The Canadian Healthcare System: How is the Country Handling the COVID-19 Pandemic? Resource by Camfil, CA

Summary:

In this blog post experts at Camfil Canada discuss the need for adequate air filtration in hospitals, break down air filtration guidelines applicable to the Canadian healthcare system, and address new changes to CSA 317 and ASHRAE 170.

As of September 8th, 2021, there are approximately 37,000 active COVID-19 cases and over 1,525,000 total cases to date¹. There is no question that the Canadian healthcare system has needed to adapt to these uncertain times and take extra caution to mitigate virus spread. To secure the safety of patients and medical staff, the Canadian healthcare system follows several guidelines from the Canadian Standards Association (CSA). The maintenance of superior indoor air quality (IAQ) is undoubtedly an important component in ensuring hospital cleanliness. As a result, there are several air filtration considerations listed by the CSA that hospital facilities should take into account.

How Does Air Filtration Mitigate the Spread of COVID-19 in Canadian Hospitals?

The Centers for Disease Control and Prevention (CDC) has long recognized healthcare associated infections (HAIs) as a threat to patient safety². As a consequence of the recent pandemic, the need to prevent HAIs is more critical than ever before and there is an increased focus on the development of infection control methods. The CDC highlights three main routes of SARS-CoV-2 virus transmission³:

Inhalation of small respiratory droplets and aerosol particles containing viable virus
Respiratory droplet and particle transmission via exposed mucous membranes in the mouth, nose, or eye of people in close proximity
Touching mucous membranes with hands that have been soiled by virus-containing respiratory fluids or touching surfaces with virus on them

Based on these transmission methods, it is reasonable to deduce that removing or trapping contaminated particles would result in lower virus transmission rates. This is where air filtration can make all the difference. A high efficiency particulate air (HEPA) filter, for instance, is able to remove 99.97% of airborne particulates at 0.3 micron, and can trap larger or smaller particles even more efficiently. That being said, the areas of a given hospital do not all require the same protective measures, and therefore air filtration standards are not one-size-fits-all. Thus, it is important to understand the specifics of the air filtration guidelines for the Canadian healthcare system.

What Air Filtration Guidelines Does the Canadian Healthcare System Follow?

Across North America, industries strive to meet guidelines from the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) for matters concerning air filtration. ASHRAE also developed the North American standard for classifying filter performance by establishing a minimum efficiency reporting value (MERV) to assess a filter’s ability to remove certain size particles⁴. While ASHRAE standards and guidelines are still applicable, the Canadian healthcare system primarily follows the guidance of the CSA.

The key document produced by the CSA underlines special requirements for heating, ventilation, and air-conditioning (HVAC) systems in the healthcare industry – it is intended to specify all the parameters required for the various areas of patient care in order to provide proper air quality.

CSA Z317.2-19 is particularly notable in light of the COVID-19 pandemic. In this section, air change rate standards have been extended for clinical settings to address airborne infection risk prevention. It should also be noted that this document supersedes previous editions and contains addenda.

How Does the New CSA Addenda Impact the Operation of Canadian Hospitals?

The latest document update was released in 2019, and it is the fifth edition of CSA Z317.2. It includes significant changes that hospital facility managers should know before making decisions about their HVAC systems. Some of the biggest changes directly listed from the CSA Z317.2 product page are⁵:

Clarification of HVAC requirements for rooms and areas used for similar or different functions, including more stringent requirements for areas in a facility used for more than one function
Information on areas with increased activity level potentially requiring a higher air exchange rate to maintain air quality
Revisions for HVAC system upgrades associated with renovations or additions
A new clause on ventilation of normally unoccupied service areas
New requirements for HEPA filter testing and performance verification

While the addenda to the CSA document was incorporated before the COVID-19 pandemic came to light, ASHRAE has also recently shared new recommendations impart with its Epidemic Task Force to address mitigation of airborne infectious diseases. These recommendations have not been directly integrated into the ASHRAE 170 Standard (the guidelines that the U.S. healthcare system follows) as this association and most others have timeline restrictions on new edition publications. However, it is evident that virus mitigation is an important topic, and it has therefore been undertaken by a separate committee.

