Gastroenterology Procedures Generate Aerosols: An Air Quality Turnover Solution to Mitigate COVID-19’s Propagation Risk

• Main Authors: Marc Garbey, Guillaume Joerger, Shannon Furr
• Format: Article
• Language: English
• Published: MDPI AG 2020-11-01
• Series: International Journal of Environmental Research and Public Health
• Subjects: cyber-physical system; gastroenterology; pandemic; COVID-19; airborne disease; airborne particles
• Online Access: https://www.mdpi.com/1660-4601/17/23/8780
• ISSN: 1661-7827; 1660-4601

The growing fear of virus transmission during the 2019 coronavirus disease (COVID-19) pandemic has called for many scientists to look into the various vehicles of infection, including the potential to travel through aerosols. Few have looked into the issue that gastrointestinal (GI) procedures may produce an abundance of aerosols. The current process of risk management for clinics is to follow a clinic-specific HVAC formula, which is typically calculated once a year and assumes perfect mixing of the air within the space, to determine how many minutes each procedural room refreshes <inline-formula><math display="inline"><semantics><mrow><mn>99</mn><mo>%</mo></mrow></semantics></math></inline-formula> of its air between procedures when doors are closed. This formula is not designed to fit the complex dynamic of small airborne particle transport and deposition that can potentially carry the virus in clinical conditions. It results in reduced procedure throughput as well as an excess of idle time in clinics that process a large number of short procedures such as outpatient GI centers. We present and tested a new cyber-physical system that continuously monitors airborne particle counts in procedural rooms and also at the same time automatically monitors the procedural rooms’ state and flexible endoscope status without interfering with the clinic’s workflow. We use our data gathered from over 1500 GI cases in one clinical suite to understand the correlation between air quality and standard procedure types as well as identify the risks involved with any HVAC system in a clinical suite environment. Thanks to this system, we demonstrate that standard GI procedures generate large quantities of aerosols, which can potentially promote viral airborne transmission among patients and healthcare staff. We provide a solution for the clinic to improve procedure turnover times and throughput, as well as to mitigate the risk of airborne transmission of the virus.