STLMade Conversations:
Jennifer DeLaney, MD

Tell us about you.

My name is Dr. Jennifer DeLaney. I am a practicing internal medicine physician in Creve Coeur. I did my medical school training and my residency at Washington University and remain on staff there as a voluntary faculty member. I was on the executive faculty there, which is the board of the medical school for two years, and am the president-elect of the Medical Staff Association for Barnes-Jewish Hospital.

How did you get started with making the Hunter-VHA ADAPT PAPR?

So in March when we learned that COVID-19 was not just a problem in China and Italy, but was also a problem for American workers, it became clear that we did not have the public health infrastructure and the personal protective equipment available to protect health care workers. As you might remember, there was a terrible shortage of protective gear. And I also saw that in China and Italy, a lot of health care workers were dying from infection acquired through their work taking care of patients who are highly contagious and also critically ill.

I noted that the Chinese workers were wearing a special kind of equipment, and I sought to get it to donate to a local hospital, but I was unable to because you couldn’t buy it — it was out of stock everywhere.

So I decided to research how to build one of these devices so that I could donate 10 to a local health care system.

Who helped make it a reality?

A whole community of people who were willing to help me make this idea become a reality. It started out with prototypes, with the involvement of the schools of Clayton, Ladue, St. Louis city, John Burroughs and Lutheran St. Charles. Their science and technology teachers helped me make a prototype using donated continuous positive airway pressure (CPAP) machines that are used for sleep apnea. Dentists across the country donated CPAPs. I got the attention of Hunter Engineering through one of my CPAP drives. They kindly took my prototype from an early creation to a device that has passed extensive regulatory testing through the National Institute for Occupational Safety and Health.

What is the PAPR?

Most people, when they think of personal protective equipment, think of devices like a mask that are static, a piece of fabric or a piece of plastic that shield you physically from either aerosols or liquids. This is a powered-air purifying respirator (PAPR), it’s a system with an air hose on the back that takes ambient air and sends it through a filter. The filter is much more effective at removing particles of viruses and bacteria. The air blows into a hood, protecting the mouth, eyes, nose, also providing a positive pressure system, so you can’t get leaks that allow the virus to come in.

So when you wear a mask, as many of you know, sometimes your glasses fog up, because you have a leak at the top, and you can’t have that sort of risk with this kind of device. So it’s much safer, and it also doesn’t require any skill to use. You just turn it on and put the hood on. It’s not complicated from that level, but it has a lot of complicated technology in it to keep people safe.

So this can be used by anyone who’s caring for a COVID-19 positive patient, be it a spouse, a home health aide, a nurse, a doctor, a respiratory therapist, anyone who’s being exposed to an infectious patient can wear this and be protected. One hospital that we’ve been in talks with in Florida is purchasing these to allow family members to visit their dying family members who have COVID-19 in the hospital.

Why is this so important?

One of the great tragedies of this pandemic besides the terrible loss of life is that most of those people who die, die alone, which is a terrible tragedy, and it’s incredibly stressful for health care workers to be the sole emotional support for the patient and the family. So to be able to have the family members come and be a comfort to the person with the severe respiratory illness is a comfort, not just for the patient and the family, but for the staff to know that that person is getting the love and attention from the people that are important to them.

And it’s nice to be able to help our community protect themselves and allow people to be safe, but also be comfortable and be able to communicate, which is often difficult. You know, when you lose visualization of people’s mouths and faces, it’s hard to measure emotional content or for people who have hearing issues be understood.

One of the reasons people sometimes get admitted to the hospital is low oxygen levels, but there’s also the issue of weakness. So sometimes people’s oxygenation is okay, but they are too weak to take care of themselves and it’s too risky for their spouse who isn’t infected or their child to care for them. And so if we can provide additional resources, that’s going to help not overload the hospitals, and also allow people to be with the ones they love. The other concern is of course that if hospital workers get infected, they’re not there to take care of patients because they have taken time off because one, you’re contagious and two, they may be sick themselves. And so by reducing their likelihood of getting infected by having them wear a device safer than an N-95, we’re hoping to help maintain our staffing capacity.

What are the other benefits of the PAPR?

It’s reusable. One of the other things that happened with this pandemic, you know, here I am at my desk with all of these masks, which are supposed to be for single use, and this is, one, a production problem, getting these; but two, it’s also an ecological problem in that you’re disposing masks again and again, and most of these are not made in America. So as other countries have supply chain issues are our resources aren’t always predictable. So early in the pandemic, China, when they were having their outbreak stopped shipping PPE. So I understand why they wanted to marshal their resources. However, that meant that no one else could buy it because most of it was made in China.

This is made in the U.S., and a lot of it is made in St. Louis. And that means that we have a secure source of protective equipment for our community and beyond.

Tell us about everyone who worked on this with you.

So I was astonished with the number of people that I had never had communication with, who stepped up and said, “Okay, I can’t do this, but this person can,” or “let me connect you with this person,” or “this is what I can do in your project.” So we had Pascoe Industries make the battery holster for the device. We had Brentwood Plastics supply the material for the hood. Zone Enterprises did the visor. There was a local sewing group, including a seamstress for the opera theatre, who did the first prototype of the hood.  Lutheran St. Charles robotics team broke down 500 C-PAPs to get motors for our prototypes. I mean, that was a lot of work.

The St. Louis city schools did the initial wiring. Clayton schools helped with that. John Burroughs School did the first prototype, and they had a 3D printing team that did a bunch of adapters and parts for early prototypes.

I also got help from Washington University on the application and on accepting donations from donors that allowed us to fund the project. Missouri Baptist Hospital gave us sample filters to try.

It was a series of community responses, terrific responses. It really gave me the confidence to continue the project. It gave me the resources necessary to do something that takes a lot of money to fund something like this, and also gave me the resources to donate the first 350 units. So these units that are going to these ICUs — they’re not paying me for them. I’m able to donate them due to the kindness of our community.

So it’s just been an amazing story. And, you know, it’s nice to live in a community where people care for each other, see the value of each other and seek to help each other. It was very heartwarming.

This conversation has been condensed and edited for clarity by Lauren Harms Milford.