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FIGHTING COVID-19


Engineering interventions’ contribution highlighted


IHEEM was among the professional engineering bodies to contribute to a ‘Rapid Review of engineering factors that will influence the spread of COVID-19 in hospital environments’ earlier this year, the results of which the Royal Academy of Engineering (RAE) – which led the initiative – published on 3 June. Focusing on the impact on infection transmission of everything from hospital ventilation and plumbing systems, to the materials used in healthcare settings, and room and equipment decontamination technologies, the Review drew on engineers’ expertise and insights. It recognised that, alongside healthcare personnel, human factors experts, statisticians, and epidemiologists, engineers and engineering ‘interventions’ can play a significant part in helping to reduce the spread of hospital-onset COVID-19. HEJ editor, Jonathan Baillie, reports.


In an article published on pages 24-26 of the July 2020 ‘online only’ issue of Health Estate Journal, Dr Hayaatun Sillem, CBE, HonFIHEEM, the Royal Academy of Engineering’s Chief Executive, pointed out that that with large numbers of infected patients in hospitals and other healthcare facilities during the COVID-19 outbreak, and healthcare workers exposed to high viral loads, there was a significant risk of viral transmission within such settings. While the primary control strategy had been to rigorously follow Government infection prevention and control guidance, it was recognised that engineering considerations – from the layout and condition of hospital plumbing and drainage systems, and the materials used in clinical areas, to the various decontamination technologies now available – could also markedly affect the extent to which the virus spreads in healthcare settings.


Drawing on rich expertise Dr Sillem explained in the HEJ article, entitled ‘Engineering better ways to control HAIs post-COVID-19’, that against this backdrop – ‘drawing on the rich expertise’ of IHEEM members and Fellows and other professional engineering institutions – the Academy had been ‘working with government to understand the important role of engineering and technology design and good practice in addressing this problem’. This had resulted in a ‘Rapid Review of engineering factors that will influence the spread of COVID-19 in hospital environments’, to which IHEEM contributed, alongside organisations including CIBSE, the Institution of Mechanical Engineers (IMechE), and the Institute of Physics and Engineering in Medicine (IPEM). The findings informed new PHE guidance on reducing the risk of COVID-19 transmission in hospital settings.1


16 Health Estate Journal September 2020


RAE Chief Executive, Dr Hayaatun Sillem.


Although acknowledging that the Review was ‘not meant to be comprehensive’, the RAE, which co- ordinated it through the National Engineering Policy Centre (NEPC), dubbed it ‘part of the engineering community’s input to government to inform the ongoing development of advice and policies’. One of the striking features of the inputs gathered, Dr Sillem explained, had been ‘the complexity of the challenge of hospital-onset COVID-19, and the wide variety of ways in which engineers could inform the approaches being adopted’. For the Review, the engineering profession was consulted ‘to understand the role of engineered systems to support the risk mitigation’. This process identified potential engineering solutions to limit hospital onset infection, outlining those already in operation in many hospitals (both in the UK and internationally), ‘near-term innovations’ that could support the COVID-19 challenge’, and ‘longer-term


considerations’. Where not already in use, the Rapid Review suggested that these ‘should be considered to be additional to specified hospital cleaning protocols, not as an alternative’.


A ‘complex and multifaceted’ problem The project partners concluded that from an engineering standpoint, hospital-onset infection ‘is a complex problem’, that depends on: n The characteristics of infections and how they spread.


n The design, use, and maintenance of hospital environments.


n User behaviours. n Interactions with external elements, such as the delivery of food and other services.


The Review’s Executive Summary says: ‘Each of these considerations is multifaceted, with opportunities for engineering design or technology solutions to either increase or suppress


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