Modified 'intubation boxes' reduce infection risk; Variant of gold-standard diagnostic test may be faster

A tool used by doctors and nurses to protect themselves from the coronavirus is flawed but a modification can improve it, researchers say.

To insert breathing tubes into patients, clinicians have been placing plexiglass boxes over patients' head and shoulders to contain any virus particles the patients might emit; the doctors then slip their hands through holes in the sides.

But droplets, or aerosols, that can contain virus particles are leaking out, researchers reported on Thursday in Annals of Emergency Medicine.

Using a test aerosol the size of virus-containing particles, they compared a commercially available plexiglass intubation box to a modified box with a vacuum system to filter the air.

Aerosols in the surrounding air "significantly exceeded allowable safety levels" with the typical box but were fully contained by the addition of a vacuum and air filtration, they said.

The researchers have applied for Early Use Authorization for their modified box, which they say could also be used to isolate awake COVID-19 patients on ships and in medical facilities.

Variant of gold-standard diagnostic test may be faster

Researchers say a variation of the gold standard test for diagnosing COVID-19 removes unnecessary steps and allows faster and less expensive testing, with at least equal accuracy.

The goal of the test, called polymerase chain reaction, or PCR, is to look for RNA and DNA, the genetic material in the virus.

Normally, in a version of the test known as quantitative PCR (qPCR), all the materials are mixed together in a single large test tube, but the results could be affected by contaminating substances such as nasal cavity contents obtained during a swab for COVID-19 testing.

To get around this problem, most qPCR tests are preceded by a purification step to remove contaminating substances.

But "digital droplet" PCR (ddPCR), an established technique, can effectively identify SARS-CoV-2 genetic material using unprocessed cells without any purification steps, the research team from the University of California San Francisco reported on Thursday on medRxiv ahead of peer review.

By making it possible to bypass the RNA extraction step, ddPCR may help ease the coronavirus testing bottlenecks caused by shortages of the extraction chemicals as well as speed the delivery of results to patients, the researchers said.  -- Reuters