A Containment Device to Protect Health Care Personnel from Infectious Aerosols

Background: Respiratory infectious diseases adversely impact respiratory health of military Service members, potentially disrupting military operations. People with respiratory infections can release respiratory pathogens in respiratory aerosols during normal activities like breathing, talking, and coughing, and during medical procedures. These respiratory aerosols can result in environmental contamination, putting others at risk of infection. There is a need to implement a new strategy for infection prevention - a strategy that reduces the emission of respiratory aerosols containing respiratory pathogens from the infectious person into the environment. Rationale: The COVID-19 pandemic has prompted the development of a variety of aerosol "boxes" and "tents" intended to reduce healthcare personnel exposures during medical procedures, but these designs have been found to restrict movements of healthcare personnel, increase procedure time and errors, and have not been subject to robust performance testing. This study will address deficiencies of these devices through the University of Utah Containment Ventilation for Exposure Reduction (U-COVER) system, a compact, portable ventilation system with a hood to surround the head and upper body of the infectious person, and a fan that draws air from inside the hood, passing it through a high-efficiency particulate air filter before discharge into the environment. The hood will capture and contain respiratory aerosols that would otherwise enter the environment. Hypothesis: We hypothesize that a compact, portable system (U-COVER) providing local ventilation surrounding the head and upper body of an infectious patient and that exhausts filtered air can reduce environmental contamination from and exposures to respiratory aerosols by > 99%, while enabling healthcare personnel to perform necessary medical procedures. Specific Aims: Two specific aims are proposed and are linked through an interactive, user-centered design process that incorporates the principles of human factors. The U-COVER system must be usable by healthcare personnel and patients, and effective at its intended purpose of reducing environmental contamination and exposures of healthcare personnel. (1) Develop a ventilated, air filtering droplet containment and aerosol elimination system tailored to four use scenarios. The four use scenarios are: emergency and trauma care invasive procedures, intensive care with aerosol-generating respiratory support systems, dental procedures, and respiratory isolation. (2) Evaluate the effectiveness of droplet containment and aerosol elimination of the novel systems. Long-Term Impact to Relevant Research Field and Patient Population(s): The adoption of easy-to-use, effective source controls to limit the emission of infectious respiratory aerosols will revolutionize infection prevention practices, and enable prevention of environmental contamination by respiratory pathogens from infectious persons in diverse settings. Relevance of the Project to One or More Focus Areas: U-COVER is responsive to the FY20 PRMRP Focus Area for Respiratory Health because the system will prevent the transmission of COVID-19 and other respiratory pathogens in aircraft, ships, and submarines. Quantitative microbial risk assessment will demonstrate the impact of U-COVER on pathogen transport and fate as well as infection risk among susceptible persons nearby infectious cases. Less