Built Environment Airborne Infection Control Strategies in Pandemic Alternative Care Sites

The impact of COVID-19 on visitors' wayfinding within healthcare centers

The novel COVID-19 pandemic has caused substantial calamities in developing countries such as Iran, which initially suffered from inadequate infrastructure essential for the pandemic control. Due to the ongoing development of this malady, healthcare centers are recognized as one of the most significant hotspots within public settings so they are directly pertinent to the physical and mental health of visitors. The main objective for conducting the present study is to investigate the impact of the COVID-19 pandemic on the visitors' wayfinding procedure within Qa'em hospital, located in Rasht, northern Iran. The adopted methodology in the present study is based on a comparison between the collected data regarding the wayfinding behavior of visitors before and after the outbreak of the COVID-19 pandemic using mixed methods, namely Space Syntax, gate counting, people following, and semi-structured interviews. The obtained empirical results displayed that visitors were significantly confused and hesitant throughout their wayfinding process after the outbreak of the pandemic. Indeed, spatial accessibility and legibility were not found to be adequate for facilitating the wayfinding of the visitors. Moreover, the requirements for the reconfiguration of furniture layout in the waiting areas, according to the underlying notions of social distancing, became conspicuous as the pragmatic implications for the post-pandemic healthcare centers.

Strategies, challenges and opportunities in the implementation of COVID-19 field hospitals: a scoping review

OBJECTIVES

COVID-19 has strained healthcare systems, requiring the redesign of their structure, human resource management and clinical approach. Countries have adopted implementation strategies and maximise field hospital functionality to address the issue of overflow of patients with COVID-19. This scoping review was based on the main research question, 'What are the implementation strategies, challenges and opportunities in managing the field hospital during the COVID-19 pandemic?', and aimed to consolidate all recent evidence on COVID-19 field hospital implementation approaches, challenges and potentialities.

DESIGN

Scoping review, following the Arksey and O'Malley's framework, and Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines.

DATA SOURCES

PubMed, Web of Science and Scopus were searched from 1 January 2020 through 31 December 2021.

ELIGIBILITY CRITERIA

Original articles, reviews, case studies and reports written in English were included. Works without full article and articles that did not answer the research questions were excluded.

DATA EXTRACTION AND SYNTHESIS

Data were extracted using a standardised data extraction form in Microsoft Excel. The findings of all included articles were synthesised narratively.

RESULTS

Eighty-five records were reviewed and 25 studies were included. For the field hospital implementation strategies, 'surge capacity', namely space, human resource, supply and system, was discussed in addition to the preparation and workflow of other services such as pharmacy, rehabilitation, food and nutrition. The management of COVID-19 field hospitals is challenging with respect to staff and resource shortages, inability to anticipate patient load and poor communication. The opportunities and recommendations for improvement of management were also highlighted.

CONCLUSIONS

The compilation of lessons learnt may help improve the future management of field hospitals, administratively and clinically.

Evaluating Efficacy of a COVID-19 Alternative Care Site Preparedness Assessment Tool for Catastrophic Healthcare Surge Capacity during Pandemic Response

During the COVID-19 pandemic, implementing catastrophic healthcare surge capacity required a network of facility infrastructure beyond the immediate hospital to triage the rapidly growing numbers of infected individuals and treat emerging disease cases. Providing regional continuity-of-care requires an assessment of buildings for alternative care sites (ACS) to extend healthcare operations into non-healthcare settings. The American Institute of Architects (AIA) appointed a COVID-19 ACS Task Force involving architects, engineers, public health, and healthcare professionals to conduct a charrette (i.e., intensive workshop) to establish guidance during the alert phase of the pandemic. The task force developed an ACS Preparedness Assessment Tool (PAT) for healthcare teams to assist with their rapid evaluation of building sites for establishing healthcare operations in non-healthcare settings. The tool was quickly updated (V2.0) and then translated into multiple languages. Subsequently, the authors of this manuscript reviewed the efficacy of the PAT V2.0 in the context of reported case studies from healthcare teams who developed a COVID-19 ACS in community settings. In summary, policy makers should re-examine the role of the built environment during emergency pandemic response and its impact on patients and health professionals. An updated ACS PAT tool should be established as part of the public health preparedness for implementing catastrophic healthcare surge capacity.

Effects of Yellow Light on Airborne Microbial Composition and on the Transcriptome of Typical Marker Strain in Ward

Airborne diseases are transmitted by pathogens in the air. The complex microbial environment in wards is usually considered a major cause of nosocomial infection of various diseases which greatly influences the health of patients with chronic diseases, whereas the illuminant of wards impacts on the microbe especially the disease marker strain is seldom studied. In the present study, high-throughput sequencing was used to study the effect of yellow light on airborne microbial composition, and changes of transcriptome of marker strains Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa, which were isolated from wards, were further studied after the irradiation by yellow light. High-throughput sequencing results indicated that yellow light significantly decreased α-diversity. The relative abundance of Firmicutes at the phylum level, and Clostridium sensu stricto 1, Paraclostridium at the genus level were significantly reduced. RNA sequencing results declared that yellow light significantly downregulated the genes associated with flagella, heme transport system and carbohydrate, amino acid metabolism in E. coli, and the genes related to arginine biosynthesis and the biosynthesis of isoleucine, leucine, and valine in S. aureus. Meanwhile, yellow light significantly upregulated the genes relating to porphyrin metabolism in P. aeruginosa. In conclusion, our work reveals the impacts of yellow light on the microbe in wards, pointing out the application value of yellow light in the prevention of infectious diseases in clinical practice.

Design and Development of Isolating Pods to Prevent the Spread of Coronavirus or Other Viruses for Hospital and Domestic Purposes

OBJECTIVES

This project investigated into the design and construction of an isolation pod to keep infected people in quarantine, thus avoiding the spread of viruses such as the COVID-19. This product was made to be used in hospitals and at homes.

BACKGROUND

Mauritius is among the few countries, which has not had any cases of COVID-19 since for since May 2020 for a period of 150 days. It has opened its borders since October 2020, and since Mauritius being a small country, the spread of any type of virus can be imminent if not controlled properly. In case there is another spread of the COVID-19 in Mauritius, then the isolation pod could be used to keep infected people in quarantine. The aims of the study were to develop a prototype of an isolation cubicle that is collapsible and can be easily erected at homes or in hospitals, whenever the need arises.

METHODS

A prototype of the pod was made with metal bars welded together and tarpaulin materials were sewn together. A HEPA Fan Extractor was fitted inside the pod to allow the air to circulate.

RESULTS

the tests carried out the pod could easily be assembled, transported and stored for further usage. From the volunteers' feedback, it was found that the pod was comfortable, spacious, and practical. The air monitoring tests carried on the carbon dioxide, temperature, and relative humidity were within the acceptable ranges.

Inpatient Capacity Management during COVID-19 Pandemic: The Yale New Haven Hospital Capacity Expansion Experience

The 2019 SARS-CoV2 virus presented a capacity demand scenario for Yale New Haven Hospital. The response was created with a focus on clinical needs, but was also driven by the unique characteristics of the buildings within our institution. These physical characteristics were considered in the response as a safety measure as little was known about the transmissibility risk in the acute hospital setting of SARS-CoV2 at the time of response. The lessons learned in capacity expansion to meet the potentially catastrophic demand for acute care services due to a novel, poorly understood pathogen are discussed here.