Coronavirus Technology Solutions

May 6, 2020

 

New Coronavirus Strain Creates Challenges

Do we Need Masks with Valves for Certain People and Certain Situations?

Filtration Webinar on May 5 also Provides Coronavirus Insights

Signature Health Care is Using UV to Sterilize Masks

Turkey has the best EU ICU Capacity at 40 beds per 100,000 People

Pressure Sensors are Important to Keeping Rooms Isolated

CWS Provides Guidance on Coronavirus for Cleanroom Operators

Should Cleanroom Operators Treat Coronavirus as Part of a Box Within a Box?

Cigarette Smoke is Similar in Particle Size to Some of the Coronavirus Aerosols

Modify Restaurants and Subways as if you are Protecting Against Cigarette Smoke

China is Expanding Meltblown Capacity Rapidly but with Difficulty Controlling Quality

Cloth Masks do not Protect Wearer or Others

Restaurant Air Flow has to be Redesigned  to Allow Them to Open Safely

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New Coronavirus Strain Creates Challenges

A new, recently discovered strain of the coronavirus has a leading researcher concerned that it will present a difficult challenge to the vaccines currently under development.

Dr David Monterfiori of Duke University was involved in a study with a team out of the Los Alamos National Laboratory that has identified the new strain. They said the new strain may be more contagious but is no more deadly the other strains of illness.

A viable vaccine is one of the key elements toward responding to the disease in the future and several tests are currently in process. Many researchers believe another severe COVID-19 outbreak could take place this fall including UCSF epidemiologist Dr. Gene Rutherford. “We’re gearing up now, our big concern is about a second wave in the fall,” he told KPIX 5.

Monterfiori’s research may indicate that the illness will be driven by the new strain and that it is already here. It became very evident that this new mutant form of the virus was spreading rapidly,” he said. The mutation involves the spikes that stick out from the surface of the virus. “That’s how it attaches to cells and gets into cells,” Monterfiori said.

If you are already infected with COVID-19, that’s the spot where the antibodies would block the virus from infecting you again. But your body’s reaction may not be strong enough when it comes to the new strain. Monterfiori worries about how it will impact how a vaccine under current development may combat the illness. “That’s the protein that’s in all the vaccines right now,” he said. “And so we’re concerned that the mutation in this new form of the virus will be a problem for the current vaccines.”

Do we Need Masks with Valves for Certain People and Certain Situations?

Two Chinese boys dropped dead within a week of one another while wearing face masks during gym class. The students, who were both 14, were each running laps for a physical examination test when they suddenly collapsed on the track. One student at Changsha’s Xiangjun Future Experimental School in Hunan province had been wearing an N95 respirator and running a 1,000-meter exam when the fatal incident occurred. It’s unclear whether an autopsy had been ordered.

Though it’s not known whether the masks played a role in either death, several schools in Tianjin and Shanghai have canceled physical education exams, according to the report.

These incidents raise the question as to whether N95 masks with valves should be substituted for those without valves under certain conditions.  One would certainly be heavy exertion. Another would be individuals who have underlying conditions e.g. asthma where breathing is more difficult that it would be for the average person.

Filtration Webinar on May 5 also Provides Coronavirus Insights

A webinar held by the Waterloo Filtration Institute on Tuesday  provided a good summary of the filtration industry and brief insights on the coronavirus challenge by Paul Marold, president of Lydall, and Val Hollingsworth, CEO of Hollingsworth & Vose. Bob Mcilvaine was also a speaker.  Details are found at

https://www.wfinstitute.com/

Signature Health Care is Using UV to Sterilize Masks

Signature Healthcare Brockton Hospital is using ultraviolet light to sterilize and reuse N95 masks to care for patients, including those who have tested positive for the coronavirus.

Under normal circumstances, hospital staff wouldn’t reuse personal protective equipment, said Stephen Borges, vice president of operations for Brockton Hospital. But given the increased need for gear to treat coronavirus patients and a nationwide shortage of it, the hospital wanted to find a way to reprocess masks and make them available to staff.

