“Although mobile clinics are usually seen as something ephemeral”, Dr. Cohen said, “I think we’re in this for the long haul.” Coronavirus testing goes mobile in Seattle, New York Times
“Consider the possibility of mobile laboratories or, if available, automated integrated NAAT systems that can be operated in remote regions and by staff with minimal training.”
Now that we’ve missed the opportunity for early testing, is it too late for testing to make a difference? Absolutely not. Tests would make a measurable difference. We should be doing a stochastic process random probability sample of the country to find out where the hell the virus really is. Because we don’t know. Maybe Mississippi is reporting no cases because it’s not looking.
MOBILE RESPONSE
Testing Strategy Recommendations for COVID-19, World Health Organization
The Doctor Who Helped Defeat Smallpox Explains What’s Coming, Wired
COVID 19/
Mobile response
The Case for Mobile Testing Mobile Testing Goals Process
Centralized The Current Situation: 1,362,936 is total number of confirmed cases of coronavirus around the globe - a number that as we speak, continues to grow. According to the CDC, most of the U.S population will be exposed to the virus in the coming months, and there will be increased instances of community spread. The rapid spread of the virus and its subsequent effects has put an immediate strain on an already overloaded healthcare system, that is now dealing with elevated rates of hospitalization and millions of people waiting in line to be tested.
Executive Summary | Perkins & Will
Distributed Background Research:
After analyzing the current response to emergency testing, the team found that centralized hospitals are not the ideal environment to deal with highly transmissible viruses, mainly because social distancing is hard to control and resources are scarce and scattered. Because of this, cities like Seattle and New York quickly identified the need to implement drive-through testing facilities that ensure secure social distances are maintained. Through our research we found that while this method has been successful in controlling the risk, in high-density areas the system could create social inequalities due to a Under this scenario, experts agree that coordination large percentage of the population depending on public of a public response will strongly rely on how quickly transportation. Other solutions such as Israel’s use of countries implement testing as the key measure by which ambulances for home testing have increased the strain on to understand and control the spread of the virus. Even the emergency response system, while other DIY methods more, the economic health of countries might depend on have not succeeded. the testing processes that give people a green light to get back to work without the risk of infecting others. The recently FDA-approved Abbot Test is evidence of the need for speed, flexibility and mobility. Our solution focuses on this new technology.
Mobile Our project: In the past weeks, our team has identified five key parameters that define the success of the testing process: mobility, accessibility, speed, flexibility, ease of implementation and scalability. Under this framework we are exploring the refitting of vehicles that can be quickly converted into mobile testing centers. To address the ease of implementation, connection to the communities and universality of the response, our starting point is the repurposing of underutilized school buses. Our concept is equitable and responsive. As outbreaks occur in different locations, deployable healthcare units respond in real-time and can be quickly assembled by under-served communities. The system gathers essential geolocation and test-result data, allowing a real-time data feedback-loop to help authorities with strategic decision-making.
2
Existing approaches Mobile Testing Pros and Cons Process
Hospital testing • Lab testing on site • Equipment,Staff, Materials easily exchanged • High volume testing
• Increased risk of transmission in journey and triage • Many hospitals’ swell zones unsuitable HVAC • Out of geographical range for many ppl • Limited scalability
?
• How might hospitals service other forms of testing (e.g. pharmacy, drive thru, home and mobile) more effectively?
Existing Approaches | Perkins & Will
Drive thru testing
Home testing
DIY
• High volume processing possible • Scalable solution
• Low chance of transmission • Equitable
• Immediately scalable • no deployment issues
• Those without private cars either cannot access or expose drivers to risk
• Comparatively labor intensive and time consuming • If using medical service vehicles it creates a system strain
• • • •
• Difficult to scale • Low volume and high cost can lead to difficulties of scalability
• How to balance equability • Quality of sample
• Interstate deployment possible but not completely mobile • Limits spread of virus but can expose drivers to risk
Fraudulent tests Inexperienced testing technique Relies on postal service Differences in financial resource
3
Our Project Mobile Testing Process What can Perkins & Will do?
