STOPDROP, Tripura's panacea for COVID outbreak

Dr. Arkadip Choudhury

May 2, 2020, 13:08:05   

At a time when scientists across the globe struggle and brainstorm to devise a vaccine that actually works against the Novel Coronavirus, one tends to forget the massive risk of not having enough protective gears which would protect those protecting us - doctors and paramedics. Dr. Arkadip Choudhury of Tripura claims to have successfully engineered STOPDROP, a one size fits all face shield that would not only protect people from the vicious droplets carrying the Coronavirus, but will also reduce the spread of the same and it seems to be actually working out there, in the field. Will STOPDROP be the panacea we all need now? Well, till the vaccine is invented anyway..

End of December, 2019. As the whole world was busy planning the New Year's Eve, a monster was unfolding its deadly wings that over the coming months would eventually overcast the very existence of human being in this world. It was the 31st of December, 2019 when the Chinese authorities alerted the World Health Organization (WHO) regarding a clustering of pneumonia cases that were occurring in the Wuhan City of the Hubei Province of China from an unknown cause, but the world might just have been in a hangover too high to have heard the alarm bells ringing. The rest is history, the rest is the dreaded present we are living in, and the rest might very well be the future ahead, unseen and quite unpredictable. Some ten or twenty years down the line, the then existing generation of analysts and historians might find no Country or Government for that matter responsible for the sheer enormity of one of the greatest disasters of modern times, the COVID-19, but there is no hiding from the fact that due to reasons whatsoever, the whole human race is running a furlong short of the small assembly of half hearted genetic materials wrapped in an envelope of proteins and lipids and christened SARS-CoV2 and the whole story today is one of the human race trying with all its might to catch up with this tiny particle. Since January of 2020 the internet has been flooding with literature of every kind regarding COVID-19. Medical articles have undergone a shift in their nature from helpless awestruck statistics to attempts aimed at preventing the spread to attempts of treating it to verified reports of the extremely diversified clinical profile not to mention that there could be no possible clinical features at all. Amidst this cocktail of chaos and glimmers of hope, the news that had repeatedly strung out of note was one related to the lack of personal protective equipments (PPEs) for the frontline workers. And who other than a medical professional would be more disturbed by this note? Leading manufacturers of medical protective equipments across the world had up scaled their production to meet the demands of the time, but like many other "unfortunates" these manufactures were too young to be living witnesses to the 1918 Spanish Flu and perhaps therefore had no idea regarding what a global demand could actually be like. The result was quite predictable, a chaos in the supply chain. This coupled with restrictions on international commercial air traffic made the procurement of the available material even tougher. This prompted national otherwise small scale producers to step up and take the place of the market giants. Although initially these national companies very well handled the situation and made the protective gears available across the country, the growing number of COVID cases and the nationwide lockdown created a similar type of disruption in the supply chain and procuring equipments kept becoming difficult. This in turn prompted local designers to manufacture and make available basic protective equipments within the locked down state. The story of STOPDROP face shield is no different. As I was working my days through in Tripura Medical College & Dr. B. R. Ambedkar Memorial Teaching Hospital in Hapania a suburban area located approximately 6 kms to the South of Agartala, the capital city of Tripura, all I could see is a strange fear looming in the eyes of everybody to some extent or the other. True, that when you are facing a crisis as this, a little fear keeps you safe, but more often than not, this fear would overwhelm their daily routines and bring the required fluidity of work to either a mushy stagnancy or an agitated whirlpool. It was not always clear as to what the exact nature of trouble was. Was it the fear of the virus, was it the anguish regarding the lack of PPEs or was it the confusion regarding the "when, which and hows" of protective equipments thanks to the never heard before suggestions and guidelines that were flowing in. But whatever it was, it was disturbing the whole system for sure. So I tried to look in to the problem from the core. The virus we were dealing with is primarily a respiratory virus. If it has to enter the body it will through either the mouth or the nose mainly. Although robust data regarding an ocular gateway of the virus to the body might still be lacking, but reports of ophthalmologist and otolaryngologist deaths in China and Italy,  and increased awareness of asymptomatic and pre symptomatic spread of new infections all favor mouth, nose, and eye protection. The next question was what to protect the mouth, nose and eye from. If the virus was in reality capable of being airborne, the only way to protect the mouth and nose would be respirators not below the grading of N-95 or equivalent which is simple terms have the capability