Esco and its More Than Four Decades of Isolation Room Experience

Esco was the first company in 1978 to build isolation rooms in Singapore and the whole ASEAN region; with its collective 42 years of experience, it is proud to launch the Esco Aster Airborne Infection Isolation Room (AIIR) Technology. It is a full-encompassing innovative solution for the exponentially rising number of individuals infected with SARS-CoV-2 virus world over; gearing towards the provision of proper isolation, while allowing optimal care and throughput, of COVID-19 positive individuals with varying viral shedding capacities.

AIIR as the Recommended COVID-19 Room Type

As hospitals are increasingly running out of valuable bed space and isolation rooms, more makeshift community care hospitals are being retrofitted in exhibition halls, sports halls, and indoor stadiums amongst others. While this set-up may serve as an aid for the pandemic-induced shortage of proper treatment and recovery areas, its open-spaced design may limit its function only to recovering and “early” well patients and to asymptomatic COVID- 19 positive patients.

In reference to the hierarchy of control for occupational hazards (Centers for Disease Control and Prevention, 2020), the following control strategies can be implemented concurrently or sequentially as listed with respect to its decreasing efficacy: Elimination, Substitution, Engineering controls, Administrative controls and Personal protective equipment (PPE). In order to decrease transmission of infectious disease, elimination and substitution are said to be considered as atypical options in healthcare settings. For this reason, engineering and administrative controls and PPE are the approaches often taken to reduce transmissible respiratory pathogen exposure in healthcare facilities. Along with this, prompt detection and effective triage and isolation of potentially infectious patients are regarded as essential in the prevention of unnecessary exposures among patients, healthcare personnel (HCP), and visitors at the facility. According to Kranthi et al. (2020), the type of isolation needed for COVID-19 patients is Airborne Infection Isolation Room (AIIR), also known in many countries as negative pressure isolation rooms, accompanied with the use of standard, contact, and airborne precautions with eye protection.

AIIR as defined by CDC is “a single-occupancy patient-care room used to isolate persons with a suspected or confirmed airborne infectious disease. Environmental factors are controlled in AIIRs to minimize transmission of infectious agents that are usually spread from person-to-person by droplet nuclei associated with coughing or aerosolization of contaminated fluids.”

AIIR should be designed in such way that it provides:

• negative pressure in the room (air flows under the door gap into the room)

• an airflow rate of 6-12 air changes per hour (ACH), and;

• equipped with a direct exhaust of air from the room to the outside of the building or recirculation of air through a HEPA filter before returning to circulation.

With the goal of reducing transmission risk, all isolation rooms designed under the Esco Aster Airborne Infection Isolation Room (AIIR) Technology is in accordance with the Centers for Disease Control and Prevention (CDC) AIIR engineering control specifications and guidelines.

The Basics of Esco Aster AIIR Technology

Esco Aster AIIR Technology utilizes Esco Airstream^® Fan Filter Unit (FFU), to facilitate clean laminar airflow supply to the patient’s side. This also comes with a built-in backstack filtration module (optional portable FFU for rapid self-assembly kits) to ensure proper containment, exhaust, and pressure control within the controlled room. Room exhaust system makes use of double HEPA filters supplemented with a UV-C kill box single pass and UV-C lighting technology.

Products under Esco Aster AIIR Technology range from a stand-alone quick install Makeshift Recovery and Treatment Isolation Room™ (MRTIR™) to rapid self-assembly kits, and isolation containers which are available in different models: Modular 20’ Container, Modular 40’ Container and Single 40’ Container Premium.

Location Feasibility Enhancement

Asymptomatic carriers who are COVID-19 positive with no viral shedding symptoms are not advised but are allowed to share rooms in hospitals or be in open makeshift hospitals. Since products under Esco Aster AIIR Technology come with modular partition systems, these can be co-located with temporary makeshift community hospitals for newly diagnosed patients, to be kept under closer observation before being moved into normal wards. These isolation rooms can also be used as temporary rooms for patients whose symptoms may be worsening and have high viral shedding. Moreover, the AIIR technology can also be used to repurpose normal hospital wards or convert non-healthcare rooms into healthcare suites.

Esco AIIR Technology Product Line

• Makeshift Recovery and Treatment Isolation Room™ (MRTIR™)

  Esco Makeshift Recovery and Treatment Isolation Room™ (MRTIR™) is a controlled negatively-pressurized room designed for COVID-19 positive individuals with mild to moderate level of symptoms, hence, with less viral shedding often characterized by occasional coughing and sneezing.

