Dr. W. Ian Lipkin, an epidemiology professor at Columbia University’s Mailman School of Public Health and one of the world’s leading infectious-disease investigators, was on his way to a meeting on campus last Wednesday. He would have preferred to be in West Africa. He worked on the ground in Asia during the SARS epidemic and in Saudi Arabia studying the respiratory virus MERS. But seven weeks ago, as Ebola continued its horrifying siege, he fell on some stairs and broke his foot.
Lipkin, who is sixty-one, had his left knee resting on a scooter, his foot in a large black boot. “I can’t possibly get into a P.P.E. suit,” he said, referring to the personal protective equipment that health workers must wear when tending to Ebola patients.
A few weeks ago, Lipkin teamed up with Linda Fried, Mailman’s dean, and Mary Boyce, the dean of the School of Engineering and Applied Sciences, to see how Columbia might help combat the epidemic. On October 2nd, Lipkin announced a university-wide design challenge: to develop low-cost technology-driven solutions to Ebola. All students and faculty, past and present, were invited to participate, and could spend up to a hundred and fifty dollars on materials. Each team had to create a prototype in less than two weeks. “We had to truncate the time frame,” Lipkin said. “People are dying.”
A day after the competition started, eighteen teams presented their preliminary ideas to a team of experts. “We eliminated fifty per cent based on relevance,” Lipkin said. “There were proposals that were naïve, that required doing complex diagnostics with saliva, things like that. These people were typically faculty. They’re hardheaded. They weren’t listening. But the undergraduates! People talk about ennui and apathy in undergraduates? I don’t see it. They came up with some fantastic stuff.”
The finalists made their presentations twelve days later, before a panel comprising Lipkin and seven other faculty members. Ponisseril Somasundaran, a professor of mineral engineering, started with a presentation on bleach foam. He played a video, shot at six that morning outside a Columbia parking garage, of a hose spraying bleach foam on a shower curtain. Using bleach in foam form can decontaminate areas more effectively than spraying a simple bleach solution, because foam smothers what it covers. Lipkin was impressed. “Think of a bubble bath,” he said. “You can see there are bubbles all over everything, as opposed to if an area is just wet.”
Next was a group of six students who had come up with an Ebola Containment Suit, which could contain a patient’s bodily fluids while providing adequate ventilation and hydration. A yellow prototype was placed on the conference table. The conversation turned to feces containment.
“We’d like to create a boxer brief, or trouser-like design,” Michael Maloney, a master’s student in civil engineering, said.
“And we’ve lined part of it with absorbency pads,” William Joe Smith, a junior majoring in biomedical engineering, added. The team estimated that the material would cost forty cents.
“That’ll cost more than forty cents!” Lipkin said.
“I called up DuPont and asked what the cost would be,” Ritish Patnaik, a junior, said. “They estimated it cost them forty-two cents on their end, but we’re hoping they’ll sell it to us at forty cents because of the purpose.”
The panel heard seven more proposals. There was a decontamination chamber for electronics, a text-message-based communication system to help coördinate surveillance, and a foldable wooden cot with a plastic covering designed to contain bodily fluids during sickness and death. It had to be presented in the hallway, because it couldn’t fit through the door.
One panelist, a doctor, was concerned with the sanitary disposal of corpses. “The pressure you get from an exploding abdomen,” he said. “Will that blow off the cover?” The presenters weren’t sure.
One of the most easily implemented ideas was a colored bleach spray, which the panel surmised might work in conjunction with Somasundaran’s bleach foam.
“The solution almost sticks, and coats every nook, cranny, and wrinkle of a P.P.E. suit,” an undergraduate engineering student named Jason Kang said. Other bleach sprays simply bead up on the suits’ hydrophobic material. “Using the color coding, you can say, ‘Here’s a blood spot. I want to spray that with blue, so I can see it,’ ” he continued.
It would cost four cents to disinfect one suit, and the solution would be easily transportable. “Think of it like those Tide laundry pods you drop in water,” Kang said.
After the team filed out, Lipkin said, “It’d be perfect for spraying down trucks and taxis. It’s exciting. I want to make sure those kids don’t get lost.”
When the presentations were finished, Lipkin was pleased. “Students are far more creative than the fossils they were talking to in that room,” he said. “That’s just the nature of who we are.” He thought that the bleach foam, in particular, could be a game changer. “People in the field told us they were having difficulty with decontamination,” he said. “If we can come up with an inexpensive way to produce the foam, and as long as it’s not going to impede the disinfecting capacity, that could go in immediately. It’s a simple solution.”
The following week, he planned to meet with a group of what he called “high-value individuals who have the potential to support some of this work.” Revised PowerPoint presentations would be sent to health workers in Africa to gauge interest. “I’m optimistic that at least one, and probably more, of these solutions will make its way into the armamentarium and will help in addressing the challenge of Ebola in Africa,” he said. “And elsewhere.” ♦