“The fact that we’ve processed them and packaged them up makes it a little easier to reuse them,” he said. “It gives the staff some sense ... It’s not optimal, but it’s much better to be able to reuse the masks and that the equipment to do this is available,” said Borges.

But given the increased need for gear to treat coronavirus patients and a nationwide shortage of it, the hospital wanted to find a way to reprocess masks and make them available to staff.

Turkey has the best EU ICU Capacity at 40 beds per 100,000 People

Turkish health care, armed with a pandemic preparedness plan issued long before the outbreak emerged in the region, has been hailed by experts for offering a good, timely response to the pandemic. Turkey also boasts an intensive care unit bed capacity that is the largest in Europe, with 40 beds per 100,000 people.

Recently, the country started unveiling new hospitals whose construction was accelerated to help combat the outbreak. Last month, the Başakşehir City Hospital in Istanbul was partially opened to serve as a pandemic hospital while construction of two new hospitals in the city, each with a 2,000-bed capacity, was launched last month. The construction is expected to wrap up in 45 days. Also in March, authorities unveiled a new hospital in the city’s Okmeydanı district with more than 600 beds and 99 high-tech intensive care units.

Sancaktepe Şehit professor İlhan Varank of the Istanbul Training and Research Hospital is among those facilities turning to negative pressure rooms to further stem the tide of the virus. The pandemic hospital admitting the greatest number of patients in Istanbul, the facility is staffed with 1,900 personnel working day and night and has converted a significant number of areas, including 16 surgery rooms and 75 intensive care beds, into negative pressure rooms. The rooms offer a relief for the staff of the hospital, which has admitted nearly 60,000 patients since March, including about 11,000 suspected coronavirus cases. Along with handling a barrage of COVID-19 patients, staff have continued to carry out surgeries, including on those suspected of having the virus. So far, about 300 patients, suffering from other diseases have been operated on.

Pressure Sensors are Important to Keeping Rooms Isolated

Many facilities are geared to meet minimal CDC and Joint Commission guidelines around isolation rooms. However, there is a huge opportunity for hospitals to update the technology that ensures proper isolation room pressurization. One of the most resourceful methods to verify pressure measurements is through real-time pressure monitoring and alert notifications.

 

The SensoScientific Differential Pressure Monitoring System is designed to meet CDC, USP, ISO/IEC, and Joint Commission compliance standards. The latest OTA Series Differential Pressure Sensors enter a low-power mode between readings, ensuring accuracy, reliability, and product longevity.

These devices piggyback off  existing Wi-Fi to upload readings to SensoScientific Cloud, accessible from any internet-ready device. Through the cloud, the user can access unlimited data records, generate reports, view calibration certificates, and receive 24/7 alert notifications the moment isolation room pressure exceeds the recommended threshold.

Loggers can be installed according to IQ/OQ/PQ standards and are a low maintenance solution to pressure monitoring and regulatory compliance.

 Positive and negative airflow

 Range: +/- 0.5 inH2O

 Accuracy: +/- 0.01 inH2O

 Uni- and bi-directional pressure measurement

 Real-time alert notifications

 IQ/OQ/PQ compliant

 ISO/IEC 17025

Differential Pressure monitoring systems help prevent the spread of infectious diseases and maintain sterile work environments by actively measuring pressurized airflow between a positive or negative buffer room and the ante-room. Wide-range wireless differential pressure sensors monitor bi-directional and unidirectional pressure and use Wi-Fi to send information to the cloud. It  notifies  via email, SMS text, voicemail, fax, or pager when negative or positive pressure rooms are not maintaining proper readings.

 

https://www.labmate-online.com/news/laboratory-products/3/sensoscientific/keeping-hospitals-safe-from-covid-19-remote-differential-pressure-system-for-negative-pressure-isolation-rooms/52028

CWS Provides Guidance on Coronavirus for Cleanroom Operators

The CWS Cleanroom blog observes that the coronavirus SARS-CoV-2 poses great challenges for cleanroom operators. Particularly in cleanrooms, it is important that viruses and bacteria cannot transmit via employees or their clothing. But can this really be achieved? Where are the pitfalls and how can they be countered? Dr. Rüdiger Laub, Head of the Cleanroom Academy was interviewed  to provide the following information.

