Implementing a Negative Pressure Isolation Space within a Skilled Nursing Facility to Control SARS-CoV- 2 Transmission Public Deposited
Background: Isolation space must be expanded during pandemics involving airborne transmission.
Little to no work has been done to establish optimal design strategies and implementation plans to
ease surge capacity and expand isolation capacity over long periods in congregate living facilities.
The COVID-19 pandemic has an airborne transmission component and requires isolation, which
is difficult to accomplish in skilled nursing facilities.
Purpose: In this study we designed, implemented, and validated an isolation space at a skilled
nursing facility in Lancaster, PA. The overall goal was to minimize disease transmission between
residents and staff within the facility.
Basic Procedures: We created an isolation space by modifying an existing HVAC system of the
SNF. We measured pressure on-site and performed computational fluid dynamics and Lagrangian
particle-based modeling to test containment and possible transmission extent given the isolation
space is considered negative rather than individual rooms.
Main Findings: Pressure data shows the isolation space maintained an average hourly value of
(standard deviation) -2.3 Pa (0.12 Pa) pressure differential between it and the external hallway
connected to the rest of the facility. No transmission of SARS-CoV-2 between residents isolated
to the space occurred, nor did any transmission to the staff or other residents occur. The isolation
space was successfully implemented and, as of writing, continues to be operational through the
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- Highlights * Negative pressure isolation space is an effective method to meet needed surge capacity during the COVID-19 pandemic and future pandemics * Planning for how and where to rapidly create a negative pressure isolation space is needed in congregate living areas such as skilled nursing facilities * This demonstration shows the feasibility of using low-cost and in-house systems to quickly create negative pressure within a skilled nursing facility hallway and to maintain these conditions, minimizing disease transmission between residents and staff
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