Our Project | Perkins & Will
• Outfit existing underutilized school buses into mobile testing centers • Design a quick and inexpensive assembly system and a set of guidelines that can be replicated across the world - a low tech DIY system that can be quickly adopted by under-served communities. • Design integrated solution that draws from multiple Perkins and Will expertise: S&T, healthcare, urban planning, P&S, IT
Our value proposition
Limit risk of transmission due to testing need
High volume testing with long operation periods
Equitable testing
Responsive capacity
Scalability Implementation- speed
Minimize transit for the person to be tested
Efficient and comfortable methods for practitioners
Solution that does not rely on proximity to a facility or a car
As the virus moves, so should testing capacity
Ability to ramp-up quickly according to need
4
Expected Outcome | Perkins & Will
Mobile testing Testing Process Expected Outcome
1
2
3
4
5
Driver sets up external registration/control point
Technician scans patients bar-code and retrieves sample from behind a protective barrier
Sample is brought into the bus and passed into the lab
Lab technician analyses samples and scans bar-code (results are inputted)
Results are submitted to official database and sample is discarded
5
Mobile testing Testing Process Process & Deliverable
Process& Deliverables | Perkins & Will
Our Team:
Incubator April
Post-Incubator May
1.0 Interviews with experts:
3.0 Kit of Parts Research:
- James Levin
- Off the shelf products
- Brenda Smith
- Alternative pre-fabricated furniture system
- Practitioners Research will focus on cost, accessibility and 2.0 Abbott Test Research
functionality
Mariana Giraldo Planning & Strategies New York
Iv Shqevi Architecture New York
Enlai Hooi Product Design SHL
Jordan Hanson Architecture New York
2020
App development: - Partnership
Panel of experts:
Pilot: Partnership - NGOs - City Agencies
4.0 Grant and Partnership Research & Coordination - NGOs & other organizations Matthew Malone New York
Deliverable:
Refined program, protocols and overall user journey.
Deliverable:
Road-map for Kit of parts development. Road-map for pilot development
Robert Goodwin New York
Yanel de Angel Boston
Deliverable:
Open Source kit of parts & assembly instructions. Pilot Bus
Kalpana Kuttaiah Firmwide
Brenda Smith New York
James Levin Boston
Budget: References: Coronavirus Testing Goes Mobile in Seattle. Retrieved from: https://www.nytimes.com/2020/03/13/us/coronavirus-testing-drive-through-seattle.html Laboratory testing strategy recommendations for COVID-19, World Health Organization. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf
Renderings/Collateral /Video Production
$1700
3D prototyping
$300
The Doctor Who Helped Defeat Smallpox Explains What’s Coming. Retrieved from: https://apps.who.int/iris/bitstream/handle/10665/331509/WHO-COVID-19-lab_testing-2020.1-eng.pdf Coronavirus News: First use of rapid test for COVID-19 happening on Long Island, retrived from: https://abc7ny.com/rapid-test-for-coronavirus-long-island-nassau-county-suffolk/6068435/ Bus, van to offer preventive care for under-served: Cambridge, retrieved from: https://www.nwaonline.com/news/2019/apr/01/two-mobile-health-centers-will-roll-out/ Mobile Health Map, retrieved from: https://www.mobilehealthmap.org/tools-and-resources and https://www.youtube.com/watch?time_continue=489&v=PcGBGOymLd8&feature=emb_title ID NOW™ COVID-19 MOLECULAR. IN MINUTES. ON THE FRONT LINE, retrieved from: https://www.alere.com/en/home/product-details/id-now-covid-19.html Interview with Kathy Saber MD, conducted by Iv Shqevi
TOTAL
$2000 6
Fold out canopy
Protective Barrier Folding Table
Pass-through
Respite/Storage
Clean Flow
Clean Lab
1
2
3
4
5
Driver sets up external registration/control point
Technician scans patients bar-code and retrieves sample from behind a protective barrier
Sample is brought into the bus and passed into the lab
Lab technician analyses samples and scans bar-code (results are inputted)
Results are submitted to official database and sample is discarded
It has become clear that in the upcoming months greatly increased testing will be needed to evaluate and control the spread of the coronavirus. How can we develop a solution that is easy, quick and cost-effective to implement, and bring it directly to underserved, high-risk communities?
Underutilized School Buses
Outfitted with testing technology
Deployed to communities at high-risk