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Gray Matter Podcast – Conversation with Peter Anderson and Jay Mansheim: Engineering an Ebola Response

Global Health Surveillance Human Health

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GRAY MATTER PODCAST: Episode 2

Transcript – Conversation with Peter Anderson and Jay Mansheim: Engineering an Ebola Response

INTRO: Dean Gray – I’m Dean Gray, chief operating officer at MRIGlobal. And this is Gray Matter, the podcast, where we dig in with experts to discuss the science and innovations that are solving the world’s greatest challenges and why this work matters in your life.

Dean Gray

Welcome, everyone. I’m Dean Gray. On this episode of Gray Matter, we’re going to keep with our topic of infectious disease, this time focusing on innovations in response to the Ebola virus epidemic in West Africa. And we’ll discuss these advancements and breakthroughs from an engineering perspective. So an engineering perspective, what I mean by that is, designing, fabricating, equipping, staffing and deploying rugged mobile laboratories and transport systems that are capable of world class, chemical and biological analysis in very difficult environments, infected or exposed personnel, evacuation systems and the development of biological pathogen, containment of all kinds.

And these are just incredible topics. Joining me today are two colleagues. We’ve worked together for years on many of these programs, Peter Anderson and Jay Mansheim. Now, Peter and Jay are two engineers who were part of teams across the institute involved in MRIGlobal’s Ebola epidemic response in various capacities for different projects and all sorts of other projects that relate to mobile laboratories and deploying and also development of unique biocontainment systems.

So let’s start off with a couple of introductions. Peter, please introduce yourself.

Peter AndersonYeah, sure. Thanks, Dean, for for the brief introduction there. So my name is Peter Anderson and I am mechanical engineer and program manager at MRIGlobal, and I’ve been at Institute for over a decade. And like Dean said, you know, I was involved with sort of the initial response to the Ebola epidemic back in 2015 and really sort of got a lot of, you know, boots on the ground experience with that with that program.

And since then, you know, all the programs that have been sort of branched out of that I’ve been involved with from an engineering aspect. And it’s really been one of the most sort of, I guess, rewarding points of my career to be at MRIGlobal and to be part of this program.

Dean Gray – Yeah. All right. Thanks, Peter. And Jay, introduce yourself, please.

Jay MansheimHi, I’m Jay Mansheim. I’m a mechanical engineer and a program manager at MRIGlobal. I started as an intern, actually, at MRI when it was Midwest Research Institute in 2008-2009, came on full time in 2010. Have spent over two years overseas on various projects for MRIGlobal and our clients, including in West Africa, which is what were going to talk about today.

Dean Gray Look, these topics, you know, when we think about why does this matter and and you think about an audience that might listen to this, why does it matter? I think we we really understand that. But a challenge that we’ve got is then to convey that. You know, and understanding that, you know, COVID was a topic for last time Ebola and related conversations around those programs are the topic this time.

But other infectious diseases are just they’re not isolated incidents. They’re becoming more prevalent. Global health can absolutely benefit and has benefited from the work that we’ve done in developing these field forward tools and teams. And so this idea of of field forward, when I say that it means successfully taking capabilities that we have in advanced laboratories like the ones we have at MRIGlobal in Kansas City in Maryland and Charlottesville and moving those out into the field. And the benefit of doing that is you’re able to provide a an understanding of environmental events faster.

And what I mean by that is you go out maybe a sample is collected, and then instead of shipped back to the United States from wherever it might be collected, whether it’s a biological specimen or a chemical sample or anything in between, the advantage of being there on-site is that fast analysis. Being able to get a rapid turnaround.

And that’s one of the biggest drivers that we had for helping the Department of Defense in West Africa. And I remember, so we’ll go back a couple of years before we talk about the innovations and some of the breakthroughs that we had. But you go back, transport yourself back to about 2015-ish time frame, right? 2015-2016 time frame, when it was determined that the United States was really going to get involved in the epidemic response in West Africa and it was the Department of Defense, if you know, I don’t think a lot of folks really understand that.

But it was the Department of Defense that ended up taking the lead for the country. And we were called on and it was from two different perspectives. The first one was we need a diagnostic capability in the field that can reduce the amount of time for determining whether or not somebody has the Ebola virus. We need to take that time from days to hours.

