despite WHO insistence that Covid-19 was not significantly spread by aerosol, the ED leadership believed otherwise based upon early experiences in China
Short Stay Unit was re-located to a remote ward away from the ED and only low risk or no risk patients were admitted - this also allowed lower risk “vulnerable” staff to keep working in a clinical environment (high risk vulnerable staff were given non-clinical duties)
patients were streamed into “High Risk” suspect Covid and “Low Risk” suspect Covid streams with the high risk patients allocated to cubicles with their own air space which was separate to the low risk cubicle air space and separate to the main staff base which fortunately had floor to ceiling walls to allow this.
patients were given surgical masks at an early phase of the pandemic and SH ED was the first to institute this even though at the time there was a shoortage of masks
antiviral air cleaners “scrubbers” were imported and placed in high risk zones such as the wait rooms, resuscitation rooms, “High Risk” suspect Covid zone and the staff base
air flow levels were increased in high risk zones - especially resuscitation cubicles
an outdoor gazebo was installed for staff to not only allow improved social distancing during meal breaks but improved ventilation
aerosol generating procedures were either banned or required to be performed in one of the two negative pressure rooms with modifications to the procedures to further reduce local spread of virus
early realisation that some patients pose higher risk of aerosol spread through their aerosol generating behaviours such as yelling out
where possible, known positive cases were placed in the negative pressure rooms if available
early introduction of regular full ED surface cleans