Although the novel coronavirus had already been spreading rapidly, most employees in the United States went to work in mid-March unaware that their lives were about to temporarily, yet drastically, change. When the number of known cases of COVID-19 rose to 1,645 across 47 states by March 12th, the US declared the crisis a national emergency the next day.
With limited knowledge of what the virus was, and was capable of, few people guessed that a regular day in March would turn out to be their last day at work—either physically for those fortunate enough to be able to work remotely, or employed altogether for the large percentage of the workforce that experienced layoffs.
For many NEBB experts, however, that was far from the case. Experts like NEBB Certified Professional (CP) Tony Kiefer, Test and Balance Foreman for Harris in Rochester, MN were preparing for the brutal effects of COVID-19 well before it became widespread in the US.
By examining the havoc wreaked in China, and then in Europe, many knew that hospitals would need to be built out and interim critical care facilities needed to be ready to operate for further ICU capacity in just a few short weeks. Those select few that had been paying attention, knew it wasn’t a matter of if, but when, the virus would inevitably take over the US.
Necessary COVID-19 Guidance
In early spring, NEBB 2019-2020 Vice President and President of Atlantic Testing Jon Sheppard was asked to join an ASHRAE subcommittee regarding the effects of the pandemic. After ASHRAE started seeing the coronavirus spike in other countries back in January, it put together an epidemic task force to help offer guidance. As part of the building readiness subcommittee, (which reports to the overarching epidemic task force committee), Sheppard uses his TAB and commissioning expertise to help answer questions submitted through the ASHRAE website.
“In this time of uncertainty, owners and operators need to know how to shut their building down if they’ve temporarily ceased operations, how to change the building status to accommodate a reduction in use, and how to prepare to properly get things back to normal—or more foreseeably, prepare for some kind of a ‘new normal.’ It’s too early to pick out trends in our industry. It’s too early to tell a lot of things, but personally, I’m expecting to see a new normal,” says Sheppard.
Many of his clients, amongst others, have been relying on the ASHRAE website for guidance throughout their work to help contain COVID-19. Although no new standards have been developed specifically for this pandemic, ASHRAE is pointing users to existing standards and documentation for implementing methods to help keep building occupants safe.
Based on questions submitted through the site, ASHRAE offers a list of online FAQs for topics like Healthcare, HVAC System Operation During Building Shutdown, How to Return the HVAC System to Normal Operation, and more. The website, which can be found at www.ashrae.org/covid19 is updated every week.
For his own firm, he’s reviewing systems manuals, sequences of operation, and helping his clients with testing to establish benchmarks for things like airflow, sequences, humidity levels, and pressurization before any changes are made to their buildings.
“It’s important to test and make sure that the building is operating like the owner thinks it is,” Sheppard says. “As you can imagine, our hospital clients have been the most proactive about this. Comfort level, humidities, airflow, fresh air rates are all taken into account.”
Pivotal, Quick Turn Projects
Working with the Mayo Clinic, Kiefer entered the frontlines of pandemic projects early on. “We started around March 10th because they had been monitoring the international community and saw how quick it hit,” Kiefer describes his experience of entering preparation mode early. “They wanted to have a plan in place for anticipated heavy patient loads.”
At the Mayo Clinic, Kiefer’s team was responsible for converting what would normally be positive patient rooms into negative rooms with dedicated exhaust. They altered over 100 rooms to meet the required number of air changes per MN health codes, as well as worked with the engineers at the clinic to set rooms to the calculated airflow for room size.
“In some cases, we had two days to do balancing work. We worked alongside Mayo’s engineers to make decisions like making adjustments if readings showed we were short on airflow,” he says.
“One of our most interesting projects was to help design and plan for two 40 x 7-foot steel trailers to be used in sanitizing surgical masks for reuse. We found out about the project on a Friday afternoon and needed to have it operational by Monday morning for a test run. And we had to come up with fans and dampers that were readily available at the Mayo Warehouse in order to meet the short time frame,” explains Kiefer, referring to the exhaust dampers and fans used during the sanitization process that occurs in the trailers. “It’s work that couldn’t be done without two of my reliable coworkers—NEBB Certified Technician John McNeil and Cheri Spading who is about to take the TAB test.”