That was job one. Can you do that? Can you take it from days to hours? And that was going to be through, all right, the mobile laboratories, as we talked about and then also the advanced diagnostic equipment and staff well-trained to be able to work with these pathogens in the field and, have the throughput to be able to make that happen.

Then there was a parallel effort and that came from a different customer set in the government who approached us and with the challenge of, okay, now we’re going to be sending people into the field and into harm’s way in West Africa. How do we get them home for safe care and also how do we keep them alive in the air if we have to do air transport?

And those were two projects that we had going on that Jay and Peter were both like just intimately involved in from the technical and programmatic perspective and working directly with the customers to try to figure both of those things out at the same time. You know, how are you going to keep people who have been exposed or infected alive so that they can receive

Western care and have the pathogen contained on a large aircraft, even if the aircraft in simulation was going to say crash. How are you going to end up still containing that pathogen?

I mean, just massive challenges that were that were part of this. The first thing that we worked on, though, was the diagnostic question. And I remember, Jay, when we were at the airport and we saw, what was that, an Antonov 124 was that what flew into. Right.

Jay Mansheim Yeah. The Antonov AN-124. The largest plane.

Dean Gray – Yeah. So when that flew in it was like this post-apocalyptic vision, you know, of this massive Ukrainian, you know, aircraft coming in into this deserted part of Kansas City International Airport where we were there getting ready to load up the laboratories. Go back to that, if you don’t mind, and just kind of let’s talk a little bit about that trip over and the laboratories that we were sending and the capabilities that we needed to set up so quickly when you arrived in- country.

Jay MansheimSo from an engineering aspect, we immediately reached out to the biologists and our safety department and all of the other folks at MRI who would need to be involved in this project and said, what do you need in a lab to diagnose Ebola and do it safely in a dirt field, basically in the middle of nowhere, Africa? And so we took those requirements, went back and forth because they would say, oh, you know, we need a six-foot biological safety cabinet.

And we’re like, well, you don’t have room for four-foot. And they say, okay. And we negotiated on what would fit got a, a layout figured out and started building. The government had required that we be ready to deploy in six weeks, which during that time was really difficult because a lot of the supplies that we needed were in short supply because the there’s a pandemic going on in the world.

So we were in short supply of Tyvek and hoods all sorts of materials were just hard to find. But we scrounged and we found all of the pieces we need, got the labs built and started, but mid process started looking at how are we going to get these twenty-foot ISO containers that we built these labs into over to West Africa?

And initially we were looking at maybe the military would transport them, but the problem was that there was no way to offload equipment in Sierra Leone and Guinea because they didn’t have the correct offloading equipment to receive it. Same thing for a 747. It takes a very special loader to get it off the plane. So the Antonov was the best choice and it was a commercial (…)

Commercially available choice that MRIGlobal was able to get contract to haul it over there for us. And it had a gantry crane built into the plane that would take the twenty-foot ISO container and bring it out above the tail and just sell it directly on a truck. That’s all you needed in West Africa was that semi-truck to take the gear.

So that’s why we picked that plane and contracted it to come in. Dedicated flight from KCI over to Sierra Leone and one to Guinea.

Dean Gray I remember that that integrated crane as part of that. It didn’t strike me until you were just talking about it right now, though, of just how important that was. Like that was a parameter that you needed once they were going to be offloaded. Otherwise they were just going to stay on the plane.

Jay MansheimRight. It’s something that clients don’t always think about. And that’s where our experience really comes into play on a project like this. We’re always thinking ten steps ahead and thinking of all the problems that we’re going to encounter in actually getting a lab deployed. So yeah, it was really, really important to get experienced field engineers involved early in the project to think about these things that other people don’t think about.

Dean Gray I think that that’s a good way to say it because, when I’ve talked to other chemists and biologists about this and we go into just a regular laboratory and we say, “hey, just flip the light switch.” And they flipped the light switch and the lights come on. You go, that’s what you expect wherever you are in the world before you analyze the sample, you expect that you’re going to have the electricity that you need. I mean the power requirements are going to be met. The equipment is going to be ready to accept samples. Your laboratory is going to be safe and have the ability and the equipment that’s available to be able to provide the answers that are need – all of these things have to go perfectly right in order to get an actual diagnostic result, you know, and that’s the end mission that we’re on right there. And so part of the responsibility and why we wanted to focus on the engineering as part of this is that that almost seems like the the unsung hero part of it, which is all of those things that have to go right in the field to be able to make sure that the mission can end up being completed.

