One of the major shifts in design that COVID-19 has shot up is definitely the focus on the management of buildings for the protection of occupant health. The research conducted by Infection Control Today shows that much indoor air management systems are not effective and putting people in danger. There are various ways of determining the connection between human health and indoor air management.
The pandemic has shifted our gaze to the ways in which buildings can effectively protect us from the disease. It has always been of critical importance, but at present, people are now paying attention to the significance of managing the building for the prevention of health issues.
Keys to improving airflow within the hospital building
In almost all buildings, airflow is generally managed by everyone from engineers to architects to facility managers except the clinicians. But indoor airflow leaves a lot of scope for preventing and reducing transmission of viruses and infections. Primary considerations that offer special attention to airflow within the building are maintaining high volumes of air exchange, keeping up the negative pressure in Airborne Infection Isolation Room or AIIR with respect to surrounding areas, protocols for entering AIIR, proper monitoring and adjustment of relative humidity, air filtration and safety of power supply within the establishment.
Responsibilities of healthcare facilities
The CDC has provided detailed guidance and regulations for reducing the scope of infection. In order to follow them, healthcare facilities should closely observe their protocols for infection control and isolate patients afflicted with symptoms of coronavirus or other respiratory problems. Patients should also wear protective masks until the time they are staying in AIIR. Other than this, there are other areas that require close monitoring and control. Some of these are:
- Maintaining the right air change rate: Though most viruses are transmitted through droplets, it is not clearly known how long coronavirus remains airborne. The airflow in a building along with the air exchange rate alone will not have a significant impact on transmission unless there is evaporation which can turn droplets into an aerosol. Therefore, precautions should be taken for ensuring high volumes of air change.
- Keeping the pressure in negative: It is of critical importance to make sure that airflow is maintained in the right vector. The AIIR must be kept at negative pressure and should be constantly recorded and monitored. If there are any unworthy changes, then local staff should be informed immediately. Many instances of infection have taken place when there is a reversal of pressure owing to the frequent door opening.
- Controlling the access to AIIR: It is very important to control the access to AIIR for keeping a record of the individuals who have access to the AIIR room for providing an airlock for maintaining pressure. It is achieved through enabling a greater level of access control system so that strictly authorized persons can only enter the facility. The airlock is also a very important aspect of providing an anteroom where healthcare professionals can use their PPE. By ensuring that both the doors are not open simultaneously, the pressure is left intact.
- Controlling humidity and temperature: The function of HVAC is providing optimum conditions for patients but these factors also have an influence on the growth of bacteria and viruses. In a recent study, it is found that as the impact of absolute humidity in spreading coronavirus is not yet confirmed, the result shows that there is no surety that it will lead to diminishing results.The AIR must have 24×7 monitoring of relative humidity and temperature though other areas within the hospitals may not have similar levels of monitoring. Generally, humidity is measured at the exhaust of any area. With IoT sensors, it is becoming easier to provide room-level monitoring of essential parameters. This offers a more detailed analysis for infection control teams for use identifying zones where humidity may have an influence on bacteria or viruses.
- Ensure proper filtration: The particle size of the virus is extremely small and therefore, optimum filtration is required to make sure that they don’t get transmitted from one place to another. It is very important to make sure that the air circulated within AIIR does not find a way to other areas within the building but is directly exhausted outwards. HEPA filters are required for the effective removal of extremely tiny particles. The facility managers must ensure that the filters are changed when there is a pressure drop.
For healthcare facilities that do not have many numbers of AIIR, patients must be isolated in the exam rooms with closed doors. Some healthcare facilities also have access to triage rooms which can be mechanically converted to negative rooms if required. For those facilities that lack high-end mechanical systems, other engineering controls can be applied. The response that is taken during the crisis should be properly coordinated with healthcare professionals for ensuring that all members can work safely using the right measures.