Powered Air-Purifying Respirator (PAPR) and High-Efficiency Particulate Air (HEPA) Buggies to Improve COVID-19 Safety for the Youngest Children: Evaluation of Prototypes

Abstract

Introduction: Young children are susceptible to COVID-19 infection in high-risk settings because they cannot begin vaccination until at least 6 months old and cannot mask safely until at least 2 years old. During essential activities, parents have attempted to protect children in strollers using rain covers, but these provide limited protection against airborne transmission. The investigator examined various models of rain-covered strollers that used either PAPR or HEPA air cleaning devices to provide safer air, so-called “PAPR buggies” and “HEPA buggies.” Materials and Method The investigation examined six models that varied based on the type of air filter, (PAPR, small/large HEPA), stroller, and rain cover, and the number of children (single or twin). Key outcomes were a qualitative assessment of strengths and limitations, air flow metrics, and sound intensity. Although all models used safe commercially-sold rain covers, the smallest model was also tested for air quality. Results The investigator evaluated each model as acceptable. The PAPR buggies are discrete, whereas the HEPA buggies offer greater flexibility in price and air flow rates. Models had a median of 185.26 air changes per hour, ACH (range of 57.22-951.33), equivalent to 12.35 times the standard for U.S. operating rooms (range of 3.81–63.42). Sound intensity was equivalent to a conversation or office setting (55.5–64.6 dB). Air quality testing revealed no safety concerns. Costs are reasonable for many families. Discussion PAPR and HEPA buggies are additional tools families can use as a part of a multifaceted strategy to improve safety in high-risk settings during the COVID-19 pandemic. The models evaluated were reasonable, provided excellent air flow, and had tolerable sound levels. There were no safety concerns, though parents are cautioned to only use commercially-sold, safe rain covers. The investigator offers suggestions for disseminating the widespread use of PAPR and HEPA buggies.