Jay MansheimBecause those are things that people take for granted at MRIGlobal Headquarters. You flip the light switch it comes on your hood just works and gets certified by our safety people. And you know that you’re coming into a great environment to do your scientific work and they don’t think about all the back end facilities and power and water and all the other requirements that it takes your fuel.

Yeah. Logistics, getting getting those supplies, many of which are hazmat into a foreign country and then transported from the airport up to rural Moyamba, Sierra Leone. Those are the things that our engineering team immediately starts thinking about when we hear of a project like that.

Dean GrayYeah, a really there’s a special way of thinking and I think it only comes from that kind an experience. You know, we’re going to come back to that too, because I want to hear about some some in-field experiences and some challenges that were overcome that kind of led us to a new design of mobile laboratory that we rolled out last year as well.

Gosh, has it been two years now? I guess it’s been two years.

Jay MansheimGoing on two.

Dean Gray It’s gone on almost two years. Peter, let’s go over to you and talk about the containment system. You know, and I know this was a this was one of these when we were called on to figure this out, we had a really just a stellar team that was working on this. I think the customer at that time, if I remember correctly, we had about two weeks to come up with a rough order of magnitude, you know, budget and design.

And then they did a national search or an international search, and then they came back to us and then we went forward and then had to do it in record time. And you were offsite a lot. You know, managing all of the fabrication, the details of this construction, which was, you know, if you think about safe containment of biological pathogens and even something that could be for transporting patients and rolled on and off of airplanes, it’s not something that had ever been done at that scale before that we knew of.

Right.

Peter AndersonRight. So I think that from the get go, the thing that really motivated me and the team was that both the Department of State at the US government and MRIGlobal leadership was 100% on board with supporting this effort to create a system that would allow, you know, Western, you know, care individuals to be transported back to the United States.

So so that sort of buy in from the highest level was really motivating to our team as we started to figure out the challenges of how we can actually create a system that could be loaded on an aircraft but safely transport somebody with an incredibly highly infectious disease back to the United States and keep, you know, keep the personnel on the aircraft safe.

But then also, you know, all the different aspects that come into play with, you know, putting a system on an aircraft, all of the safe to fly standards that have to be met. It was a tremendous challenge. So really from the beginning, we quickly realized that there was really cots, equipment that could meet any of our requirements.

So it was just check checklist by checklists, like figuring out like, okay, well, we have to design the structure to withstand, you know, rapid decompression and crash scenarios. Then we have to figure out, okay, well, what kind of biocontainment systems do we have to have in place?

And how do those, you know, relate to those safe to fly standards. And it just, you know, nothing was matching up. Basically, you couldn’t buy anything off the shelf. And so it was like system by system, we were figuring out, okay, well, we’re going to just design it ourselves. And instead department was 100% on board, backing us up. MRIGlobal leadership, 100% on board, backing us up. And so we were just step by step working through all of the different, you know, design aspects.

And it was, you know, it was pretty intense and pretty stressful. But you knew at the time that it was like going to be worth your effort.

Dean Gray – Yeah. Yeah, it was going to be something that was so just magnificent from an engineering perspective and from a mission perspective. And you knew that when it was deployed, there was a high likelihood that it was going to save somebody’s life.

Peter AndersonRight? No, exactly. Yeah. So I mean, that that underlying sort of aspect was always there with us. You know, we were spending you know, we flew out like I think the day after Christmas to start to design the system with our subcontractor. And but it was just it was just there was no question that’s what we were going to do. And that’s what we were, you know, set up to do.

Dean GrayBoth of these examples, one thing that I just really love about that time, aside from it being just a 24/7 feeling all the time and it feels like we went from that epidemic then almost right into the pandemic, you know, or it prepared us. It felt like it kind of like sharpened our capabilities a lot, but it brought together, from my perspective, the entire institute on these efforts, because we had the needs of the best projects, right?