to filter about 95 percent of the suspended particles in ambient air, while protecting the eyes would require safety goggles with complete seal. None of these were available in quantities enough to provide for all those who were constantly exposed to the air possibly contaminated with the virus. On the contrary it was actually at least theoretically easier to cut down the more proven way of the viral transmission that is via respiratory droplets ejected from the nose and mouth of the effected individual over shorter distances and landing directly in to the nose, mouth or eyes of a health care worker. The answer to this was to use a face shield. Face shields are clear visors attached to a head band which when worn properly protect the wearer from a direct spatter just like the wind shield of a car protects the driver from all the oncoming dust, sprays and rain drops. The advantage of this protective equipment is that, if designed properly, it is usually light in weight, easy to wear and in expensive to make so that adequate availability can be ensured and improper reuse prevented. This concept of prevention of viral transmission has been used worldwide since a long time. Post COVID-19 outbreak in India, few designers from different parts of the country came out with their own designs of face shield which were actually good. But the problem was elsewhere. Firstly, the local demands were so high that it was difficult for most manufacturers to supply these articles outside the feeder area. Secondly even if a manufacturer was ready to sell out a part of its daily produce, the inter-state courier services had slowed down significantly to be able to ensure a constant supply chain and thirdly even if a surface transport was available to do so, the price of transportation and retail sale would add up to the otherwise in-expensive device and make it expensive all over again thus negating one of the vital concepts of this protective equipment. There was only one way out. Design it within the state itself and to stay uninterrupted, do it at home. The first step towards it was to study the basic construction of a head shield properly and then draw a plan to substitute parts of the shield with raw materials available locally. For example, the soft sponge used as a padding inside most premium versions of the shield was replaced by cheaper compressed polyester foam used as packing materials and inexpensive furniture cushioning. Adjustable plastic head band was replaced by half inch clothing elastic to ensure a "one size fits all". The second step was to procure the materials amidst the lockdown. Fortunately, the lockdown itself had slowed down the consumption of the construction materials and stationary items required for building the face shield. My trusted car seat maker made the foam and elastic available from his stock while my friend from printing press ensured a steady supply of the stationary. The next challenge was to devise the shield in the form of a kit that could be assembled when ever required. When the prototypes were made, it seemed easy, but when kits were being built the durability of the assembly became an issue and we had to work on it for quite some time to solve it which included waking up my car customization friend in the wee hours of the morning to borrow his heavy duty stapling kit and calling in the press guy to my living room turned workshop to train him and hand him over the task of large scale production. Finally we had a product that was light in weight, comfortable to wear, optically clear, provided an adequate coverage of the mouth, nose and eyes while still keeping the production cost and the price low. The COVID-19 Task Force at my Medical College and my Department of General Medicine had extended their invaluable support during the entire process and encouraged me all through while my family bore with the chaos of the workshop that I had made in my house a long time since my days of work education at school. The advantage of the kit and assembly method came to use once again when the shield was distributed among the various segments of medical and support staffs in the hospitals who requested for customized versions of the shield to suit their requirements. For example, the ENT specialists demanded a smaller and sleeker version of the shield that could be used with their head mirrors while the Ophthalmologists demanded a half face cover version to use their ocular examination devices with ease, all of which could be made using the same kit with minimal alterations. A separate version of the shield has also been designed to fit the requirement of intensivists engaged in the potentially dangerous procedures such as endo-tracheal intubation and surgeons to provide for their operative requirements. The shield is also believed to provide excellent spatter protections to the frontline staffs engaged in the flu clinic, security personnel and cleaning staff handling liquid wastes all the time. Till date more than two hundred shields have been supplied to the college with another at least three hundred on order to be supplied soon. Still in the early days of practical usage, we are rigorously testing the product for its durability and user comfort in all head sizes. A small step though, we firmly believe that this face shield that we have pet named "STOPDROP" meaning a device that stops droplets, will certainly prove to be a giant leap towards providing an affordable basic protection in the fight against the new vice of nature, SARS-CoV2.


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