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HAI in the COVID-19 Era: Is there any Sustainable Solution for Airborne Infections?

Dilip Patil

Even before COVID-19 pandemic was unleashed on mankind, healthcare facilities have been waging a constant battle against infection control. With invisible Coronavirus looming large the environment precautions like hand-hygiene, surface cleaning, wearing mask/PPE and maintaining social distance have become the new normal, informs Dilip Patil, CoFounder, Director, Trivector Group & BabyQuest Cryobank, writes about how innovative technologies of Trivector bridges this gap.

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Most of these conventional infection control plans have been in place for decades– changing linens, washing hands, sterilizing instruments and surfaces– yet we encounter several seasonal outbreaks and life threatening pandemic like COVID-19. With more and more pathogens and bacteria developing antibiotic resistance, it’s becoming obvious that healthcare facilities, be it hospitals , nursing homes, clinics, need to re-evaluate their infection control plans.

Airborne infection needs more focus

Current infection prevention protocols remain heavily focused on hand and surface cleaning. Even for SARS-COV-2, more focus has been on droplet and contact precautions. We have been missing an important link- AIR. In fact, whatever is in the air at one point settles down on surfaces and creates contact points for spreading the infection. It is now established that the aerosols or smaller droplets generated by infected patients or medical procedures travel a long distance in the air and float in the air for a very long time. It is paramount to close the infection control loop by neutralizing thes impurities in the air, before they settle down on the surfaces and create contact points. Both the World Health Organization (WHO) and U.S. Centers for Disease Control and Prevention (CDCP) say that poor ventilation increases the risk of transmitting the coronavirus.

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Air circulation, proper ventilation and filtration is necessary and it is one of the best prevention from SARS-COV-2. The air-disinfection technologies can be broadly classified as TRAP and KILL. The most popular TRAP method of air-disinfection is duct based Air Handling Units/ HVAC with HEPA. They are expensive to install, difficult to maintain and consume huge power. If not maintained properly or replaced on time there is always a risk of filter-bacteria colonization which would amplify the infection across the facility.

Also read: Healthcare Associated Infection major risk; need urgent attention for quality care: Dilip Patil

The KILL technologies include chemical disinfection (e.g. Hydrogen Peroxide, Formaldehyde fumigation etc), germicidal UV and photo catalytic oxidization are other methods to kill the pathogens. But all these methods come with their inherent draw-back and side effects and provide only a point-in-time solution. In case of UVGI (UV-C), the side effects of UV on skin and eyes are well known. On the other hand, over the counter portable air-purifiers are mostly based on ionization. Ions, photons, hydroxyl radicals, ozone and other byproducts of discharge generated by these devices react with the pathogens to neutralize them in the air, make them heavier and get deposited on surfaces. Ionizers do not kill, but just neutralize the pathogens. The byproducts of ionization discharge including free radicals are detrimental for human health and are not advised to be used in patient occupied areas.

During the times of COVID-19, multiple devices which are claimed to be effective in neutralizing Corona virus have been introduced. Most of these devices are based on same old ionizing radiation sometimes supplemented with series of filters or use of UV irradiation which come with their inherent limitations and may not provide adequate protection. We have to find new tools for the new age problems of airborne infections. This brings us to the question: Is there a sustainable solution for airborne infections? Use of cold plasma for disinfecting air (which has been a safe and approved method of choice for disinfecting medical devices for years) could be the solution.

Plasma technology: A boon for air infection

What is Plasma? Plasma is the fourth state of matter (after solid, liquid and gas). If the infected air is subjected to a destructive high energy plasma field created by dielectric barrier discharge in a contained space, the microorganisms which come in contact with this field get destroyed to DNA level within millisecond. Thus, the bacteria, viruses, fungi, mold, odors and VOCs get eliminated and only the disinfected air which is safe to be consumed by human beings comes out of the device without any direct or indirect side-effects.

This innovative low-energy plasma technology manufactured by Novaerus, Ireland is brought to India by Trivector group, a leading healthcare company since 1993. These devices are validated for their efficacy and safety by more than 30 independent agencies, including NASA. This non-discriminating green technology is proven to eliminate different viruses, bacteria, fungus, VOCs and particulates in a fraction of seconds. Thousands of these devices are being used all over the world in hospital ICUs, OTs, OPDs, IVF labs, corporate offices, classrooms, ambulances etc. These units were recently validated and proven (ARE Labs, USA) to kill surrogate markers of COVID-19 up to 99.99 percent within 15 minutes. These Plasma based portable Novaerus machines are protecting healthcare workers and patients from the spread of COVID-19 in many hospitals and establishments, including COVID-19 hospitals in Mumbai and New Delhi. Dozens of these machines are helping IVF labs in India getting better blastocysts and a minimum 25 percent increase in pregnancy rates, by improving the air-quality in the lab.

There are three different models, based on the size of the room, the risk factor of infection and the remediation time. The area covered by different models is from 100 square foot to 1000 square foot with an average 8-10 feet height room. These units are also available for easy rent from two weeks(homequarantine) to up to one year. These units are really proving to be life-savers, especially for immunocompromised individuals.

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