Like Kiefer’s work at Harris, many NEBB firms were used to finding out about a job, followed by a request for completion just days later. In the midst of a national outbreak, time is not on anyone’s side.
“Around late March, we started getting calls from local hospital clients. They needed isolation wings set up with negative pressure rooms and needed us to go in and verify air changes in the rooms. All our clients were calling with emergencies. We got calls at 9:00 p.m., 4:00 a.m., all hours of the day. They were in panic mode,” recalls NEBB CP Nick Muscolino, Manager at Aero Building Solutions near Chicago. “They were reaching out to find out what their systems could handle, or what additional equipment could be applied to meet their new needs.”
“We were selected by the Army Corps of Engineers to open two auxiliary care hospitals and not only set up the airflow, but also help the design team determine feasibility of the conversions. It was a unique situation, as the hospitals were shuttered and had not been in operation for at least a few years. No one knew what they were getting into. We didn’t see drawings ahead of time; everyone was looking at them together, coming up with strategies, and walking the building together,” Muscolino remembers. “It involved a lot of survey work and critical thinking. The team of engineers and contractors worked together to see what we could use, what we couldn’t, and assess supplementary needs for ventilation, air changes, and pressure.”
“Hospitals are set up for infectious disease control based on cascading pressure from room to room and corridors. Our goal was to increase ISO spaces for COVID-19 patients and protect all doctors, staff, and other non-COVID patients,” Muscolino continues. More outside air (OA) was introduced, and by increasing airflow, he and his team achieved better air quality in the designated spaces.
“We were consulting with the engineer and mechanical contractor from the very beginning. Our techs worked 12-hour shifts, Saturdays and Sundays, to meet a quick turnaround deadlines,” he explains.
NEBB TAB CP Caleb Antone of Gootee Services in Metairie, LA also knows the effects of working to beat the peak outbreak well. His work at a Veterans Affairs (VA) hospital in New Orleans to increase the number of available beds from 25 to around 125 began in emergency mode.
“We came into the picture and it was a mad dash to get them where they needed to be. It was my job to verify that things could run correctly after the VA facility/maintenance staff retrofitted things like ductwork and equipment,” Antone confirms. “Everyone was doing their part quickly to ensure they got the materials and equipment needed to get the job done. In order to get the right ductwork, for example, the team travelled to a neighboring city. We also had to determine how far we could push certain equipment to perform well beyond what it was designed to do. It was a challenge, but we did it.”
The team worked around the clock to accomplish everything in a little over four weeks. Antone said he was often working 14-hour days, and at one point worked a stretch of 16 days without a single day off. They took it one building, one floor at a time, making sure not to disturb the critical care processes occurring in the ICU while patients were there.
“We needed to ensure air wasn’t going to bleed out into the corridors or other areas where workers and medical staff were treating illnesses unrelated to COVID-19,” states Antone. Because the VA facility was only about four years old with a pandemic area designed as part of the top floor of one of two inpatient buildings, it was better prepared than most, but still required adjustments to meet the growing needs of the virus.
“Military facilities already have systems in place to protect from bioterrorism, such as a major button that can be used to shut down the building’s HVAC and close dampers off to any outside air. Now, they are working to update their facilities to also include a pandemic button which operates a little differently to accommodate a virus such as COVID-19. For example, outside air is increased, while the amount of recycled air is decreased,” adds Sheppard.
Protecting High-Risk Populations
Although healthcare has made up the lion’s share of work performed during the pandemic, senior living and advanced care communities have also presented important opportunities for NEBB firms.
“Long term care facilities are converting wings of their buildings into negative patient rooms in order to help protect other residents and to take pressure off of the hospitals, if necessary,” mentions Kiefer. His work with the Homestead of Rochester, a facility housing long term care residents, was executed as a means of proactively preparing for the capability of serving COVID patients, if needed.