Dr. Laub, is it possible to prevent SARS-CoV-2 from entering the cleanroom?

No - the penetration of viruses into cleanrooms cannot be completely prevented.

However, much can be done to prevent the virus from finding its way into the cleanroom - for example, by wearing appropriate cleanroom clothing and accessories such as goggles, gloves and other protective materials. And of course, making cleanroom users aware by training and instruction. The risk potential is highly dependent on their behavior. However, even with the utmost caution, there will never be 100% safety. Because the weak point is the cleanroom user. Due to the long incubation period, employees could potentially carry the virus, and thus transmit it while not feeling ill, or perhaps haven't felt any symptoms yet.

Provided that sufficient testing capacity is available, cleanroom personnel could be tested preventively in so-called "critical infrastructures" - for example, in cleanrooms of hospital pharmacies - at very short intervals or if suspicion exists. Basic principle: Early detection - early removal from processes - reducing risk.

Let's move on to the topic of prevention: What additional protection options do you currently recommend for cleanroom personnel to prevent the coronavirus from being transmitted into the cleanroom?

Basically, the airlock processes, cleanroom clothing, behavior, as well as robust cleaning and disinfection measures form very effective barriers against the penetration of viruses; however, SARS-CoV-2 is particularly treacherous and demands further measures.  In this exceptional situation, more protection is advisable. I therefore recommend the following supplementary measures to keep the risks to a minimum: As a matter of principle, only one person should currently be in the airlocks leading directly to the production areas.  Another starting point is protective clothing - for example face protection. This should now also apply in the cleanroom classes where this is currently not provided as standard - i.e. also in the GMP cleanliness classes D and C / ISO cleanliness classes ISO 9 to ISO 6. Since the virus can be spread further via the hands, gloves are currently also a must in all cleanrooms - even if it is not provided for the normal protocols for that cleanroom class. Additional protection is provided by cleanroom wipes, which can be used to clean surfaces and other items as required.

The remainder of this interview can be found at

https://www.cws.com/en-IE/news/how-keep-coronavirus-out-cleanroom-interview-dr-rudiger-laub-2020-04-21

Should Cleanroom Operators Treat Coronavirus as Part of a Box Within a Box?

The CWS interview with Dr Laub talks about certain measures for coronavirus mitigation to be taken prior to entering the cleanroom such as masks and a procedure to pass through the initial airlock. Should operators be thinking of the cleanroom as a box within a box? The big box is the Class 500,000 area surrounding the cleanroom. What if this is reduced to Class 100,000?  What if every employee in street shoes has to step on a UV/Ozone foot sanitizer? What if the mask protocol in the larger box and in travel to and from work is coordinated with a mask exchange program at the plant entrance?  As the McIlvaine Alert shows, an N95 quality mask is needed due to the fact that much of the virus transmission is through small aerosols. So the Cleanroom operator can provide masks for travel to and from the cleanroom.

Cigarette Smoke is Similar in Particle Size to Some of the Coronavirus Aerosols

In an AFS publication, Wilson Poon of W.L. Gore provided analysis of cigarette smoke particle size.

Cigarette smoke is an important aerosol in the air filtration industry and research. It is an unwanted aerosol and therefore there are many applications for air filtration (ex. cigarette filters, residential and commercial ventilation filters, home air cleaners).

Cigarette smoke is especially important to air filter performance for several reasons. First, the size of cigarette smoke particles are near the most penetrating size of air filters (100-300 nm). As a result, they are relatively difficult to capture. Secondly, the efficiency of electret filter is severely degraded by the semi-volatile cigarette particles. It is believed that they form a film on the fiber surface and effectively shield or remove the charges. If this occurs, the electrostatic efficiency of the filter suffers. The remaining mechanical efficiency is usually poor because electret is a depth filter and the fiber size is relatively large. Furthermore, a cigarette can produce a large amount of aerosol quickly. Imagine a room with several cigarette smokers! Whereas large particle (>5 micrometer diameter) tends to settle down by gravity quickly, cigarette smokes are relatively stable and their lifetimes can be on the order of days or weeks. Therefore, cigarette smoke can be viewed as a stringent test for air filters.