  Esco MRTIR™ can also be retrofitted into hospital wards to convert normal beds into temporary isolation rooms with optional anterooms. These hospital wards can be returned to normal wards after COVID-19 pandemic.

  

  Figure 1. Isometric View of Esco Makeshift Recovery and Treatment Isolation Room (MRTIR™)

• Optional Rapid Self-Assembly Kits

  Esco also offers self-assembly kits which can be used for enclosed spaces which call for rapid deployment of controlled room environment. This kit includes the following components:

  • 4'x2' Ceiling Esco Airstream® Fan Filter Unit(s) (FFUs)
  • Portable Fan Filter Box(es) with UV-C killbox
  • Pressure gauge for differential pressure monitoring
  • Sealed door(s) with door frame and pre-filter for inlet of air
  • Door interlock with sensor: when door is opened, portable fan filter box will ramp to maximum capacity for containment whilst ceiling FFU supply air will slow down.

• Modular 20’ and 40’ Container

  An isolation room built with a personal en suite bathroom and anteroom; designed for severe viral shedding COVID-19 positive individuals, often characterized by frequent coughing and sneezing with no other severe symptoms that require admission to intensive care wards.

  

  Figure 2. Top View of Esco Modular 20’ Container

• Single 40’ Container Premium

  An isolation room built with personal en suite living room, bathroom and anteroom; designed for individuals who want private space without any other severe symptoms that may require admission to intensive care wards.

Space Shortage Alleviation

Surge of individuals requiring treatment from healthcare professionals has brought about space shortage as appropriate and suitable facilities have been compromised due to high demand. On such occasion and in conjunction with other Esco Aster’s COVID-19 products, Modular 40’ Containers can be built into full medical centres such as Esco Aster Turnkey Treatment Center (TTC). TTC is adapted from WHO Severe Acute Respiratory Infections (SARI) guidelines, provides total containment for healthcare worker protection and to greatly reduce health system exhaustion. It is an easy to assemble-disassemble modular treatment center for immediate relocation of COVID-19 positive patients.

Figure 3. Isometric View of Esco Modular 40’ Container

Esco’s Unending World Class and Worldwide Legacy

Esco remains unwavering throughout the world’s circumstances. Today, as nations try to relentlessly combat the COVID-19 pandemic, Esco wages itself forward and brings turnkey solutions to aid in the recovery and treatment of COVID-19 positive patients.

 

References:

1. Centers for Disease Control and Prevention. (2017). Glossary of Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings. Retrieved on 30-March-2020. Retrieved from: https://www.cdc.gov/infectioncontrol/guidelines/isolation/glossary.html?fbclid=IwAR2QyjeGY5oC6ooDCIve07dVmvQJ9dPLng52ITngPeTikLd5kx1sGuKjXg0

2. Centers for Disease Control and Prevention. (2020). Strategies for Optimizing the Supply of N95 Respirators. Retrieved on 30-April-2020. Retrieved from: https://www.cdc.gov/coronavirus/2019-ncov/hcp/respirators-strategy/index.html

3. Sitammagari, K., Skandhan,A., Dahlin, A. (2020). What Hospitalists Need to Know About COVID-19. Medscape. Retrieved on 30-March-2020. Retrieved from: https://www.medscape.com/viewarticle/926634?fbclid=IwAR3qkd6b4w1skGSngmmh2gO0RkrNDLG73Rvjh1O2AJhj4qVeN6QhzvRSjt8#vp_2

 

About Esco Aster

Esco Aster is a contract development and manufacturing organization (CDMO) spun out as an independent subsidiary in 2017 from the Esco Group of companies founded in 1978. Process Development for clients was previously provided within the group with our partners as early as 2002.

Esco Aster is focused on offering vaccine-, bio- cell- and gene-therapy development manufacturing services using primarily its proprietary Adherent Tide Motion Platform supplemented by single-use suspension and fermentation, downstream bioprocessing, and custom bioengineering equipment for client-specific therapeutics. Within the chem- biopolymer- cosmetic, personal care, cosmeceutical- segments, we excel in converting batch processes into continuous flow chemistry, closed aseptic processing within isolators, along with a variety of skin safety/efficacy testing services.