How Does the ASHRAE Epidemic Task Force Address COVID-19?

Some of the best practices for reducing airborne infectious aerosol exposure explored by the ASHRAE Epidemic Task Force include⁶:

Following requirements for social distancing, wearing of masks and other PPE, reducing occupancy, and increasing hygiene procedures
Promoting space air mixing without causing strong air currents that increase the chance of direct transmission
Verifying that HVAC systems are functioning as designed
Using combinations of air filters and air cleaners that achieve a MERV 13 rating or better for recirculated air from HVAC systems

As a caveat regarding the last best practice that is illustrated, a point within new addendum A of ASHRAE 170 states that MERV ratings are assumed to be non-degrading. Therefore, “MERV” should actually denote air filtration products with “MERV-A” ratings, however, this is not a formal requirement.

Choosing the Right Air Filter For Your Hospital Facility

Hospital facility managers and appropriate stakeholders should consider air filtration best practices in order to ensure that the right steps are taken to protect the health of medical personnel, patients, and visitors and maintain a safe indoor environment.

Canadian air filtration expert Berni Baier recommends a variety of filtration solutions for different patient care areas that can be installed directly into air handling units (AHUs). The air filter efficiency rating for surgery and critical spaces and protective environments are typically required to be HEPA grade⁷. In systems utilizing box-style filters, the Filtra 2000 is a HEPA filter that rests in an anodized aluminum enclosing frame with a poured-in-place sealing gasket. Due to the filter’s large media area, pressure drop is lowered and the life of the filter is significantly lengthened. Another option from the Absolute V air filter line is the Absolute VG. This HEPA grade final filter also maintains a low pressure drop and has an optimized, compact design.

For other patient care areas such as inpatient spaces and procedure rooms, Baier suggests using an air filter with a rating of at least MERV 13/13A. MERV 13/13A filters are meant to protect people (not just equipment) and have an improved capture efficiency from 0.3-1 micron. The Hi-Flo ES from the Hi-Flo line comes in various MERV-A ratings and has the lowest average pressure drop to ensure the lowest energy cost in the industry. It may be used without a prefilter to further reduce energy costs. The Durafil ES² is a high capacity, high efficiency, V-style air filter that is in an ABS plastic enclosing frame. It is also available in various MERV-A ratings.

If AHUs cannot support new filter installments, or if further protection is preferred, the CamCleaner CC500 acts as a standalone unit. It is a combination HEPA/gas removal filter, meaning it is effective in both particulate and molecule removal and delivers a healthier indoor environment.

There are a variety of factors that determine which air filtration solutions will best protect your hospital facility. Be sure to contact an experienced commercial building air filtration consultant to find the air filtration solutions that are right for your building.

About Camfil Canada Clean Air Solutions

For more than half a century, Camfil has been helping people breathe cleaner air. As a leading manufacturer of premium clean air solutions, we provide commercial and industrial systems for air filtration and air pollution control that improve worker and equipment productivity, minimize energy use, and benefit human health and the environment. We firmly believe that the best solutions for our customers are the best solutions for our planet, too. That’s why every step of the way – from design to delivery and across the product life cycle – we consider the impact of what we do on people and on the world around us. Through a fresh approach to problem-solving, innovative design, precise process control, and a strong customer focus we aim to conserve more, use less and find better ways – so we can all breathe easier.

The Camfil Group is headquartered in Stockholm, Sweden, and has 33 manufacturing sites, six R&D centers, local sales offices in 30 countries, and about 4,800 employees and growing. We proudly serve and support customers in a wide variety of industries and in communities across the world. To discover how Camfil Canada can help you to protect people, processes and the environment, visit us at www.camfil.com/en-ca/.

Media Contact:

Holly Gardner

Camfil Canada Inc.

T: 437-929-1161

E: Holly.Gardner@camfil.com

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Resources:

¹https://health-infobase.canada.ca/covid-19/epidemiological-summary-covid-19-cases.html

²https://www.cdc.gov/hai/prevent/prevention.html

³https://www.cdc.gov/coronavirus/2019-ncov/science/science-briefs/sars-cov-2-transmission.html