Infections are the leading cause of death in Long Term Care facilities, accounting for 380,000 deaths annually,1 including influenza, pneumonia and others. Unfortunately, SARS-CoV-2 will only worsen this statistic. Pathogen-carrying droplets or aerosol particles and poor indoor air quality have taken center stage in today’s fight against COVID-19 in healthcare facilities, and it’s estimated that as high as 43% of all COVID-19 deaths have been in Long Term Care facilities.2 It’s crucial to consider modifications to airflow as well as clinically effective solutions that may prevent airborne transmission in Senior Living communities. Let’s evaluate three different HVAC infection prevention indoor air quality solutions to help fight COVID-19:

  1. Dilution & Filtration
  2. Ultraviolet Germicidal Irradiation (UVGI)
  3. Needlepoint Bipolar Ionization (NPBI)

1. Dilution & Filtration

According to ASHRAE: “Ventilation and filtration provided by heating, ventilating, and air-conditioning systems can reduce the airborne concentration of SARS-CoV-2 and thus the risk of transmission through the air.”3

Dilution reduces the concentration of particles and pathogens in the air in an indoor space. This can be accomplished simply by opening windows or by adjusting HVAC system air change rates to increase exhaustion of indoor air while bringing in outdoor air. While fresh air doesn’t kill the virus, it dilutes the concentration and reduces the level of exposure for residents, making infection less likely.

Senior Living COVID-19 HVAC

Pros:

  • Cost-effective
  • Traps particles and pathogens
  • Thoroughly tested, documented and well understood
  • Enhanced effectiveness when combined with other IAQ technologies like NPBI

Cons:

  • Unconditioned spaces can cause thermal stress to vulnerable seniors and increase risk of infection
  • Increasing outdoor air intake in high-pollutant areas can contribute to poor air quality
  • Full make-up air capabilities not standard on many Senior Living HVAC systems

Filtration goes a step further to trap particles and pathogens from outside or recirculated/conditioned air in a filter as they pass through an HVAC system. This is available on most air handlers and as a thin filter for dust on PTACs.

  • Minimum Efficiency Reporting Values (MERV) ratings are a measure of a filter’s ability to capture particles 0.3 to 1.0 microns. MERV values are not standard and will vary from one brand to the next, so it’s important to check brand, system and compatibility.
  • High Efficiency Particulate Air (HEPA) filters are a type of pleated mechanical air filter and can theoretically remove at least 99.97% of dust, pollen, mold, bacteria, and any airborne particles with a size of 0.3 microns. The diameter specification of 0.3 microns responds to the most penetrating particle size (MPPS).4 Generally, your HVAC system needs to be compatible with a HEPA filter or it may not work as effectively. More system power would then be required, resulting in increased energy bills and extra strain and maintenance on your system.

MERV Filter Indoor Air Quality COVID-19

Pros:

  • Cost-effective
  • Traps particles and pathogens
  • Thoroughly tested, documented and well understood
  • Enhanced effectiveness when combined with other IAQ technologies like NPBI

Cons:

  • Does not trap VOCs (odors)
  • Requires regular replacement
  • May decrease HVAC system efficiency if HEPA or higher MERV rating filters are installed

2. Ultraviolet Germicidal Irradiation (UVGI)

Ultraviolet light has long been known for its disinfection properties. UVGI emits a specific band of UV light (radiation) that can break down pathogens, and is available in many applications to treat water, surfaces and indoor air. It can be installed in several ways.

Resident Rooms ‒ this portable option can be put into an unoccupied resident room to periodically disinfect surfaces

Cabinets ‒ this large cabinet sucks air through and past UV lights for periodic disinfection; residents may be in the room, but the unit is loud

Upper Room ‒ this positions light at the upper ceiling, giving some benefit at all times, but needs circulation to help ensure contaminated air reaches the unit 

UVGI in HVAC Air Handler Units

UVGI for healthcare HVAC systems is typically installed near the primary air conditioning coil. Most airborne pathogens that the UV light is concentrated on or that pass within the UV bulb’s line of sight can be destroyed, and its positioning near the coils provides added sterilization of condensation that forms on coils and fins. Combining with filtration to remove passing dead pathogens makes for an even more effective solution.