Because they they involved biologists, they involve chemists, they involve engineers, good program management, subcontractors, where we need them and outside expertise where we need them as well to kind of pull together. And the entire institute brings its weight to bear to be able to help solve these things. And that’s one of the times where I really saw it come together for the organization and just for just highlighting the the talent that we have.

And I remember some of the early design meetings having, we had a couple of flight surgeons that were in and also just talking about the medical gear that was going to be needed to have on board. And then down to the mechanical engineering perspective, down to the very bolt that was going to have to be removed and how on a decontamination event so that it when it gets wheeled off the plane and it gets decontaminated and then gets set back up again and put back on so that they could be essentially landed and then back in the air as soon as possible.

Every design consideration was made towards that and to our customers credit and I mean this for both of the projects, to our customers credit, even though the government ends up getting a bad rap in some areas from, from a lot of from a lot of different, you know, perspectives. But taking all politics out of this, they had some really super bright people that we work with from our government organizations. Excellent contracting people, really good program managers and just excellent logisticians and technical folks who were very they were 100% mission driven right along with us.

And they’re the most satisfying people to work with in that situation because they are all about just getting the job done for the country, in this case, for the world. You know, it’s a good feeling that’s that’s the impactful part of this. And there’s there’s this there’s this opportunity with what we’ve developed in these areas to then we’ve taken them forward.

You know, everything that we learned from the epidemic back in 2015 as an organization, we have advanced on all of those capabilities over the years. And I want to go back to the mobile laboratories part too, because, you know, Jay, with your deployment experience, which is which is unique, I mean, it’s like that’s hard to do, right? I mean, that is something where you’re leaving your family.

You’re going to be gone for three or four months. It’s it’s a deployment and you’re going to be out under circumstances that are going to be difficult. And it’s your job under any conditions that you meet, you’ve got to keep all of that equipment going. And so you have to understand how it operates from A to Z. Everything in between. You have to understand.

Yeah. And you need to understand really how to take apart fix everything that’s going to be present in a laboratory like that, which is just like it’s mind bending. What was one of challenges that you had, say, in West Africa in particular that maybe, I don’t know, that maybe surprised you? You know, not not like an HVAC system that you knew was going to end up getting dusty in some other thing.

But something else that just kind of surprised you, that just threw a loop in in some in some plans that you had that you had to respond to.

Jay MansheimWe were in such a remote location, I knew that getting fuel out there, you know, the amount of diesel fuel that we needed was going to be difficult. But I didn’t I think I underestimated how difficult it would be because when we were initially planning and looking at the capital city, it was a big city, was there’s fuel point gas stations and we didn’t know yet what village we were going to or where we’re going to eventually deploy.

And then we finally found out that, you know, the site had been selected. Moyamba, Sierra Leone was the first place that we went. Very rural, central Sierra Leone, West Africa and getting fuel trucks arranged and paid by an American company to come deliver fuel was a lot more difficult than we had anticipated, but we needed to get up and running.

So we were a Western Union-ing… We were sending cash Western Union to West Africa, picking up in a backpack and buying diesel, you know, a thousand gallons at a time instead of showing up in a big fuel truck at first, like you would think a bunch of guys in a couple Ford Rangers with a bunch of five gallon jerrycans full of diesel showed up.

But that’s what it took to get going. So that’s what we did. 00;22;01;26 – 00;22;19;19 – Dean Gray

Yeah. Then you have like a like a couple of mile walk or something like that to the, to the site from that. I mean I think you had to arrange at one time, it may not have been during that deployment, but actually help work with local infrastructure to have a road improved or a road built somewhere in one of the sites that you are operating in.

Jay MansheimYeah, I think in Guinea they had to there was a covert that just had some board delayed over it and car and stuff would drive over it. But the semi-trucks and the forklifts that we were going to use couldn’t get over it. So it had to be filled in and you know, some dirt work done just to get the trucks to the site.

And then the forklift that they were using to offload the containers didn’t have a fan on the on the radiator. So it would it could run for about 5 minutes and it would overheat and they’d have to pour some water on the block, cool it down, wait a few minutes, and they could drive it again. So problems that you wouldn’t ever think of here in the United States.

