COVID-19 is a threat to the very people fighting it—nurses, doctors, and other first responders, who are exposed to virus-carrying droplets, or aerosols, from infected patients. Now, a team has developed two devices that could reduce their risks by sucking away infectious aerosols: a helmet to be worn by a patient, and a small tent in which a patient could be enclosed. The devices haven’t been proved to work in clinical settings, but their inventors hope they’ll reduce the toll among health care workers, at least 90,000 of whom worldwide have been infected with COVID-19, according to the International Council of Nurses.
Talking and coughing can expel virus-carrying droplets, and medical procedures needed for the sickest COVID-19 patients—such as intubation, tracheostomy, and cardiopulmonary resuscitation—are thought to generate even more aerosol droplets. The tent and helmet would capture them with negative pressure, generated by a pump that draws exhaled air through filters, researchers reported yesterday in the International Journal of Tuberculosis and Lung Disease.
Negative-pressure rooms have been used in hospitals since the 1980s to keep airborne germs from spreading. But such rooms cost about $120,000, says Nathan Haas, an emergency medicine physician at the University of Michigan (UM), Ann Arbor. He and his colleagues wanted to develop a cheaper way to create a negative pressure environment for patients. The new devices could lower the need for negative-pressure rooms, which are scarce in many parts of the world, Haas says.
That could benefit patients as well as those who treat them. Fear of infection leads many hospitals to forgo therapies that could help COVID-19 patients but release a lot of aerosols, such as noninvasive ventilation with masks and oxygen delivery via nasal tubes, according to the authors. Instead, doctors resort to mechanical ventilation, which is harder on patients but doesn’t produce as many aerosols after the initial intubation step.
The helmet can be used when staff transport patients, Haas says; the tent can enclose the upper body of a bed-bound patient wearing a mask and allows staff to perform several procedures that release droplets.
“They represent a really simple solution to … potentially help with reduce virus transmission and increase the safety of health care workers, as well as patient safety,” says Ben Bassin, an emergency medicine physician at UM and member of the research team.
To produce the prototypes, the researchers teamed up with FlexSys Inc and DEKA, companies that are now preparing to scale up production. The team hopes to get U.S. Food and Drug Administration approval for both devices by the fall and commercialize them by the end of the year. They estimate the helmet will cost less than $150.
When the researchers tested their devices with a healthy volunteer, they saw 97% to 99% fewer particles outside the devices than inside. They also tested the devices’ ease of use and comfort with seven COVID-19 patients. The feedback from patients and staff was good, Bassin says.
But Reuben Strayer, an emergency physician at Maimonides Medical Center in New York City, notes the tests did not prove that these devices work to protect medical staff in real-life situations. He says he wants to see independent validation “to see if they perform as they are advertised.”
If they do work, he adds, “We would like to have these devices in use as soon as we can. The earlier that we can have access to better devices to take care of patients and to protect staff, the better.”
sciencemag.org, 15 May 2020