases such as: tuberculosis, measles, chickenpox, Severe Acute Respiratory Syndrome (SARS-CoV), Middle East Respiratory Syndrome (MERS-CoV), influenza (flu), and Coronavirus disease 2019 (COVID-19).
While hospitals have negative pressure rooms, they are not being used at scale to help manage viral exposure to the virus.
In addition to existing PPE usage, Lumina believes that creating negative pressure rooms at scale to treat those infected with the virus will protect healthcare workers, as well as hospital patients that are seeking care currently unrelated to coronavirus infection.
Makeshift negative pressure solutions may also be available for existing hospital spaces, and this should be explored facility by facility. In addition, Lumina suggests that the state create a fleet of mobile negative room pressure units that could be deployed to any healthcare facility or local area designated to treat coronavirus patients. The facilities could be moved as the virus moves geographically, giving the flexibility to send resources where they are needed most, when they are needed most.
Recognizing the pressures in the system to provide medical personnel with PPEs, this approach will help minimize risk of contracting the disease, as concentrated exposure to the virus materially increases risk of contracting the virus.