Multimodal infection control bed isolation system: towards safeguarding emergency rooms from future pandemics

Coronavirus disease (COVID-19) exposed how emergency rooms (ERs) can be overwhelmed during a large-scale airborne outbreak, forcing closures and disrupting emergency care. In this proof-of-concept study, we developed and evaluated a prototype of a multimodal infection control bed isolation system (MICBIS) integrating physical isolation, air circulation with HEPA filtration, and automated UV-C disinfection, designed to help ERs remain operational during airborne-disease outbreaks. The initial design was guided by computational fluid dynamics (CFD) simulations; a prototype was then installed and validated in a full-scale ER mock-up by dispersing the biological indicator (BI) Bacillus subtilis with a Collison nebulizer. In biological validation under steady-state, static conditions in an enclosed laboratory environment, no viable BI was recovered outside the integrated unit, both airborne and settled BI within the enclosure fell below the detection limit, and remaining BI on the internal surfaces was inactivated within 20 min by UV-C. Because the MICBIS was designed as a standalone unit requiring no modifications to the ER or its ventilation, we expect it can be deployed rapidly at an open ER bed. Following this feasibility study, additional validation of this system is required in a dynamic clinical environment.