Coronavirus Technology Solutions

May 4, 2020

Testing with Sartorius Filters in Singapore Hospital Shows Virus Deposition in Vents

STARC Systems to Provide Critical Isolation Rooms

Portafab Supplies Temporary Isolation Rooms

Healthmark Provides Tags, Labels, Trolleys for Reprocessing N95 Masks but also Cooling Accessories

Ortner Furnishes Fan Filter Units for Retail Check Out

Ortner Furnishes Three Way Airlock H2O2 Decontamination System

Partitions Without Laminar Air Flow May Increase Virus Transmission

Octanorm Supplies Partitions for a Large London Emergency Hospital

Telstar’s Micro Biosafety Cabinets are Suitable for the Manipulation of Samples with Biological Risk Level 3

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Testing with Sartorius Filters in Singapore Hospital Shows Virus Deposition in Vents

From January 24 to February 4, 2020, three patients at the dedicated SARS-CoV-2 outbreak center in Singapore in airborne infection isolation rooms (12 air exchanges per hour) with anterooms and bathrooms had surface environmental samples taken at 26 sites. Personal protective equipment (PPE) samples from study physicians exiting the patient rooms also were collected. Sterile premoistened swabs were used.

Air sampling was done on two days using SKC Universal pumps (with 37-mm filter cassettes and 0.3-μm polytetrafluoroethylene filters for 4 hours at 5 L/min) in the room and anteroom and a Sartorius MD8 microbiological sampler (with gelatin membrane filter for 15 minutes at 6 m³/h) outside the room

Specific real-time reverse transcriptase–polymerase chain reaction (RT-PCR) targeting RNA-dependent RNA polymerase and E genes⁴ was used to detect the presence of SARS-CoV-2 .

Samples were collected on five days over a two week period. One patient’s room was sampled before routine cleaning and two patients’ rooms after routine cleaning. Twice-daily cleaning of high-touch areas was done using 5000 ppm of sodium dichloroisocyanurate. The floor was cleaned daily using 1000 ppm of sodium dichloroisocyanurate.

Clinical data (symptoms, day of illness, and RT-PCR results) and timing of cleaning were collected and correlated with sampling results. Percentage positivity was calculated for rooms with positive environmental swabs. Institutional review board approval and written informed consent were obtained as part of a larger multicenter study.

Patient A’s room was sampled on days 4 and 10 of illness while the patient was still symptomatic, after routine cleaning. All samples were negative. Patient B was symptomatic on day 8 and asymptomatic on day 11 of illness; samples taken on these two days after routine cleaning were negative

Patient C, whose samples were collected before routine cleaning, had positive results, with 13 (87%) of 15 room sites (including air outlet fans) and 3 (60%) of 5 toilet sites (toilet bowl, sink, and door handle) returning positive results Anteroom and corridor samples were negative. Patient C had upper respiratory tract involvement with no pneumonia and had 2 positive stool samples for SARS-CoV-2 on RT-PCR despite not having diarrhea.

Patient C had greater viral shedding, with a cycle threshold value of 25.69 in nasopharyngeal samples compared with 31.31 and 35.33 in patients A and B

Only one PPE swab, from the surface of a shoe front, was positive. All other PPE swabs were negative. All air samples were negative.

There was extensive environmental contamination by one SARS-CoV-2 patient with mild upper respiratory tract involvement. Toilet bowl and sink samples were positive, suggesting that viral shedding in stool⁵ could be a potential route of transmission. Post cleaning samples were negative, suggesting that current decontamination measures are sufficient.

Air samples were negative despite the extent of environmental contamination. Swabs taken from the air exhaust outlets tested positive, suggesting that small virus-laden droplets may be displaced by airflows and deposited on equipment such as vents. The positive PPE sample was unsurprising because shoe covers are not part of PPE recommendations. The risk of transmission from contaminated footwear is likely low, as evidenced by negative results in the anteroom and clean corridor.

This study has several limitations. First, viral culture was not done to demonstrate viability. Second, due to operational limitations during an outbreak, methodology was inconsistent and sample size was small. Third, the volume of air sampled represents only a small fraction of total volume, and air exchanges in the room would have diluted the presence of SARS-CoV-2 in the air. Further studies are required to confirm these preliminary results.

