DESIGNING ISOLATION ROOM FOR COVID-19 INFECTED PEOPLE

Posted on 28 Aug 2021

INTRODUCTION:-

Amidst the pandemic of COVID-19, the globe is not just suffering from the financial crisis but a very critically humongous loss of lives. With all of this, we are in intense demand of creating infrastructure to cope with the number of patients getting affected with this widely spreading pulmonary virus. Patients with known (or suspected of the) infection are physically isolated from other patients (Physical isolation ceases only when the patient is no longer capable of transmitting infection or an alternative diagnosis is made.)

Considering the above facts, Hospaccx team helps you in “Isolation Room Designing and Constructing”. This is macroficial study of ’DESIGNING ISOLATION ROOM FOR COVID-19 INFECTED PEOPLE’ if you want to get into more detail you can contact hospaccx.india@gmail.com

Creating Isolation Chambers/ Rooms for COVID-19 affected patients:-
In India, certain guidelines for creating infection control in healthcare infrastructure are described by Indian Health Facilities (IHF) and the Department of Human Services (DHS). These guidelines describe how to construct isolation rooms in hospitals and aim to provide standards for new as well as old health care facilities and are designed as a reference document for engineers, architects and infection control personnel.

(A minimum of 20 % of the total bed complement in Inpatient Accommodation Units (across the whole facility) used or overnight stay shall be provided as Single Bedrooms (Type S).
All HPUs providing inpatient overnight accommodation shall provide at least one ‘Class S – Standard’ Isolation room. All facilities at Level Four and above shall provide at least one ‘Class N – Negative Pressure’ Isolation room per 100 overnight beds.)

HOW TO DESIGN ISOLATION ROOMS?

Isolation rooms are classified based on their functions as follows:-

Class S (standard pressure): Class S rooms are for isolating patients capable of transmitting infection by contact or droplet routes.
Class N (negative pressure): Class N rooms are for isolating patients capable of transmitting infection by airborne droplet nuclei.
Class P (positive pressure): Class P rooms may be used to isolate immune-compromised patients.

{Until 15th March’20 it was considered that the COVID-19 can transfer only through physical contact with droplets of the infected person, but unfortunately we don’t have shreds of evidence to prove if this research is perfectly reliable as the virus being too new to science.

But, on the 16th of March’20 research conducted by WHO has guided its medical staff to consider Coronavirus as airborne infection and the virus can sustain in the air (in some settings depending on heat and humidity of the region).

Therefore places with lesser humidity and cooler climatic conditions should necessarily design CLASS ‘N’ type of rooms for their healthcare facilities.}

WHAT ARE CLASS ‘S’ ISOLATION ROOMS?

Note that Standard pressure rooms are used for patients requiring contact or droplet isolation.
A standard room with normal air conditioning is appropriate.

Recommended elements

A staff hand washbasin within the room.
An ensuite bathroom.
A self-closing door.

Optional elements

Pan sanitiser near the room.
Label to indicate standard pressure isolation room.

WHAT ARE CLASS ‘N’ ISOLATION ROOMS?

The isolation room requirements for persons known or suspected to have infections requiring airborne precautions (such as chicken pox, measles and infectious pulmonary and laryngeal tuberculosis) will determine the need for Class N rooms.

It is important to consider cases suspected of such infections in these calculations. Patients suspected of having open tuberculosis or laryngeal tuberculosis require such isolation until either the diagnosis is excluded or they are rendered non-infectious by treatment. In larger health care facilities there are nursing, economic and engineering benefits for co-locating class N rooms.

Special areas which require either one or more Class N rooms or an area with air-handling to Class N standard include :

Emergency departments;
Intensive care units—adult, paediatric, newborn; and,
Procedure areas such as bronchoscopy suites or sputum induction rooms.

Recommended elements

Maintain a negative pressure gradient from the room to the anteroom and the ambient air. This is accomplished via a separate exhaust system dedicated to each room that removes a quantity of air greater than that of the supply system. Exhaust air ducts should be independent of the common building exhaust air system to reduce the risk of contamination from back draught.
Construct an anteroom with each room with a pressure less than the adjacent ambient pressure.
Install an ensuite bathroom. The ensuite entrance should not be in the anteroom. An ensuite is not a mandatory requirement for a NPR in an emergency department. A clinical risk assessment should be conducted to determine if the ensuite can be excluded. En-suite exhaust shall not be connected to the common building toilet exhaust system.
Provide 100% outside air ventilation.
Duct the exhaust directly to the outside discharging vertically at 10m/s.
Supply air and exhaust systems to be of a constant volume system.
Fit a Non-hand operated clinical handbasin within the room and anteroom.
Install a self-closing door, with well fitting, durable door seals taking into consideration the direction of door swing in relation to room pressure. Doors can be interlocked.
Label as a negative pressure isolation room.

QUARANTINE ROOMS:-

In such cases Isolation Rooms require the following provisions:

Anteroom that operates as an airlock with interlocking doors; both doors must not open at the one time; the Anteroom must be large enough to allow for bed movement.
Alarm to be activated on loss of differential pressure; time delay may be required to permit entry/exit from room.
Self-closing and interlocking doors.

PLANNING TO CREATE ISOLATION ROOMS IN ALREADY CONSTRUCTED HOSPITALS?

As per the current infrastructure of India, it is estimated that India has 1 hospital bed for every 1,826 patients and only 1 isolation bed for every 84,000 patients. So even if a 10% population of India gets infected with COVID-19, approximately 13 crores of people having Corona Virus and hence we have an infrastructure for only 1500 people.(These counts are not to scare you, but make yourself aware of this situation)

But, don’t panic.

We here at Hospaccx can provide you solutions for that. Since we all know that constructing new hospitals is going to be difficult tasks, there are methods of creating hospital beds into isolation chambers. Hence, we can accommodate the huge number of people in different healthcare facilitating buildings with a lesser number of dedicated isolation rooms.

HERE IS HOW YOU CAN DO IT:

According to AIDM (Airborne Infection Disease Management) temporary negatively pressured isolation rooms are created when there is an outbreak of a certain disease which becomes an epidemic or pandemic. Such rooms can be broadly divided into:

1. Isolation rooms with air-discharging towards the outward direction (to the outer environment)
2. Isolation rooms with air-discharging towards the internal air-system.
3. Curtain TNPI (Less effective method).

We can create isolation rooms in houses and warehouses too. How?

1. Creating HEPA Filters at home:- (Easy method using , used cartons and exhaust fans)
2. Installing self-use no-touch systems.
3. Disposable essentials.

*This article is a summary for the construction of isolation wards for the COVID-19. For more information and any design requirements please contact Hospaccx.