The paper linked below provides  the results of particle size measurements done by previous researchers. The count median particle size is between 0.1 to 0.3 μm, near the most penetration particle size of high efficiency particulate arrestor (HEPA) filters. For depth filtration media like microfiberglass, the loading of smoke particles would not be detrimental because the oil droplets can wet the fibers and spread out. For microporous membrane, the loading of smoke particles can have a detrimental effect on the pressure drop. Due to surface filtration, the oil droplets are collected near the surface. As the oil accumulates on the surface, it chokes off the airflow. It is therefore not recommended to use microporous membrane in environments with cigarette smokers.

https://www.afssociety.org/cigarette-smoke-size-distribution-and-effects-on-filters/

Modify Restaurants and Subways as if you are Protecting Against Cigarette Smoke

McIlvaine has questioned the CDC guidance to meat processors to install partitions around workers. Further questions are raised about social distancing due to the small size of coronavirus aerosols. The article above analyzes the size of cigarette smoke. Numerous articles in this Alert  show that a significant quantity of virus is transmitted in aerosols or on particles of similar size to cigarette smoke.  McIlvaine summarized this in Laminar Flow Not Partitions and Masks Not 6 ft Distance are the New Recommendations

It is well understood that cigarette smoke will move around partitions and drift much farther than six feet. Unidirectional flow, HEPA filters and N95 masks are the answers for many situations.  One would be subway stations.

Ban smoking at outdoor restaurants in Sweden' - The Local

Another would be restaurants where the guidance has been to reduce occupancy to 25 percent.  As can be seen from the smoke filled bar below, distancing is not an effective solution.

Opinion: Why Germany needs to take the smoking ban more seriously ...

In a study of coronavirus transmission in a restaurant in Southern China the biggest factor was the air flow pattern. Those far away from the transmitter but in the air flow pattern of the air conditioner became infected. Those close but not in the air stream did not. So the answer is HEPA filtration and unidirectional air flow away from individuals such as vertical downward flow. Restaurants could invest in a few fan filter units at $2k each and seat more people at less risk.

China is Expanding Meltblown Capacity Rapidly but with Difficulty Controlling Quality

In China, the largest exporter of medical masks in the world, about 4,000 new companies have registered to manufacture or trade melt-blown fabric since the beginning of the year, according to Tian Yan Cha, an online service tracking companies' credits and registries. Last year, only about 300 new companies registered melt-blown businesses. 

Yangzhong, a city of about 340,000 residents in Jiangsu province, became a marketplace for melt-blown fabric seemingly overnight.

Machines that used to produce other types of nonwoven fabric were converted to make the melt-blown fabric. Most of these machines came from nearby cities such as  Zhangjiagang, about 100 miles away from Yangzhong

Zhe Huang, who manufactured nonmedical masks in Zhangjiagang, said it’s not easy to make medical-grade masks. They require strict production conditions such as a dust-free work site and filters that meet medical standards.

To make the filter fabric, thousands of solid polypropylene granules are melted and extruded from nozzles into high-velocity hot air streams, forming fine filaments, “the size of your hair,” said Gajanan Bhat, who heads the Department of Textiles, Merchandising and Interiors at the University of Georgia. Those ultra-fine fibers are bonded and collected on a moving screen, becoming a sheet of webs. “It’s like a spider web; multiple layers of spider webs,” said Bhat, who has published extensive research on melt-blown fabric and the spunbond fabric that sandwiches it in masks.

By April 9, local media had caught on to what was happening in Yangzhong and took a critical stance: “The myth about being a billionaire from the melt-blown fabric encourages farmers to stop their farming, workers to quit their stable jobs and companies to throw away their reputation to join this gold rush,” the Yangzhong Daily Newspaper wrote on its front page.

