Temporary Negative Pressure Isolation Room Capacity vs Potential Need
US Isolation Room Capacity is not measured by the
American Hospital Association (AHA) but it is estimated
to be around 2/3rds of ICU Capacity which is 68,558 for Adults.
The current Pandemic may require several times more capacity.
Covid Clean Systems present a viable and effective solution
to aid in increasing this capacity.
Introduction
Covid Clean was incorporated on April 8th, 2020 almost a month after Nicolas Bouri, an Ethics and Logic Student from Minnesota, decided not to wait for the others to do what was needed. Upon research of the situation in regards to possible infection rates, isolation room capacity, and witnessing the exceedingly expensive and unimpressive solutions being deployed he knew a better solution was in order.
His father Samir had been in the ICU in Sacramento in the previous year where he was told by staff (in front of his father!) that there was nothing that could be done to save his life and he had 24 hours to live. Samir was in the ICU for 3 weeks and intubated for most of that time. He was slowly dying. The air was being forced into his father so forcefully that the skin on his face started to peel away due to the air blowing past the mask before they intubated him. He was told that Samir had restrictive lung disease and there is no cure. Samir had never been a smoker and the rate of decline was abnormal and Nicolas explained this to the nurses to no avail. A week prior, Nicolas, not one to stand idle and accept the lack of information from staff spent many days on his cell phone reading everything about his fathers conditions and how to read the ventilator. After several days he started to request an examination for fluid on his father’s lungs. It was met without enthusiasm. When the chest scan came back it was proclaimed there was no pulmonary edema which Nicolas suspected. This made no sense, everything pointed to that exact reason. When the nurses told Nicolas his father had 24 hours to live (without concern in front of his father), Nicolas had to have a heart to heart with his sedated father. Prior to which he gave a large tablet so he could communicate via digital chalkboard. This was something he felt the hospital should have had as a communication solution in the first place. Samir explained he was ready to go and would give up. Nicolas holding back tears told his father to be a soldier and try to survive until his twin could fly in to say goodbye and to give him a few more days to try and find a way to save him. His father agreed to fight until he could say bye to his other son.
Nicolas turned to the nurses a few hours later and requested that a drain be surgically inserted to remove any possible fluid build-up. He was earlier told that it was not wise due to possible infection. Nicolas said since you gave up on him and he is going to die anyway the risk is not unwarranted at this point. The staff conceded. Two liters of fluid came off of his father’s right lung. Samir had unilateral diaphragm paralysis due to heart surgery 15 years prior, which is why the nurses recorded his condition as restrictive lung disease. In one day Samir was removed from intubation. Later, the doctor and staff doing the morning round was visibly astonished by this news and instructed the respiratory techs to issue a test with low-pressure assistance to see how his oxygen level would respond. The respiratory techs not following the instruction turned off the machine to which Nicolas was unaware. When the doctor came back he tried to hide his shock from the rest of us that his techs turned off the machine against his orders, but explained Samir was breathing 100% on his own. Nicolas was very upset with how such trained professionals could get something so obviously simple wrong from the start to the end. His father now with Nick’s help is no longer on daily oxygen support which Samir lived with for several years.
Knowing that ineptitude was exceedingly rampant across humanity and that the Covid-19 situation was a global issue he felt obligated to learn as much as he could to see what needed to be done as his father was at high risk and did not want to see his father triaged away to die without assistance. He learned that the US spends $700Billion on national defense, that one of the biggest risks to the US was a pandemic, and that ultraviolet germicidal irradiation (UVGI) technology was the most effective mitigating factor. However, the top US companies who produce this product sent all production overseas and during the pandemic, supplies were months behind and being held up. The US did not make its own UVGI lights! (We finally found a US manufacturer) Others were selling fake UVGI-LED’s through Amazon in mass. Nicolas warned Amazon several times over several months about this fraud and explaining he was the CEO of Covid Clean yet nothing was done by Amazon and management never returned his requests. They continue to sell fraudulent products in a pandemic fully aware of the scam. He also learned that there was no regulation by the Occupational Safety and Health Administration (OSHA) on UVGI exposure limits. Nicolas stated the level of incompetency across the board was never-ending and made his blood boil.
He resolved to be the change he needed to see to save his father’s life again and the lives of many others so he designed the Covid Clean system.
