Abstract
The SARS-CoV-2 virus has so far infected more than 31 million people around the world, and its impact is being felt by all. Patients with diseases such as COVID-19 should ideally be treated in negative pressure isolation rooms. However, due to the overwhelming demand for hospital beds, patients have been treated in general wards, hospital corridors and makeshift hospitals. Adequate building ventilation in hospitals and public spaces is a crucial factor to contain the disease (Escombe et al. 2007 PLoS Med. 4; Escombe et al. 2019 BMC Infect. Dis. 19, 88 (doi:10.1186/s12879-019-3717-9); Morawska & Milton 2020 Clin. Infect. Dis. ciaa939. (doi:10.1093/cid/ciaa939)), to exit lockdown safely, and reduce the chance of subsequent waves of outbreaks. A recently reported air-conditioner-induced COVID-19 outbreak caused by an asymptomatic patient, in a restaurant in Guangzhou, China (Lu et al. 2020 Emerg. Infect. Dis. 26) exposes our vulnerability to future outbreaks linked to ventilation in public spaces. We argue that displacement ventilation (either mechanical or natural ventilation), where air intakes are at low level and extracts are at high level, is a viable alternative to negative pressure isolation rooms, which are often not available on site in hospital wards and makeshift hospitals. Displacement ventilation produces negative pressure at the occupant level, which draws fresh air from outdoors, and positive pressure near the ceiling, which expels the hot and contaminated air out. We acknowledge that, in both developed and developing countries, many modern large structures lack the openings required for natural ventilation. This lack of openings can be supplemented by installing extract fans. We have also discussed and addressed the issue of the ‘lock-up effect’. We provide guidelines for such mechanically assisted, naturally ventilated makeshift hospitals.
Highlights
COVID-19, the disease caused by the virus, SARS-CoV-2 is a pandemic and a global emergency which has stressed and in some cases overwhelmed healthcare systems across the world [1]
We argue that displacement ventilation, where air intakes are at low level and extracts are at high level, is a viable alternative to negative pressure isolation rooms, which are often not available on site in hospital wards and makeshift hospitals
While adequate ventilation is essential to maintain a healthy indoor environment in hospitals and other public buildings, the dominant flow pattern is a critical factor for the removal of contagions, and crosscontamination between the occupants
Summary
COVID-19, the disease caused by the virus, SARS-CoV-2 is a pandemic and a global emergency which has stressed and in some cases overwhelmed healthcare systems across the world [1]. In London, an exhibition and convention centre was converted into a 4000-bed Nightingale-style emergency hospital in 9 days Other such new emergency hospitals have been created in the UK in Manchester, Birmingham, Bristol and Glasgow. We show that displacement ventilation, either natural or mechanical, where air is drawn in through lower-level inlets and extracted at high level, can significantly reduce the spread of airborne contagion, and save the lives of healthcare workers, carers and patients [2]
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