Implementing a negative pressure isolation space within a skilled nursing facility to control SARS-CoV-2 transmission

Area of Science:

• Environmental Engineering
• Infectious Disease Control
• Healthcare Facility Design

Background:

• Airborne transmission necessitates expanded isolation capacity in congregate living, particularly skilled nursing facilities (SNFs).
• Limited research exists on designing and implementing long-term isolation solutions for SNFs during pandemics.
• COVID-19 highlighted the challenges of isolation in SNFs due to airborne transmission.

Purpose of the Study:

• To design, implement, and validate a negative pressure isolation space within an SNF.
• To minimize SARS-CoV-2 transmission between residents and staff.
• To establish a replicable model for enhancing isolation capacity in SNFs.

Main Methods:

• Modification of an existing HVAC system to create a shared negative pressure isolation space.
• On-site pressure differential measurements to validate containment.
• Computational fluid dynamics and particle modeling to assess transmission risk.

Main Results:

• The isolation space consistently maintained an average negative pressure of -2.3 Pa.
• No SARS-CoV-2 transmission occurred within the isolation space or to/from staff and other residents.
• The isolation space was successfully implemented and remained operational throughout the pandemic.

Conclusions:

• SNFs can be cost-effectively retrofitted to create negative pressure isolation spaces.
• This approach provides a viable solution for minimizing airborne disease transmission in SNFs.
• The study demonstrates a practical method for expanding isolation capacity during health crises.