Significant environmental contamination by patients with SARS-CoV-2 through respiratory droplets and fecal shedding suggests the environment as a potential medium of transmission and supports the need for strict adherence to environmental and hand hygiene.

Published Online: March 4, 2020. doi:10.1001/jama.2020.3227

STARC Systems to Provide Critical Isolation Rooms

STARC Systems, a manufacturer of temporary modular wall containment systems used for occupied renovations, has been deemed “essential” and will refocus all production on instant isolation solutions to dramatically increase the number of units available for healthcare facilities throughout the country, helping to protect more healthcare workers and patients and reduce the spread of COVID-19.

Typically, STARC Systems modular wall solutions are used in occupied healthcare renovations to eliminate dust, debris, and pathogens from impacting patients and employees. Now, rather than keeping pathogens from escaping a construction site, these panels are used to eliminate the spread of COVID-19 by creating instant negative pressure isolation anterooms and airborne infection isolation rooms (AIIR).

“For years we have relied on STARC Systems solutions to provide a safe environment for healthcare workers and patients during health healthcare facility renovations,” said Brian Hamilton, Director of Healthcare and Life Sciences, Consigli Construction. “Now, STARC has become critical in our response to provide hospitals with immediate patient isolation rooms to reduce the spread of coronavirus. These rooms allow overflowing healthcare systems or entirely repurposed facilities to separate patients who are sick from other patients and healthcare workers who are not.”

STARC Systems’ isolation rooms exceed the ICRA Class IV and ASTM E-84 healthcare requirements for infection control and fire/smoke spread and its surfaces are easily disinfected. They have continued to be used at national healthcare facilities, such as Massachusetts General Hospital, Cleveland Clinic, and Seattle Children’s in occupied renovations to meet the highest infection control standards.

Portafab Supplies Temporary Isolation Rooms

Whether  to create a standalone airborne infection isolation rooms with anterooms or wall temporarily quarantine entire sections or floors of a hospital, PortaFab offers solutions for clean, quick construction.

• Hospital Isolation Walls
• Patient Rooms
• Nurses Stations
• Anterooms
• Hospital Testing Facilities
• Triage Centers
• Temporary Hospitals in Convention Centers
• Deployable Shelters
• Multi-Purpose Facilities

Healthmark Provides Tags, Labels, Trolleys for Reprocessing N95 Masks but also Cooling Accessories

Healthmark provides  ways to beat the heat within the SPD or Operating Room with  lightweight, latex free cooling devices. Simply submerge the head gear or neck band in cold water for 2-3 minutes, and the enjoy hours of cooler temperatures. For additional heat relief, pair in one of the Cool Aids vests, which utilize cold packs core body cooling.

Healthmark provides custom labeling solutions to fit a variety of customers’ needs. As facilities have started to reprocess N-95 masks, they’re looking for ways to clearly identify those that have gone through the decontamination process. One of the custom labels created for a customer is a small 5/6” x 1 ¼” green “CLEAN” label with removeable adhesive that can put on masks after reprocessing and removed prior to reuse.

Due to supply shortages, many facilities are reprocessing N-95 masks after use. In order to transport the high volume of these masks, a customer is using  2220 trays and trolleys, traditionally designed for flexible endoscope transport, to transport them between the point of use and the Sterile Processing Department.

With UV disinfecting systems being used for new purposes and used more frequently, customers are finding the UV Indicators (UVI-001) a useful tool to verify the use of such systems.

Ortner Furnishes Fan Filter Units for Retail Check Out

Ortner Cleanroom Unlimited” has been dealing with comprehensive cleanroom technology for more than 30 years and across all industries: from pharmaceutical, medical, BSL (“Bio Safety Level”) high-security laboratories and food production to the mechatronics, electronics, and microelectronics sectors. For around 20 years now, Ortner Reinraumtechnik GmbH has specialized in the development and manufacture of equipment, systems, and processes for creating microbiological and particulate cleanliness.  This is now applied to mitigating coronavirus in many applications including retail checkout

The system draws in the room air at the top and blows the filtered particle- and germ-free air in a quiet, low-turbulence piston flow over the individual and the checkout zone.