“One of our hospital clients also has a two-story nursing home on the same property. Nursing care patients from the upper floor were moved down to the 50 beds on the lower floor that were dedicated for non-COVID patients. That way, any COVID care that needed to take place on the second story did not put the healthier residents at higher risk,” explains CEO of Gaghan Mechanical, Inc, Kevin Gaghan. “It’s been hard finding the real estate to create the number of projected beds needed. At one facility alone, the state said they needed to come up with 200 more beds.”
Essential Ingenuity
In light of the challenges brought on by a sudden pandemic, industry experts have been forced to get creative. Between starting to offer some services remotely, obtaining and teaching about PPE in resourceful ways, and meeting Centers for Disease Control and Prevention (CDC) regulations in a pinch, NEBB firms have found ways to flex their strengths in the presence of COVID-19.
“I’ve been on five or six Microsoft Teams meetings per day. It’s a different world now. We’re balancing, and consulting with engineers and mechanical contractors. We’ve learned we can do commissioning virtually and are doing it a lot more than we previous thought to do. We’re just as efficient now as before when we were in the office—if anything, we’ve had to tighten things up and become more efficient. Of course, there’s only so much we can do virtually,” states Muscolino.
Closer to the capital in Alexandria, VA, Gaghan agrees, “We have been extremely busy, designing and installing equipment in hospital rooms with rooms that have windows which open—a challenge requiring original design.”
He has been working with smaller size hospital clients to prepare isolation rooms, including windows that are negative pressure. The rain shield he designed for the windows prevents water and mold and allows for expanded negative isolation rooms on an as needed basis, all while meeting negative pressure CDC requirements. “State and local jurisdictions require negative rooms just for COVID patients and additional rooms for non-COVID patients to keep them separate. Once we figured out how to do one, we made little tweaks to learn how to perfect the rest.”
Others faced the challenge of little to no PPE, or how to train teams on proper gowning of new PPE and were left to their own devices to figure it out. “Our client required a mask very early on, but masks were in short supply. We were only provided masks in we were working in the OR. My wife made my mask,” says Kiefer.
“We set up standards and PPE requirements for working in hospitals and other COVID patient areas. In active hospitals, our techs were basically gowned up like doctors and nurses. Scrubs, booties, you name it, so we had to train guys as quickly as possible on the use of additional PPE. It was a challenge to bring them all in and do the training while social distancing. We gave them PPE in person and showed them how to put on and take off properly,” Muscolino says. “Our techs really stepped up—and they were called to do a lot. I find it very admirable because they all have families, too,”
“We were lucky we had such a great group of people to work with. We had a big pool of experience to draw from for everybody to come together and make it happen. There were no egos involved; we were all working toward the same goals,” affirms Antone.
The Foreseeable Future
Although initially there was no end in sight as the number of reported COVID cases soared day after day, a shift appeared to take place as more of the population began to take serious precautions to limit exposure and increase safety for all. Some fortunate states even experienced far fewer COVID patients taking up hospital beds than anticipated. In fact, some of the facilities that were built out for additional ICU capacity were barely used.
“Luckily, we haven’t had to really use them. We may need them in the fall though,” warns Muscolino. “Only time will tell if we have to do more,” Gaghan adds.
“Now, after focusing on healthcare, setting up systems, and consulting with them the past few months, our focus has shifted to OA adjustments and supplementary filtration systems to potentially mitigate any airborne pathogens for buildings that need to reopen safely. We are assisting commercial buildings with best practices to reopen buildings to occupants. How do you bring your water systems online as safely as possible? There’s an energy component to that, as well. We are helping provide safe spaces for occupants while being cognizant of energy usage,” remarks Muscolino. “We’re dealing with different states regulations, too.”
“A lot of people have fears, but a lot of it comes down to common sense. Use PPE, protect yourself. Educate employees on what they have to do and how to protect themselves, but at the same time, don’t force anyone to work where they feel unsafe,” states Gaghan.
All in all, these essential services performed by NEBB CPs have helped save lives during a devastating outbreak that had already claimed over a half-million lives worldwide at the time of print. We may not know what the rest of this unprecedented year will entail, but NEBB CPs can walk confidently (and safely!) into these next months, knowing that the work they perform truly matters.
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