ABSTRACT
Low-cost improvised continuous positive airway pressure (CPAP) device is safe and efficacious in neonatal respiratory distress. There is a great necessity for similar device in adults, and this has been especially made apparent by the recent Coronavirus Disease 2019 (COVID-19) pandemic, which is unmasking the deficiencies of healthcare system in several low-resource countries. We propose a simplified and inexpensive model of improvised CPAP in adults using locally available resources including aquarium air pumps and a novel pressure release mechanism. Although the safety and efficacy of improvised CPAP in adults are not established, the conceptual model we propose has the potential to serve as a lifesaving technology in many low-resource settings during this ongoing pandemic and thus calls for expedited research.
Subject(s)
COVID-19/therapy , Continuous Positive Airway Pressure/instrumentation , Equipment Design/economics , Respiratory Therapy/instrumentation , Adult , Humans , Noninvasive Ventilation/instrumentation , SARS-CoV-2ABSTRACT
High-throughput, high-accuracy detection of emerging viruses allows for the control of disease outbreaks. Currently, reverse transcription-polymerase chain reaction (RT-PCR) is currently the most-widely used technology to diagnose the presence of SARS-CoV-2. However, RT-PCR requires the extraction of viral RNA from clinical specimens to obtain high sensitivity. Here, we report a method for detecting novel coronaviruses with high sensitivity by using nanopores together with artificial intelligence, a relatively simple procedure that does not require RNA extraction. Our final platform, which we call the artificially intelligent nanopore, consists of machine learning software on a server, a portable high-speed and high-precision current measuring instrument, and scalable, cost-effective semiconducting nanopore modules. We show that artificially intelligent nanopores are successful in accurately identifying four types of coronaviruses similar in size, HCoV-229E, SARS-CoV, MERS-CoV, and SARS-CoV-2. Detection of SARS-CoV-2 in saliva specimen is achieved with a sensitivity of 90% and specificity of 96% with a 5-minute measurement.
Subject(s)
Artificial Intelligence , COVID-19 Nucleic Acid Testing/methods , Machine Learning , Nanopores , COVID-19 Nucleic Acid Testing/instrumentation , Coronavirus 229E, Human/genetics , Equipment Design/economics , Humans , Limit of Detection , Middle East Respiratory Syndrome Coronavirus/genetics , Nanoparticles/chemistry , Polymerase Chain Reaction , SARS-CoV-2/genetics , Saliva/virology , Sensitivity and Specificity , SoftwareABSTRACT
Disposable N95 respirator masks are the current standard for healthcare worker respiratory protection in the COVID-19 pandemic. In addition to shortages, qualitative fit testing can have low sensitivity for detecting poor fit, leading to inconsistent protection. Multiple groups have developed alternative solutions such as modified snorkel masks to overcome these limitations, but validation of these solutions has been lacking. We sought to determine if N95s and snorkel masks with attached high-efficiency filters provide consistent protection levels in healthcare workers and if the addition of positive pressure via an inexpensive powered-air purifying respirator to the snorkel mask would provide enhanced protection. Fifty-one healthcare workers who were qualitatively fitted with N95 masks underwent quantitative mask fit testing according to a simulated workplace exercise protocol. N95, snorkel masks with high-efficiency filters and snorkel masks with powered-air purifying respirators were tested. Respiratory filtration ratios were collected for each step and averaged to obtain an overall workplace protocol fit factor. Failure was defined as either an individual filtration ratio or an overall fit factor below 100. N95s and snorkel masks with high-efficiency filters failed one or more testing steps in 59% and 20% of participants, respectively, and 24% and 12% failed overall fit factors, respectively. The snorkel masks with powered-air purifying respirators had zero individual or overall failures. N95 and snorkel masks with high-efficiency filter respirators were found to provide inconsistent respiratory protection in healthcare workers.
Subject(s)
COVID-19/prevention & control , Cost-Benefit Analysis/standards , Health Personnel/standards , Masks/standards , N95 Respirators/standards , Adult , COVID-19/economics , Cohort Studies , Equipment Design/economics , Equipment Design/standards , Female , Health Personnel/economics , Humans , Male , Masks/economics , Middle Aged , N95 Respirators/economics , Occupational Exposure/economics , Occupational Exposure/prevention & control , Personal Protective Equipment/economics , Personal Protective Equipment/standards , Prospective Studies , Reproducibility of ResultsSubject(s)
Coronavirus Infections , Endoscopy, Gastrointestinal , Equipment Design , Infection Control/instrumentation , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Pandemics , Pneumonia, Viral , Betacoronavirus/isolation & purification , COVID-19 , Coronavirus Infections/epidemiology , Coronavirus Infections/prevention & control , Coronavirus Infections/transmission , Endoscopy, Gastrointestinal/adverse effects , Endoscopy, Gastrointestinal/instrumentation , Endoscopy, Gastrointestinal/methods , Equipment Design/economics , Equipment Design/methods , Gastrointestinal Diseases/diagnosis , Humans , Infection Control/methods , Occupational Exposure , Pandemics/prevention & control , Pneumonia, Viral/epidemiology , Pneumonia, Viral/prevention & control , Pneumonia, Viral/transmission , Respiratory Protective Devices , SARS-CoV-2ABSTRACT
As the number of coronavirus 2019 disease (COVID-19) cases in the United States began mounting in the early weeks of March, health care workers raised the alarm about a looming shortage of ventilators to treat patients. On March 30, 2020, Ford Motor Company announced plans to produce 50,000 ventilators in 100 days [1], and General Motors followed suit on April 8, stating that it would deliver out 6,000 ventilators by the end of May and another 24,000 by August [2].