The facility is designed and assembled by experts from across the department and should enable testing of up to 1,500 people a day.
In mid-March, in response to the unfolding Covid-19 pandemic, WITH Medical quickly set up test tents where important workers and others who remained on campus could be safely screened for the new coronavirus. In the tents, nurses and doctors administered nose sticks while dressed in fully personal protective equipment or PPE.
It quickly became clear that medical staff had to regularly replenish their PPE – a resource in short supply, desperate for testing on a daily basis. There was also the possibility that a nurse, by attenuating all that PPE at the end of an eight-hour shift, could risk inhaling infectious particles that might stick to dresses, surgical masks, and face masks.
“One of the biggest challenges in Covid testing is [that] you put the person performing the test at a not insignificant risk, ”says Brian Schuetz, MIT Medical Chief of Staff.
Weather conditions were also a challenge when a Norwegian champion at the end of March threatened to raise the tents. Given the hot summer months, Schuetz and his medical team knew that major adjustments needed to be made to improve the safety and comfort of both patients and staff.
“We made an early decision that we should think differently about how we did things,” says Schuetz.
Over the course of two months, he and experts from across campus worked tirelessly to design and build MIT’s latest test facility – a 60-foot trailer that now serves as the main test site for asymptomatic members of the MIT community who need to return. to campus.
Inside the renovated trailer is room for a check-in station and six test bays. Floor-to-ceiling plastic partitions run the length of the trailer, keeping medical personnel on one side and those being tested on the other. In each test bay, a tester on one side of the partition can fit her arms in large rubber gloves that extend to the other side so that she can perform a nose stick without any of the parties coming into physical contact.
The trailer is also equipped with an upgraded HVAC system, calibrated so that the air on each side of the separators does not mix. The two separate compartments in the trailer allow medical personnel to safely test people while wearing a simple surgical mask, rather than full PPE.
“The result is: the people behind the plastic are very safe,” says Schuetz. “If we can make our team comfortable and patients comfortable, we can help everyone be safer.”
The trailer started in early July with capacity to test up to 1,500 people a day. MIT’s group of information systems and technology wired the trailer to MIT’s Covid Pass system, which gives an MIT member access to campus facilities if they have tested negative for coronavirus. The trailer has been designated as a test site for asymptomatic members with access to the Covid Pass app.
The whole experience takes about two minutes. The nasal plates are analyzed at the Broad Institute of MIT and Harvard, and results are introduced into the Covid Pass system; those who have been tested can check their results via the app.
“One of the biggest challenges in all of this effort was figuring out how to get all of these different pieces together, and I think we’ve created a solution that works together to help campus stay safe.” says Schuetz. “It really is an example of MIT at its best – innovation from scratch.”
A race against time
This basic effort started quickly when Schuetz first approached Elazer Edelman, director of the Department of Medical Technology and Science, looking for additional sources of PPE for the medical tents that were originally used.
“And Elazer said, ‘Wait a minute – MIT is the best place in the world to find people who can do exactly what we want,'” recalls Martin Culpepper, a professor of mechanical engineering and a member of MIT’s management team at Covid -19. .
So the medical team focused their vision on testing the MIT community, not in tents with medical staff in full PPE, but in a well-ventilated, weather-protected space.
Edelman connected with Culpepper, who reached out to campus workshops for material resources and expertise. Meanwhile, Schuetz worked with the Department of Facilities to acquire two trailers.
“We order trailers for construction projects all the time, and that’s nothing out of the ordinary, except now we’re in the middle of a pandemic and there are not many trailers out there,” Paul Murphy, director of special projects in the Construction Campus team, reminds facilities. “But everyone stepped up and knew how important this was, and within four days we had two trailers that could normally take months with this type of fit-out.”
Culpepper met with Tasker Smith, technical instructor at the Department of Mechanics, and Jennifer O’Brien, technical instructor at the Department of Architecture, who together designed a test room designed for the larger, 60-foot trailer, based on initial conversations with medical staff.
“The early stages were about napkin sketches, cardboard, duct tape and bubblegum – whatever it takes to help you wrap your mind quickly around this thing,” says Smith.
O’Brien built a rough model of a test bay and invited several nurses and doctors to test it out.
“After experiencing creating custom furniture, I thought there might be a need they will find out they have that they would not think of in advance,” recalls O’Brien. “I realized that, for example, based on the testers’ large width of height and shoulder width, existing designs found online at the time may not have been comfortable for everyone.”
So she made a crucial adjustment to the final design and built the gloves into an extra panel in each window that can be adjusted up and down to accommodate a tester’s height. The team then worked with Culpepper to acquire materials for the building itself.
“At that time, the whole world realized they had to buy plastic sheets to protect people who interact with each other, like cashiers and students, so there was a big curvature,” O’Brien says. “We were fighting against time and had to get this thing up and running as fast as possible to manage a larger MIT population as soon as they started returning to campus.”
While she and Smith began building the physical layout of trailers using campus construction crews, Culpepper worked on the Facilities to optimize the trailer’s HVAC system.
“We performed all sorts of calculations of how much air had to be turned at a given time, with the number of individuals that would occupy both sides of the trailer,” Murphy says.
The team designed a positive pressure HVAC system that pumps 700 cubic feet per minute of outside air through one side of the trailer’s plastic separator, in a way that keeps one side at positive pressure and the other under negative pressure – a balance that prevents air on each side from mixture. A large, custom-built exhaust stack blows the air about 12 feet above the trailer.
So far, approx. 4,000 people tested in the trailer. The ultimate goal is to get all members of the community who work and live on campus tested up to twice a week, with the trailer as a key component of this strategy. However, Schuetz notes that the development of testing technologies, medical guidance, and the prevalence of Covid-19 in the wider Massachusetts community are likely to result in changes in testing strategy in the coming months.
Looking to a hopeful future, Schuetz suggests that the trailer can be configured for other purposes, such as testing people for antibodies or even administering a vaccine.
“It’s not over now that it’s built,” adds O’Brien, who along with Smith puts together a pack of shareable specifications for anyone interested in building similar facilities. “It continues to be a versatile design, and we’re still here on campus if necessary to update it.”