Medical Response Planning for Pandemic Flu

Harrison, Jeffrey P.; Bukhari, Syed Zeeshan Haider; Harrison, R. A.

doi:10.1097/hcm.0b013e3181cd8ab1

“…In the aftermath of the severe acute respiratory syndrome outbreaks of 2003, the demand for such rooms increased, dramatically [7][8][9][10]. Many of these were eventually utilized in the management of patients infected with the 2009 pandemic influenza A/H1N1 virus [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms

Tang

¹

,

Nicolle

²

,

Pantelic

³

et al. 2013

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Hospital isolation rooms are vital for the containment (when under negative pressure) of patients with, or the protection (when under positive pressure) of patients, from airborne infectious agents. Such facilities were essential for the management of highly contagious patients during the 2003 severe acute respiratory syndrome (SARS) outbreaks and the more recent 2009 A/H1N1 influenza pandemic. Many different types of door designs are used in the construction of such isolation rooms, which may be related to the space available and affordability. Using colored food dye as a tracer, the qualitative effects of door-opening motions on the dissemination of potentially contaminated air into and out of a single isolation room were visualized and filmed using Reynolds-number-equivalent, small-scale, water-tank models fitted with programmable door-opening and moving human figure motions. Careful scaling considerations involved in the design and construction of these water-tank models enabled these results to be accurately extrapolated to the full-scale situation. Four simple types of door design were tested: variable speed single and double, sliding and hinged doors, in combination with the moving human figure. The resulting video footage was edited, synchronized and presented in a series of split-screen formats. From these experiments, it is clear that double-hinged doors pose the greatest risk of leakage into or out of the room, followed by (in order of decreasing risk) single-hinged, double-sliding and single-sliding doors. The relative effect of the moving human figure on spreading any potential contamination was greatest with the sliding doors, as the bulk airflows induced were large relative to those resulting from these door-opening motions. However, with the hinged doors, the airflows induced by these door-opening motions were significantly greater. Further experiments involving a simulated ventilated environment are required, but from these findings alone, it appears that sliding-doors are far more effective for hospital isolation room containment.

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“…Facility readiness between rural and metropolitan health systems also needs to be investigated further. In the United States, 69% of hospitals indicated having airborne infectious isolation rooms in a 2006 survey; these tended to be large hospitals in metropolitan areas 115 (#377, Level V). Vulnerabilities of health systems to COVID-19 in rural areas are observed globally, including in Vietnam 116 (#985, Level V).…”

Section: Health Systems In Crisesmentioning

confidence: 99%

Health Systems and Services During COVID-19: Lessons and Evidence From Previous Crises: A Rapid Scoping Review to Inform the United Nations Research Roadmap for the COVID-19 Recovery

Baral

¹

2021

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This rapid scoping review has informed the development of the November 2020 United Nations Research Roadmap for the COVID-19 Recovery, by providing a synthesis of available evidence on the impact of pandemics and epidemics on (1) essential services and (2) health systems preparedness and strengthening. Emerging findings point to existing disparities in health systems and services being further exacerbated, with marginalized populations and low- and middle-income countries burdened disproportionately. More broadly, there is a need to further understand short- and long-term impacts of bypassed essential services, quality assurance of services, the role of primary health care in the frontline, and the need for additional mechanisms for effective vaccine messaging and uptake during epidemics. The review also highlights how trust—of institutions, of science, and between communities and health systems—remains central to a successful pandemic response. Finally, previous crises had repeatedly foreshadowed the inability of health systems to handle upcoming pandemics, yet the reactive nature of policies and practices compounded by lack of resources, infrastructure, and political will have resulted in the current failed response to COVID-19. There is therefore an urgent need for investments in implementation science and for strategies to bridge this persistent research–practice gap.

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“…In the aftermath of the severe acute respiratory syndrome outbreaks of 2003, the demand for such rooms increased, dramatically [7][8][9][10]. Many of these were eventually utilized in the management of patients infected with the 2009 pandemic influenza A/H1N1 virus [11][12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Correction: Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms

Tang¹,

Nicolle²,

Pantelic³

et al. 2014

PLoS ONE

0

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Hospital isolation rooms are vital for the containment (when under negative pressure) of patients with, or the protection (when under positive pressure) of patients, from airborne infectious agents. Such facilities were essential for the management of highly contagious patients during the 2003 severe acute respiratory syndrome (SARS) outbreaks and the more recent 2009 A/H1N1 influenza pandemic. Many different types of door designs are used in the construction of such isolation rooms, which may be related to the space available and affordability. Using colored food dye as a tracer, the qualitative effects of door-opening motions on the dissemination of potentially contaminated air into and out of a single isolation room were visualized and filmed using Reynolds-number-equivalent, small-scale, water-tank models fitted with programmable door-opening and moving human figure motions. Careful scaling considerations involved in the design and construction of these water-tank models enabled these results to be accurately extrapolated to the full-scale situation. Four simple types of door design were tested: variable speed single and double, sliding and hinged doors, in combination with the moving human figure. The resulting video footage was edited, synchronized and presented in a series of split-screen formats. From these experiments, it is clear that double-hinged doors pose the greatest risk of leakage into or out of the room, followed by (in order of decreasing risk) single-hinged, double-sliding and single-sliding doors. The relative effect of the moving human figure on spreading any potential contamination was greatest with the sliding doors, as the bulk airflows induced were large relative to those resulting from these door-opening motions. However, with the hinged doors, the airflows induced by these door-opening motions were significantly greater. Further experiments involving a simulated ventilated environment are required, but from these findings alone, it appears that sliding-doors are far more effective for hospital isolation room containment.

show abstract

Medical Response Planning for Pandemic Flu

Cited by 5 publications

References 12 publications

Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms

Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms

Health Systems and Services During COVID-19: Lessons and Evidence From Previous Crises: A Rapid Scoping Review to Inform the United Nations Research Roadmap for the COVID-19 Recovery

Correction: Different Types of Door-Opening Motions as Contributing Factors to Containment Failures in Hospital Isolation Rooms

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