India is now at a critical phase in the pandemic. With more than 425,000 cases, the country is fourth in the list of worst-affected nations. In the midst of the crisis, however, little attention has been paid to the rising number of healthcare workers testing positive in the course of duty.
With the healthcare system stretched, a further layer of protection is clearly needed. From turning conventional stethoscopes digital to making personal protection equipment (PPE) kit coveralls with infection-proof fabric, some startups are working on the solutions.
A SAFE fever clinic
Designed and developed by DIY.health, a Mumbai-based, pandemic-response focused startup, the SAFER Clinic is essentially a negative pressure (an isolation technique that minimizes the risk of contagion) fever clinic. It has a glass glove wall separating the doctor and patient, enabling safe examination and testing. Each patient has their own cabin.
SAFER, or Safe Assessment Fast and Effective Resolution, is engineered along the lines of the bio-safety cabin used in labs. “It is a device in which you can run experiments. It is completely sealed,” explains Swapneil Parikh, co-founder, DIY.health.
The startup initially came out with the SAFEST testing kiosk, similar to a phone-booth testing kiosk. It then considered taking the kiosk indoors or building a structure “that not only kept the doctors safe but also prevented the patients from infecting each other,” says Parikh. For this, it came up with a negative pressure solution: negative air pressure on the patient’s side, positive pressure in the doctor’s portion, with glass separating the two. “Think of negative pressure as a vacuum,” says Parikh. “Droplets and aerosols are getting sucked up. Positive pressure works as an air pump that throws the air out. Nothing from the patient’s side can get to the doctor’s side,” he adds. The air pressure system is complemented by HEPA filters, a disinfection system and virus burners. DIY.health followed the Ashrae (American Society of Heating, Refrigerating and Air-Conditioning Engineers) guidelines—it not only conducted computational flow dynamic simulations to ensure clinic functionality, this was also vetted by professionals who do similar checks for hospitals. One cabin in the clinic costs ₹2-2.5 lakh, including taxes. “It also depends on the configuration and solutions that are used in the cabin,” adds Parikh.
At present, two SAFER clinics are in use at Mumbai’s NSCI Covid Care Centre and BYL Nair Hospital. Parikh says they intend to keep the designs open source. “That’s our preference. This way people can build it in other cities,” he adds.
Antiviral fabric
The availability and use of PPE kits has been a point of much debate. At a time when news reports indicate India is being able to scale up production, a startup backed by the Indian Institute of Technology (IIT), Delhi, has created two types of infection-proof fabric for healthcare settings. Fabiosys Innovations, which uses a combination of 100% cotton and a proprietary disinfecting solution, initially collaborated with the Delhi-based All India Institute of Medical Sciences to create an antibacterial fabric for ICUs. “But then covid came and we had to modify our technology to be able to develop antiviral fabrics,” says startup founder Yatee Gupta.
Fabiosys is developing two lines: an antibacterial fabric that can kill 99.9% of bacteria in 2 hours and an antiviral fabric that neutralizes 99.9% of viruses within 25 minutes. “Our plan is to make healthcare garments out of these two products. Right now we are in the process of manufacturing coveralls, which falls under the category of PPE kits,” says Gupta. “We will focus on products depending on the needs of the healthcare facilities,” he adds.
The fabrics are dipped in three sets of proprietary chemicals and processed through repurposed textile machines. “When this dipped fabric is passed through the machines, the reaction between the chemicals and the fabric creates antibacterial and antiviral nanoparticles on the surface,” explains Gupta. Cotton was an obvious choice, given its comfort and availability. Once he is ready, Gupta plans to supply the coveralls through HLL Lifecare Ltd, a government agency responsible for the procurement and supply of PPEs and coveralls, and private hospital chains. The fabrics can be used in bedsheets and curtains too. Gupta says they will be “affordable”—only about 10% more than what hospitals are paying for PPE coveralls.
Digital stethoscope
Ayu Devices, a startup incubated at IIT, Bombay, has developed a digital stethoscope. The AyuSynk is a compact electronic Bluetooth module that can be attached to a regular stethoscope to record, share, analyse and amplify heart and lung sounds by 16 times.
Adarsha K., co-founder of Ayu Devices, says that when covid-19 struck, they received enquiries about whether the device could be used from a distance. “Many pulmonologists rely on stethoscopes to see whether there are any problems in the lungs. But in PPEs they cannot use normal stethoscopes because their ears are covered. For this, we have Bluetooth capabilities built into our device, which lets a doctor listen to the sounds using headphones,” he explains.
The startup has also designed the AyuShare app to share and analyse the recorded sounds using Artificial Intelligence. For instance, it can tell whether a heart beat is normal or not. “So far, we were concentrating on making the device useful for recording heart sounds but after covid-19 we are focusing on lungs because in pneumonic conditions there are abnormal lung sounds which doctors need to listen to,” says Adarsha.
There have been two recent hardware additions to AyuSynk: a USB receiver and Bluetooth headphones. With the help of these, doctors can wirelessly transmit the information to their smartphones and listen to the sounds, via the headphones, inside the PPE. The setup costs about ₹18,000 and is currently being used by over 10 hospitals across Mumbai.
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