Little Rock native's work aids covid fight

Intubation box designed to protect medical professionals

A modified intubation box is shown in this undated handout photo. The clear plastic barrier is placed over the head and upper body of a patient, but the modification at left is a vent similar to the range hood over a kitchen stovetop. Little Rock native Cameron H. Good said the vent has shown promise in drawing out aerosol droplets that could contain the novel coronavirus, thereby helping to protect medical workers.
A modified intubation box is shown in this undated handout photo. The clear plastic barrier is placed over the head and upper body of a patient, but the modification at left is a vent similar to the range hood over a kitchen stovetop. Little Rock native Cameron H. Good said the vent has shown promise in drawing out aerosol droplets that could contain the novel coronavirus, thereby helping to protect medical workers.

WASHINGTON -- A Little Rock native believes he and his colleagues have found a low-cost way to lower the risk of covid-19 exposure.

The goal, Cameron H. Good said, is to help protect health care professionals and to save lives.

Early research, the neuroscientist said, is promising.

This month, Good co-authored a paper for the Annals of Emergency Medicine titled "Improved Testing and Design of Intubation Boxes During the Covid-19 Pandemic."

Bearing the names of nine researchers, Good and Dr. David Turer were the two lead co-authors.

An intubation box is a clear, plastic glass barrier that is placed over the head and upper body of a patient before a breathing tube is inserted into the airway. There are two round holes at one end of the box so that medical professionals can access the patient and complete the procedure.

Researchers found that intubation boxes, on their own, are unable to prevent the escape of aerosols that may carry SARS-CoV-2, the virus that causes covid-19. With adaptations, however, the boxes can be made effective, the study indicated.

The key is to suction out the aerosols before they are able to escape.

Good, who works at the U.S. Army Combat Capabilities Development Command's Army Research Laboratory in Maryland, helped design a biocontainment device that does just that.

And it's not just effective; it's affordable, he said.

A graduate of the Joe T. Robinson High School and the University of Central Arkansas, Good took a job in 2005 at the National Institute of Health after earning his doctorate in neurobiology from the University of Arkansas for Medical Sciences.

An Army researcher since 2012, Good's focus is on "soldier protection," he said, and he studies everything from sleep deprivation to body armor. He began working on his latest project in March, shortly after lab employees were told to stay at home.

Prevented from using his normal work space, he began looking for ways that he could tackle the covid-19 challenge while working remotely.

It took some adjustment.

"I'm just a very hands-on worker, so being stuck at home, working from my dining room table, it was a foreign concept for me," he said.

For the military, covid-19 is more than an abstraction.

An outbreak aboard the USS Theodore Roosevelt, a nuclear-powered aircraft carrier, left more than 1,100 sailors infected.

Given the tight quarters on the ship, it easily spread, ultimately claiming the life of at least one crew member, Chief Petty Officer Robert Thacker Jr. of Fort Smith.

Good looked for ways to prevent SARS-CoV-2-laden aerosols from spreading in confined quarters -- ships and submarines and the like.

"We had this opportunity to really help people out in the pandemic," he said. "I wasn't going to sit idly by and not try."

Good got encouragement from military brass and help from a fellow researcher.

"Our commanding general ... sent out a call to everyone and just said, 'If you have any ideas that can help, we're listening.' So that was also a big push for us to really get this moving," he said.

Early on, Good reached out to Turer, a longtime friend who was completing a residency at the University of Pittsburgh Medical Center.

In addition to his training as a plastic surgeon, Turer also possesses a master's degree in electrical engineering from Purdue University and a master's degree in biomedical engineering from the University of Michigan.

With most elective plastic surgery postponed due to the pandemic, Turer had also shifted his focus to covid-19 research.

His goal was to lower the risk of covid-19 exposure in medical settings.

Due to coronavirus restrictions, "we were both working from home," Good said.

Rather than pursuing separate research tracks, they decided to collaborate.

"[We] came upon this concept of a ventilation box to isolate patients and to essentially prevent the spread of covid-19," Good said.

Rather than using high-cost, hard-to-find parts, they opted for the kinds of supplies that are available at Home Depot, Lowe's or similar home improvement stores.

"We came up with a couple of different designs," Good said. "In terms of actually hands-on building, that was all [done] in Dave's basement up in Pittsburgh."

Initial testing seemed promising.

"We were both shocked at the early success, how well it worked," Good said. "We both quickly realized that we had this really cool concept and had this novel kind of device. ... [We] just started working from there to validate it and refine it further."

Covid-19 patients breathe out -- and cough up -- aerosols containing the virus. The minute particulates can remain in the air for hours, potentially infecting doctors, nurses, fellow patients and anyone else in the vicinity.

"Boxes with negative pressure," Turer said, can eliminate the threat.

"Negative pressure," Turer said, is "just a fancy way of saying 'vacuum' or 'suction.'"

The device, Turer said, is analogous to the range hoods that are installed above kitchen stovetops.

"Let's say you're cooking something. If you don't have anything to vent that air out, what happens? Your whole house will just fill with smoke. But if you turn on that fan, that fan draws the air ... outside where it obviously isn't a problem," Turer said.

By vacuuming up the aerosols soon after they are exhaled, the risks can be sharply lowered, Good and Turer believe.

When the air is passed through a special filter, 99.99% of the virus-sized particulates can be captured, they said.

As the project progressed, Good and Turer invited others to help. Experts volunteered to run tests to ensure that the device was effective.

When the results were positive, Good, Turer and the others submitted their findings to the Annals of Emergency Medicine for publication.

Now they're seeking an emergency use authorization -- or EUA -- for the devices from the U.S. Food and Drug Administration.

"We have manufacturing and assembly partners identified," Turer, the study's other lead co-author, said. "As soon as the EUA is granted by the FDA, we can make these available."

The Pentagon has also taken notice.

An article about the study, titled "Innovative Biocontainment Unit Shows Promise," was featured this month on the Defense Department's website.

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While the cost for the devices has not yet been set, the researchers predict it will be affordable enough that it can be widely used in the U.S. and around the world.

Once its approved and on the market, the device "absolutely" will save lives, Turer said.

"I think it extends far beyond covid[-19]," Turer said.

The devices should be able to slow the spread of "any kind of airborne respiratory infection," he added.

Since completing his residency in Pennsylvania, Turer has taken a job in Texas.

With covid-19 restrictions eased, Good has returned to his Army lab.

Research on the biocontainment box continues there, he said.

The ideal version would be silent, small, portable and easy to store.

While the new device has enormous humanitarian potential, it also is "a new way to protect soldiers," Good said.

"What we really want is a battery-operated system that is super quiet so that we could ... deploy [it] on ships or aircraft or, essentially, any austere environment," Good said.

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