Dean Gray – Yeah, yeah. You just got to adapt to, overcome and keep going. Yeah. You know, there were probably when you were out there too and this was a, you know, in order to prep for, you know, we didn’t know at the time, but our own our own version of mobile laboratory design that became Athena and the time spent in the mobile laboratories was really what led to some the innovations that were put in our own design for this laboratory.

What were some things that you remember as being like an aha moment over there, you know, where and we’ll just say in your various deployments that struck you as all these are improvements that we can make if we get the opportunity to make our own version of a mobile laboratory.

Jay MansheimI think one of the big improvements is putting the uninterruptible power supply, building that into the structure, because power is such an important part of the mobile lab that you put these UPS’s – uninterruptible power supply, on all the equipment to make sure it’s got clean power. And instead of having them scattered throughout the lab, sucking in a bunch of dirt and then dying and risking your equipment, we integrated it into lab system, into the container, and it cleaned up the lab a lot, kept the equipment in a safer spot, and just generally really helps power the the equipment inside the lab, which is the important part of the whole reason you deploy a mobile structure is to provide that equipment a safe place to operate.

Dean Gray – Right.

Jay MansheimAnd good, clean power.

Dean GrayRight. And as we’re deploying more now, not just chemistry capabilities, but biology capabilities and just that that need to protect some equipment that wasn’t quite 100% ruggedized to be out in the field like that is is even more important now until some of the technology keeps up with where it needs to operate, you know.

Jay MansheimRight. And as soon as they do that, then they’re going to they’ll make even more new non- fieldable equipment that’s even better. So there will always be a need for a mobile structure.

Dean Gray Yeah. Yeah, I agree. You know, thinking about containment of pathogens. So back, back to, you know, the containment and that that large scale. But give it give us an idea of the scale of that transport system that we just talked about, Peter. And then I want to know, you know, in your opinion, what kind of innovations have we made since then, even with how we go about our design parameters.

Peter Anderson – Right, so we were tasked with creating a system that could be loaded on a aircraft and transport up to four patients with a, you know, highly infectious disease. But at the same time also have the ability for medical personnel to treat those patients during flight. And so the reality is that we ended up with a structure that mimics a forty-foot ISO container.

So it was forty-feet long and, you know, about eight-feet wide and tall. So and close to twenty- thousand pounds. So we’re talking a very large aircraft that this is operating on. But what that does is it allows medical personnel to enter into the space where the patients are properly care for them and then safely exit out in flight, which was a huge breakthrough for us because it allowed for, you know, flights, you know, from West Africa, you know, all the way back to the United States and allowing the, you know, the patients to actually, you know, provide, you know, you know, get care during transit.

So this was definitely a new system. And again, like nothing really ever. Like, no, no equipment really matched our engineering requirements. So everything was sort of from scratch. So we had to come up with a, you know, all of the HEPA filtration systems, the, you know, the pressure monitoring systems, the, you know, the interior coating systems that could withstand all of the significant pressures that come from, you know, going up in an aircraft, all the flight, you know, requirements, but then also meet with the sort of marry-up with the biocontainment requirements.

So so those two things sort of, you know, combining together really ended up with a system that had never been developed before and really, you know, at the time was developed for Ebola. But certainly the eye was always towards like what’s what’s next.

Dean GrayRight? Right. That’s a that’s another good point about kind of the working with our customers in that capacity and their mind was towards, okay, this can work for the current situation, but is it going to be a solution going forward? And that was part of the design, which is important for both of these kinds of systems, is that they don’t really have a shelf life.

You know, from the mobile laboratory perspective and the improvements that we’ve made and the modularity, it improves with the equipment that we’re able to put in it and then protect and, you know, feed clean power to and be able to keep them operational in the field. And then with the containment systems, it has to do with, if this is going to be good for this particular BSL-3 or BSL-4 agent or is it going to not be I guess, you know, and taking that consideration with how they’re tested. That is a good, you know, preventing these things from having a shelf life just based on that technology with good design fundamentals.

It was just key for this because they’re relevant to talk about now, even though it’s been several years since the first development of them and our I think it’s I mean it’s definitely clear to us I don’t know, it’s clear to everybody that our ability to control infection and through public health measures, diagnostics, vaccine delivery, antibiotic delivery has changed the way that we live.