The aseptic air flows out over the employee at a flow rate of approx. 0.2m/s and envelops the employee in a protective cover. This current is usually not perceptible to humans, does not usually cause draughts, and is established as an international state-of-the-art technology.

The low-turbulence laminar flow flows freely over the employee into the adjacent room and thus suppresses possible contamination. The air is transported from the ground back to the suction point of the laminar flow system before being filtered and reinjected in recirculation mode.

Due to the high air volume (per system approx. 600 –1000 m³/h) and the permanent filtering to 100 % sterility, the entire room is extensively cleaned. This creates additional protection in the entire environment. The laminar flow systems can be designed as pure air modules or with options such as LED lighting (open green / closed red), freely selectable coatings, design elements, or advertising lettering.

The laminar flow system also offers protection in other times of risk, such as for flu and influenza, pollen allergies, or other contagion hazards. The described effects continuously clean the room air of fine dust and pathogens.

https://www.ortner-group.com/en/latest-information.php

Ortner Furnishes Three Way Airlock H2O2 Decontamination System

The Kantonsapotheke Zürich is one of the leading hospital pharmaceutical competence centres in Switzerland. The focus is on the use of the latest technologies for the production of remedies. For the new building at the Kantonsapotheke Zürich a 3-way H2O2 decontamination airlock with integrated laminar flow was developed by Ortner Reinraumtechnik.

H2O2 airlocks are among the most practical decontamination systems in the life science and pharmaceutical sectors. The environmentally friendly H2O2 technology allows an almost unlimited application for material-friendly lock processes. Based on past experience and innovative plant engineering, H2O2 lock technology is a very safe decontamination method and is "state of the art" today. In addition to perfecting H2O2 input and output, Ortner has been working in recent years on the development of high-performance compact systems. Thanks to this system development, safe and flexible H2O2 solutions are available for a wide range of applications.

The special feature of the installed H2O2 decontamination airlock was to construct a 3-way airlock in order to safely guarantee the loading situations for all 3 infeed and outfeed directions. The challenge here was, despite the 3-way solution, to ensure the best possible distribution of the hydrogen peroxide via additional ceiling nozzles.

In order to be able to reproduce the complex production process easily for daily use, a comprehensive decontamination concept was developed and introduced. Together with the Kantonsapotheke Zurich, the monitoring system was developed and integrated to meet the specific challenges of the pharmacy. The user can now select different loader recipes for different loading conditions. A validated system was handed over.

For the Cantonal Pharmacy of Zurich it was a great challenge to define the exact loading situations in advance. Because the fact is: Optimized cycle development and validation is only possible if the batch carts are always consistently loaded. In this project, Ortner was able to achieve a fast cycle of approximately 30 minutes for the loading conditions glass and metal containers. For the plastics (overpacked Petri dishes, overpacked disinfectant containers, PE bags, etc.) a cycle time of less than 60 minutes could be achieved through optimal distribution logistics on the loading carts. The total cycle time is mainly influenced by the absorption behavior of the objects, especially of plastics in the airlock. This means that the most critical time factor is in the aeration phase, as the airlock can only be unloaded again when the prescribed mak value of < 0.5 ppm is reached.

Various materials show a strong absorption of airborne hydrogen peroxide during the decontamination phase.

This is followed by a long desorption phase during the ventilation of controlled environmental conditions such as an H2O2 airlock. A clumsy choice of material or an incorrect loading configuration can therefore possibly lead to a very long ventilation phase. This phenomenon is one of the main reasons for the discrepancy between theoretical and real values when estimating the aeration phase of a plant to be decontaminated with hydrogen peroxide. For this reason, our design of decontamination plants is based on a special simulation program, by which e.g. the placement of the injection areas for hydrogen peroxide can be defined exactly in advance. Thus, a very precise indication of the expected cycle times can be realized.