UVGI Air Handler HVAC Infection Prevention COVID-19

Pros:

  • Proven effective 
  • ASHRAE recommended
  • Doesn’t affect system efficiency and airflow
  • Won’t damage unit coils
  • Energy efficient

Cons:

  • Requires regular cleaning and replacement to maintain efficacy
  • Reactive: only kills what it “sees”
  • Harmful: precautions required to avoid exposure to skin and eyes

3. Needlepoint Bipolar Ionization (NPBI™)

Installed into new or existing HVAC systems, including rooftop units and PTACs, NPBI uses an electronic charge to create a plasma field filled with a high concentration of positive and negative ions. As these ions travel with the air stream and flood facility spaces, they attach to particles, pathogens and gas molecules to:

  • Inactivate pathogens
  • Agglomerate fine sub-micron particles that can be filtered or fall out of the air
  • Break down harmful and/or unpleasant VOCs (odors)
Needlepoint Bipolar Ionization Indoor Air Quality Technology

The proactive nature of NPBI technology ‒ flooding both positively and negatively charged ions into the rooms where residents congregate ‒ gives it added efficacy against hard-to-find-and-kill pathogens by not limiting treatment to only air that passes through the HVAC system. Combining with filtration to remove passing dead pathogens makes for an even more effective solution. This technology differs greatly from simple negative ionization, which affect particles only, can create ozone and typically has lower effectiveness because of very low airflow rates and clean air delivery rates (CADRs).

Pros:

  • Lab tested to kill or inactivate many viruses, including SARS-CoV-2 
  • Proactive: ions are sent into spaces to find and inactivate pathogens
  • Doesn’t affect system efficiency and airflow
  • Won’t damage unit coils
  • Energy efficient
  • No maintenance required

Cons:

  • Some older versions of ionization technology could create harmful ozone; confirm with the manufacturer that their technology is certified to not create ozone

Break the Chain of Infection with HVAC Infection Prevention Solutions from Direct Supply

We’re your partner when it comes to enhancing Indoor Air Quality for your building, staff and residents with consultation, expertise and service. We offer the latest in Needlepoint Bipolar Ionization (NPBI) technology from Global Plasma Solutions that inactivates 99.4% of SARS-CoV-2 in 30 minutes!5 Our experts will work with you to tailor a solution to your needs and see your project to completion with expert installation services from TELS® Building Management. 

Call 888-433-3224 or learn more about an Indoor Air Quality solution for your Senior Living communities from Direct Supply.

References

1 “Long-Term Care Facilities | CDC.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, https://www.cdc.gov/longtermcare/index.html. Accessed 25 June 2020.

2 Times, The New York. “43% of U.S. Coronavirus Deaths Are Linked to Nursing Homes.” The New York Times, 27 June 2020, www.nytimes.com/interactive/2020/us/coronavirus-nursing-homes.html. Accessed 30 June 2020.

3 “COVID-19: Resources Available to Address Concerns.” Home | Ashrae.Org, https://www.ashrae.org/technical-resources/resources. Accessed 25 June 2020.

4 “What Is a MERV Rating? | Indoor Air Quality (IAQ) | US EPA.” US EPA, 19 Feb. 2019, https://www.epa.gov/indoor-air-quality-iaq/what-merv-rating-1.

5 Inactivation results based on sensitivity testing conducted by independent third-party testing laboratory using control chambers. Multiple data points are used to formulate performance validation statements. The technology is used in a wide range of applications across diverse environmental conditions. Results in non-lab environments will vary; clients should evaluate their individual application and environmental conditions when making an assessment regarding the technology’s potential benefits. For all independent laboratory results, contact your TELS representative. The use of this technology is not intended to take the place of reasonable precautions to prevent the transmission of pathogens (including COVID-19). Comply with all applicable public health laws and guidelines as well as CDC guidance.