And these mobile systems have allowed us to take the capabilities of diagnostics to the point of need. All right. So a faster answer to help more people and then also to be able to look at advanced and develop advanced evacuation capabilities, to be able to take people from places where of great harm and places where they can be cared for, you know, with with the greatest with the greatest care that we know of.

And all of those are those new developments that came from this need that happened in West Africa, in this epidemic response. And it’s not something that is going away. We’re just in between these events right now. And, you know, I know that our laboratories that we’re talking about now, they were also used during the COVID pandemic. Both of them, you know, both of these systems that were used, whether they were set up to then be modified to deliver or to take samples.

I think that with the Kansas Department of Health that we were working with for remote areas, actually, why don’t you spend a minute talking about that, Jay. That was a really good different type of mobile laboratory than one we’d done before.

Jay Mansheim – Yeah, the Kansas Department of Health came to us as they knew that we did mobile laboratories, and they were looking for a way to get that capability out to the field more because even though you’re hearing that states they still had problems with transporting a sample from western Kansas or some of their more remote areas in their state, back to Topeka for analysis at their laboratory.

So they were looking at moving around quite often like on a daily basis. So we decided to take all the lessons learned from building other types of mobile labs in ISO containers and put it into the back of a basically a food truck. And so we did that project fairly quickly, delivered them to Kansas and they started using them almost immediately for mobile COVID-19 diagnostics in rural communities, and have since moved over to using that same lab for community outreach for STEM education.

So they’ve got this great this great mobile lab that’s that’s ready to go for the next pandemic or the next event that happens. But they’re putting them to good use right now for education and training while we’re waiting.

Dean Gray – Training on equipment and kind of back to the laboratories that we deployed in West Africa. They’re still there. That was part of that was part of the deal is be able to transfer those to the local ministries of health along with training program to help provide infrastructure so that when this happens again that a lot of the equipment in the capabilities are already going to be there on site with trained staff to be able to run them.

Right. I think that’s a really that’s an important part of the mission.

Jay MansheimA bunch of different countries had had brought mobile labs in to West Africa for the Ebola pandemic, but our labs were some of the only ones were asked to stay and taken to the capital as the you know, to augment the country’s reference laboratory capabilities. And we were the ones that were asked to provide trainers to the host nation’s medical staff to teach them how to do what we had been doing.

They could carry on even once we were gone.

Dean Gray – Yeah, I think that’s that’s just great. I mean, there’s, you know, things that we’ve been talking about that it only comes from being in this work for decades, you know, really, I mean, you know, in some capacity, I think in the mobile laboratory space, at least for maybe 20 years. Probably close to 20 years. And then understanding design and containment of pathogens and laboratory design for, my gosh, a lot longer than that at MRIGlobal.

But then being able to transfer that understanding into a mobile system is just a really unique, unique application on that. You know, it’s just something that you can’t just grab a bunch of people and say, hey we’re going to do this. It’s like, you’ve got to have that hands on experience and understanding of all the different systems before you can think about how you’re going to apply them in different areas.

Yeah, there I think both of them are really impressive. And it’s also, you know, if we think about the training that’s going on, you just mentioned with the Kansas Department of Health and how that’s being used for training now, it is hopefully that is going to help with complacency, I guess, against complacency for future pathogens and future epidemics or future pandemics.

You know, it’s a it’s like our minds always have to be towards, okay, this is what we’ve done. This is how we applied it to Ebola. This is how we applied it to SARS-CoV-2. Now this is how we’re going to apply it and modify it with what’s next, you know, and thinking about what’s next and what’s down the road.

And it’s it’s going to be very interesting for sure. We really interesting. You guys do great work. You guys do really great work. I love talking with you today about this. I could talk with you all day about it. So, Peter Anderson, Jay Mansheim, thank you very much for your time and for your your dedication to these projects.

It’s greatly appreciated. Thank you.

Jay Mansheim –Thank you.

Peter Anderson – Yeah, thanks Dean.

Dean Gray – All right.

OUTRO: Dean Gray– Thanks for joining us on Gray Matter. I’m Dean Gray and you can find me at Dean Gray on LinkedIn. Or to learn more about our work visit, MRIGlobal.org.