Dealing with the COVID-19 Surge

Approaches to create safer spaces for patients, staff and visitors

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Here are two approaches to increasing patient room capacity that may be necessary to deal with the COVID-19. To deal with surges in demand, hospitals are reassessing facilities for a potential influx of people needing testing and requiring quarantined care. To make your facilities safer as you move forward:

  • Consider negative air pressure in patient rooms to create safer commons areas (e.g. corridor, nursing stations, waiting rooms).
  • Use portable UV lights to help disinfect rooms

Create negative air pressure in patient rooms to create safer common areas
Standard hospital patient rooms have neutral air pressure. This means the “supply air” equals the amount of the “return air” from the patient room, including exhaust from the bathroom. In most facilities, only a variable air volume (VAV) box controls airflow without manual adjustment of dampers in return air and exhaust.

In a surge situation, you can create a “negative pressure” room if you limit supply air to be less than the return and exhaust air by 100 or 200 cubic feet per minute (CFM). Do this to all rooms on a floor and you have a negative pressure floor. Do this to all floors in a wing you have a negative pressure wing.

When you need more rooms during a surge, you can change variable air volume (VAV) control settings of the existing maximum flow. This converts the “neutral-pressure” room to a “negative-pressure room.” If your existing heating and cooling equipment allows, increase outside air to 100%.

Healthcare Mechanical Engineer Tracy Van Damme says it’s important to calculate supply, return and exhaust air for core areas of your floor. “Determine if air pressure adjustments are needed for nursing stations, offices and corridors,” Van Damme says. “If your floor air pressure becomes too negative in terms of air pressure, adjacent areas of the hospital will be impacted.”  

Van Damme also recommends looking beyond mechanical systems. “Consider your building envelope – interior walls, exterior walls and windows. Your building and wall envelope must be examined,” says Van Damme. “There may be gaps where air can leak.” The American Institute of Architects/Facility Guidelines Institute (AIA/FGI) standards provide direction for single-patient room design.

Not every room was constructed be a “negative-pressure” room. Consult a registered design professional to help make these assessments. While existing equipment and conditions may not be perfect there are solutions to deal with emergencies.

Use portable UV lights to help disinfect rooms
Prior studies have proven UV-C light can inactivate various forms of the coronavirus family with a sufficient dose of UV-C light.  A hospital-grade portable UV-C emitting machine can help to disinfect rooms where Covid-19 patients have been, according to Healthcare Mechanical Engineer Tyson Scheidecker.

“While it doesn’t replace the need to physically disinfect a room by staff since UV light only disinfect surfaces in its line of sight,” Scheidecker says. “It can be done prior to cleaning staff entering the room to reduce their risks or after as a belt-and-suspenders approach to cleaning for the next patient that enters the room.”  

UV-C machines come in many different sizes and capabilities from low-powered units meant to be in place overnight to high-powered robotic machines that can disinfect a patient room or operating room in a hour or less using remote control or automation. Consult a manufacturer or product representative to determine the best fit for your hospital’s needs.

See the BBC News story about robotic UV lights

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Tracy Van Damme is a mechanical engineer with 20 years of healthcare experience. With special emphasis in hospital heating, ventilating, air conditioning (HVAC) design, Tracy’s experience includes the design of surge capacity wings and isolation rooms.

Tracy Van Damme, PE

Mechanical Engineer


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Tyson Scheidecker is a mechanical engineer with 11 years of healthcare experience. Tyson’s projects incorporate high-efficiency designs within budget while meeting the challenges of ever-changing code and infection control requirements.

Tyson Scheidecker, PE

Mechanical Engineer