What Are Negative Pressure Rooms and Can They Save Lives?

Based on a simple concept, these pressure rooms can help protect healthcare workers against infection.

3 min read
What Are Negative Pressure Rooms and Can They Save Lives?

The novel coronavirus is a disease that primarily travels via infected droplets that could transfer through the air.

For hospital workers and fellow patients, a room that reduces viral load inside could literally save lives. These magical rooms exist, and are called airborne infection isolation rooms or negative pressure rooms.

So how exactly do these work and why don’t we have more of them in India? FIT speaks to Dr Sumit Ray, a senior consultant of Critical Care Medicine in Delhi to get some answers.

What is a Negative Pressure Room?

“Basically it is a room that throws the ambient air from inside, outside,” says Dr Ray, and in doing so reduces the viral load and risks of infection too.

“What a negative pressure room does is very simple - it reduces the viral load in aerosalised spaces. So if you have a place where you have COVID-19 positive patients and aersol-generating procedures (which can be a simple cough as well) the air and subsequent virus is thrown out by a negative pressure. So the viral load reduces and the chances of infection does too.”
Dr Sumit Ray

Guidelines on disease control by the Ministry of Health and Family Welfare add that a negative pressure in isolation rooms is suitable for patients who need aerosolisation procedures like intubation, suction nebulisation. Rooms like these usually have standalone air-conditioning, not part of the central air-conditioning of the hospital.

“Negative pressure is not usually required in normal hospital settings - but with an infectious disease like COVID-19, they become important. Since hospitals don’t already have them and it’s a crisis situation, we may need to use jugaad to pump out the air and use exhaust fans,” says Dr Ray.

MoHFW also suggests that if ACs are not available, 3-4 exhaust fans can create the same effect of driving air out.

According to the health ministry, one way to save costs is in large district hospitals. These can use only natural ventilation if there have “large windows on opposite walls of the room allowing a natural unidirectional flow and air changes.”

Does India Have the Infrastructure?

“Usually hospitals have positive pressure isolation rooms to stop outside infections from patients, doctors and anyone else coming inside to help protect immunocompromised patients - people who have had transplants or invasive surgeries for example. It’s usually the other way around, but in COVID-19 we have to protect the healthcare workers and other patients from a positive patient.”
Dr Sumit Ray

To generate a negative pressure often is a matter of titration and changing the air pressure. “Most hospitals don’t usually need negative pressure rooms,” he adds.

Another worry is to control areas of secondary infection which might come about in the process of generating negative pressure zones - although for now the priority is that it does not spread to other patients and healthcare workers re-iterates Dr Ray.

“There has to be a balance between managing costs, ensuring places for positive pressure exist because this will always be needed, and creating/changing rooms to negative pressure ones. There is no perfect way to do it and it will differ in different hospitals.”

Hospitals also have to keep in mind returning to normal settings once the pandemic is over and stopping the use of negative pressure rooms. This would also incur a cost, it’s unavoidable but has to be accounted for.

For now, the focus should be on the place where aerosol would be generated the most - like the ICUs says Dr Ray,

In light of the new ministry order to end mandatory 14 day quarantining for HCWs, measures to protect healthcare workers from getting the virus in the first place must be undertaken. In the coming days as cases increase, it may need to be all hands on deck.

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