Searching the Internet one night, UCSF pediatric cardiologist Athira Nair found something she wasn’t really looking for – a life-saving prototype ‘box’ designed by a doctor from Taiwan that protected caregivers from the COVID-19 virus. She thought, “This could help protect my coworkers at Community Regional Medical Center,” and that’s when she decided to make one.
 
“It’s a plexiglass box with armholes cut in it where physicians can place their hands through to treat a COVID-19 patient,” she describes. “The light-weight box is placed over the patient’s upper body during procedures so you’re not exposed to the virus while you’re leaning over a suspected or positive patient during a procedure.” Any droplets breathed out from the patient’s lungs are trapped inside the box, protecting the caregiver.
 

Fresno handyman, doctors build and test box

She couldn’t believe something so simple was able to block the droplets. Now she needed to make one for Community Regional where she practices. So she enlisted her ‘handyman’ next-door-neighbor Jay Russell to craft one.
 
Dr. Nair bought the materials and Russell worked on the design based off the prototype. He said he’d make a box and then the glue would fail or the armholes would not be big enough.  After a few more boxes, he got the fabrication down to a science. The first box was ready to try in Community Regional’s Emergency Department after testing, practicing, and approval for its use. And, it was a hit.

Peace of mind while treating COVID-19

“As a physician myself, I could just imagine being in that situation [worried about exposure to the virus droplets]. That’s where the thought process came from,” Dr. Nair says about designing the box. “For the patients, they get a doctor who’s fully involved in the procedure, who’s not worried about their own safety.”
 
The “peace of mind” for the physician is that there is no aerosolizing of droplets and they are not being exposed while trying to do a life-saving procedure.
 

It’s reusable, practical and saves on PPE

With the current shortage of personal protective equipment (PPE), this box saves on having the caregiver openly exposed to droplets and thus using less PPE, Dr. Nair says. It’s practical as well.
 
“Apart from the other protective equipment that you are wearing, you have an additional physical barrier,” she says.  “Also, the box is reusable.”
 
To clean the box, you simply follow the standard disinfecting procedures for hard surfaces as recommended by the Center for Disease Control and Prevention. The box also cuts down on the number of people wearing PPE to clean the medical rooms after the caregivers perform a procedure because the droplets are confined to the box.
 

Simple innovation now in use

“This is such an innovative idea that Dr. Nair has come up with – and so helpful,” says UCSF emergency medicine physician Rais Vohra, who is currently the interim Fresno County Public Health Officer. Dr. Vohra helped put several prototypes of the device into use at Community Regional's emergency department. “These will definitely help protect our patients, our nurses and physicians during cases where we need to attend to critically ill patients. We have asked her to make more.”
 
Besides the emergency department, Dr. Nair says they also designed a smaller box to use with children in the hospital’s Pediatric Intensive Care Unit. Dr. Nair and Russell have offered to make more or share the ‘specs’ with any hospital that needs these.
“We didn’t build these boxes to make money, we made them to help – because it’s the right thing to do,” Russell says.  “It’s what you do during a time like this … find ways to help.”