Isolation Room Capacity
The AHA estimated 42,562 airborne infection isolation rooms in the US. The estimated need during a mild pandemic is many times this, for critically ill patients. We can not afford to have the most vital population (medical staff) during an unknown contagion to go unprotected and die off during a crisis. The emergency preparedness plan of many hospitals is to use a fan placed on the ground with a HEPA filter to blow air out a window or into the HVAC system to create a negative pressure within the room. In other instances tents costing an inappropriate amount are set up to house overflow patients. The issue with this solution is that it does not protect staff from the patient, but it may protect the birds in the trees. These tents are also at risk of being blown over during storms. Personal Protective Equipment such as proper masks was also not in sufficient supply. This insufficiency was so critical the US spent $600Million on machines that can clean medical masks so they may be used several times. We all know that the masks are only marginally effective.
A better solution was complete containment through robust mobile and modular ultraviolet germicidal air-purifying temporary negative pressure isolation (UVGI-AP-TNPI) units. The design allowed for considerable benefits in regards to cost, ability, and rapid deployment. Douglas Fir wood was decided on for the frame due to its ease of manufacture at the local level and has the highest fire rating of all wood. The wood can be cut with notches for quick and study assembly. The 4×4 (3.5” x 3.5” ) structure allows 4’ spacing between columns and a wide face so two sheets of PC can be screwed into the same column to create a seal. On the outside, 3M performance level duct tape can be used to ensure an air-tight seal. 3M supplied free samples of this and vinyl tape to assist in the effort. The wood screws should use ethylene propylene diene monomer (EPDM) washers to protect the polycarbonate (PC) from cleaning agents.
The PC is easily attached to the frame with wood screws and does not pose the risk to cracking that other clear plastics have. The PC used is a UV stabilized blend that blocks harmful UV-C radiation so an autonomous mobile robot (AMR) can sanitize the outer room without removing the patient. The PC also allows the complete visual light spectrum (VIS), Near-infrared (N-IR), Radiofrequency (RF), and wireless medical telemetry service (WMTS) to pass. This allows no restriction for beneficial electromagnetic frequency (EMF) use and blocked all of the EMF that was harmful, specifically frequency in the UV range.
An airlock entry was included to increase the isolation of air between the interior and exterior of the isolation unit and airflow from the supply is vented into this space to create a clean air barrier.
Nicolas then designed a UVGI-AP to filter the air in and out of the system. While doing this he understood that the effectiveness of the system could be calculated so he aggregated the data and hired a Physics team to conduct the calculations. After several weeks the UVGI scientific calculator was made. He also knew that current products on the market being sold were highly ineffective due to both low power or the complete lack of UVGI. The COVID-19 virus is 125nm and can easily pass through the HEPA filter pores of 300nm. UVGI was needed at sufficient power to deactivate all airborne viruses. Some viruses are significantly more resilient to UV-C than coronavirus. The reflection of the surface of the metal wall reduced the irradiation within the chamber considerably so a reflective material was searched for. Nicolas landed on Porous PTFE from Porex that can reflect up to 97%. Upon speaking to Porex and reading their report he begged for the thicker material that was not commercially available that could reflect at 99%. Porex stepped up and sent a sample that they do not commercially sell.
Now the effectiveness of the system allows the air to be vented directly back into the room the TNPI resides without safety concern or used in areas where ventilation is not available such as field hospitals. This level of effectiveness was not available prior. The construction of the AP units can be built by HVAC fabricators around the US with commonly used materials. The final assembly can be done on-site by the healthcare maintenance staff.
Covid Clean estimates that for less than the cost of the $600Million to clean masks for multiple reuses, complete mobile isolation units can be deployed adding over 60,000 additional isolation rooms to the US 42,000 capacity. These systems, when used in surgical operations, could save the US billions per year in healthcare-associated infections and many lives.
The system is designed to clear overhead equipment in hospital rooms and allow the movement of beds in and out by surpassing minimum hospital entry width regulation by up to one foot. The system by its nature is a viable option to use in rural areas in the US and throughout the world. The system requires a supply of electricity of 1800W which can be split into two power sources. Most rooms in the world can supply this amount without special electrical engineering. On the low end, the system only needs less than half this power. When a new virus occurs in the future these systems can be deployed quickly to isolate, slow, or even stop a global pandemic from occurring potentially saving the world Trillions.
Conclusion
The Covid Clean UVGI-AP-TNPI is a solution that deserves considerable attention and funding. The vast return on investment is obvious.
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