In early March, when COVID-19 struck Dougherty County, the Dougherty County Board of Commissioners approved an immediate pur- chase need for Emergency Medical Services (EMS) to obtain decontamination systems to sanitize ambulances that could be potentially exposed to the virus with each call they responded to. Recently, Curis Decontamination, the manufacturer of the systems, cited Dougherty County in a case study for their effectiveness of the technology in the EMS environment.

Through the case study, Dougherty County EMS, along with Children’s Hospital of At- lanta, partnered with Pathogend of Georgia, a bio-decontamination services company, to perform treatments and collect data. The system utilized in the study is a portable fogging device combined with a proprietary seven percent Hydrogen Peroxide solution, which together are EPA registered for high-level disinfection. To calculate treatment time, the device was programmed for the cubic footage of the space being treated.

The targeted environment for the study was the interior of the ambulances, where the device was programmed to treat the space of the forward cab and all compartments in the rear cabin at one time. Once started, the system engulfed the space with Hybrid Hydrogen Peroxide (HHP), a combination of vapor (VHP) and aerosolized hydrogen perox- ide fog. Following the initial delivery, the device then intermittently injected solution via PulseTM technology to maintain the concentration of Hydrogen Peroxide for a set dwell time, which for this study included times of both 20 minutes and 30 minutes. As the hy- drogen peroxide naturally decomposed to oxygen and water, no neutralization process was necessary.

For the disinfection of the ambulances, they were parked in a large non-climate con- trolled garage, where the HHPTM device was placed inside the rear cabin and directed toward the window opening to the front cab. ATP pre-swabs were collected and chemi- cal and biological indicators were placed in challenging locations throughout the ambu- lance. The device was started and the ambulance closed for the duration of the disinfec- tion cycle. Following this cycle, the ambulance was opened and allowed to air out. ATP post-swabs were collected, chemical indicators checked, and all biological indicators were retrieved and processed.

Overall, the ATP swab readings demonstrated a notable reduction in the presence of or- ganic matter, including viruses and live particles, possibly including dangerous germs, from pre to post disinfection. Both porous and non-porous materials were swabbed with non-porous materials repeatedly demonstrating a complete or near complete reduction in organic matter, and porous materials demonstrating a great than 50 percent reduction in organic matter, which was consistent with the known greater difficulty in disinfecting porous materials.

Growth of bacteria indicated a less than 99.9999 percent reduction in present patho- gens and conversely, a lack of growth indicated a sign of successful high-level disinfec- tion of all treated spaces. The study results showed a significant and measurement im- provement in the ambulance environment following treatment with the CURIS® 7 per- cent Hybrid Hydrogen PeroxideTM system.

“Pathogend of Georgia has helped EMS during the COVID-19 Pandemic by providing manufacturing guidelines so that we can keep our ambulances clean and help protect our staff and patients during medical calls,” said Sam Allen, EMS Director for Dougherty County. “By using the Pathogend machine and following CDC guidelines, our depart- ment has maintained a rate of eight percent of all staff to be infected with COVID-19 and all of them have made a full recovery to returned active duty.”