Public signs of trouble for the startups appeared two days later, on April 11, in a news release from Yangzhong’s emergency management bureau. It accused a melt-blown company of violating the Production Safety Law of the People's Republic of China. The agency said the company didn’t post obvious safety warnings on its air compressor and hadn’t put its employees through safety training. 

The next day, the emergency management agency found a hotel in Jingkai District of Yangzhong had violated fire ordinances by using some of its rooms for manufacturing the melt-blown fabric. The hotel, it reported, was temporarily sealed up and under investigation.

Almost as quickly as the industry appeared in Yangzhong, it disappeared. Mounting concerns about the quality of the product brought its melt-blown fabric manufacturing to a grinding halt.

A 95% filtration rate is required for medical-grade surgical masks, according to the American Society of Testing and Materials. High protection masks such as N95s should have a rate of 98% or higher.

Yangzhong’s Administration for Market Regulation randomly tested fabric from eight manufacturers of melt-blown fabric in early April. When the agency's report came out, five of the samples met neither standard, and only two could be used for high-protection masks. Three were not even close, filtering out 45% or less.

On April 14, the city noted in a news release that it had been pushing to overhaul illegal melt-blown production since late March and issued warnings to 225 enterprises making or selling “three-no” textiles – products without production date, name of manufacture and sanitary certificate.

The next day, the city went further, shuttering 867 melt-blown businesses. Wei was surprised to see his hometown pop up as a hot search on Weibo for a post reporting that “#All Yangzhong companies that produce the melt-blown fabric shut down for rectification.” 

Wiping out the melt-blown industry in Yangzhong probably won’t be the end of it, according to dozens of experts in the industry contacted by USA TODAY, including manufacturers, investors and traders. The demand is too great.

Even as the city cracked down on all the fabric production, melt-blown makers loaded their machines into their car trunks and transferred them to nearby cities.

In February, the average retail price for the fabric in China increased tenfold, from 40,000 yuan per ton to 400,000 yuan per ton, according to China Merchants Securities. Before the COVID-19 pandemic, the market price for such fabric in China was 20,000 yuan – about $2,800 – per ton, according to China's State Administration for Market Regulation.

Masks that leave China through official channels go through extensive certification intended to prevent exports of substandard material. Entering the USA adds another layer of scrutiny.

There are other routes. Relatively small orders from individuals – or even larger organizations – can be sent through the mail.

A box of counterfeit masks destined for Texas was seized by the Cincinnati Border Patrol.

Last month 25,000 counterfeit masks from China were found at a DHL hub in Kentucky.

Cloth Masks do not Protect Wearer or Others

In an interview with Infection Control Today®, Lisa Brousseau, ScD, expert on infectious diseases said that the CDC’s suggestion that cloth masks offer any kind of protection flies in the face of the data. “It was clear that even surgical masks weren’t working in healthcare settings or controlling COVID-19,” Brousseau said. 

Brousseau also said: “Surgical masks, I decided, based on the literature, might have a role as source control for people who have symptoms. Say if they’re staying home and they have some symptoms. They shouldn’t be something you’d wear if you have symptoms going out into the public because you shouldn’t be going out into the public service. But it’s a good option for patients to wear in healthcare settings where they—especially for those who are experiencing symptoms—to what I would call diminish the viral load.”

She added that “at the end of the day, the only thing that provides personal protection for the person wearing the mask is a respirator.”

https://www.infectioncontroltoday.com/mask-respirators/cloth-masks-are-useless-against-covid-19

Restaurant Air Flow has to be Redesigned  to Allow Them to Open Safely

Previous McIlvaine articles discuss using ceiling fan filter units in the restaurant dining area and then downward laminar flow of HEPA filtered air. The extent to which  this air could move at floor level and then become part of the kitchen exhaust would be beneficial in terms of  minimizing viral contact.  Here is the system which has been offered by Trane and needs to be revised.