As with any decontamination project, in the final phase a cycle validation and all necessary measurements using chemical and biological indicators were performed to provide evidence of a log-6 reduction. Sterility testing as well as weld seam testing and weld seam documentation were part of the qualification in order to meet the GMP (Good Manufacturing Practice) requirements.

To determine the "decontamination value", i.e. the time period during which a biological indicator is inactivated in a quantum region based on a series of experimental data, Ortner uses the "Limited-Holcomb-Spearman-Karber method".

To carry out this procedure, an exposure time must be evaluated in advance. This is divided into several time ranges of equal size, whereby all three time ranges of the survival curve of the biological indicator must be covered:
- The survival time (all survive);
- The Survival-Kill Window (mixed);
- The kill time.

Ortner  used this scientific method to verify the bio-indicators used and to determine the D-value for each sample location of a load. The biggest advantage of this method is the reliable determination of the shortest possible cycle time, e.g. for H2O2-locks with high throughput density.

Partitions Without Laminar Air Flow May Increase Virus Transmission

Where social distancing isn’t possible, temporary partitions help protect production associates at Perdue Farms’ Milford, Del., facility.  This could actually increase the transmission rate.

It depends on the air flow patterns.  McIlvaine has a recorded video explaining why partitioning has to be part of a laminar flow pattern and not an obstruction to it. Solutions such as Ortner has provided for checkout counters can be applied to food processing lines.

Octanorm Supplies Partitions for a Large London Emergency Hospital

The new 4,000-bed Nightingale emergency hospital in London was opened recently but it is hoped it will not be needed as urgently as previously thought because hospitals in the capital are coping better with the coronavirus.

It had been thought that intensive care units in London would be overflowing by this point, but political sources said they had been told the capital’s hospitals were three-quarters full, which is better than expected.

In a highly praised high-speed build involving an unprecedented partnership between the NHS and the Ministry of Defense, the vast ExCeL conference centre in east London has been converted into a hospital, Ready To Take Up To 500 Patients In The First Wave.

Telstar’s Micro Biosafety Cabinets are Suitable for the Manipulation of Samples with Biological Risk Level 3
 
The recent emergence of coronavirus 2019-nCoV in Wuhan has led research centers to work in-depth to find potential antivirals or vaccines to treat or prevent novel coronavirus infection. Given the rise in demand of the specific technological equipment to address these research processes, the company has reinforced the production of Bio II Advance Plus and BiOptima, the new generation of Class II Microbiological Safety Cabinets (MSC) designed for use in high-risk microbiological research and high toxicity applications in laboratories and hospitals, to ensure the maximum level of operator protection.
 
The coronavirus nCoV2019 is a specimen identified as a biological agent in risk group 3 therefore it must be handled in Class II type A2 Biological Safety Cabinets within a safety level 3 (BSL-3) containment laboratory environment. Biosafety Level 3 pathogenic agents are those microorganisms that can cause serious illness in humans and as such constitute a grave danger to personnel, with a high possibility of transfer to other people who, nevertheless, responds positively to an effective treatment or prophylaxis.
 
The Telstar Class II Microbiological Safety Cabinets intended for the manipulation of microorganisms with biological risk levels 2 and 3, the Bio II Advance Plus and BiOptima, offer such high-efficiency biological protection that prevents direct contact between the sample and the operator. They have been designed in accordance with the European EN 12469 standard for Microbiological Safety Cabinets and certified by TUV Nord in Hamburg (Germany).
 
BiOptima provides operator protection with the inflow air barrier, product protection thanks to HEPA-filtered laminar downflow in the working area and environmental protection through the exhaust HEPA filter. Furthermore, the compact Bio II Advance Plus has been designed to offer the highest level of safety for the product, the operator and the environment. With maximum containment capability it always guarantees to provide maximum safety.
 
All these series not only conform to the EN 12469 standard on Class II biological safety cabins (30% exhaust, 70% recirculation unit), but also comply to the main requirements assigned by NSF / ANSI 49 (Class II A2), JIS K 3800, SFDA YY-0569 and AS 2252.
 
Telstar also specializes in the development of integrated solutions for biological containment areas (P3) and mobile biosafety units.