Preventing Respiratory Viral Illness Invisibly

NCT ID: NCT05084898

Last Updated: 2026-01-13

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

NA

Total Enrollment

550 participants

Study Classification

INTERVENTIONAL

Study Start Date

2021-10-01

Study Completion Date

2025-05-01

Brief Summary

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Elderly people who have multiple health problems are at higher risk of illness from viral respiratory infections, such as influenza (the flu) and COVID-19. This is especially true for residents in long-term care because the usual methods of infection control (handwashing, mask-wearing, and distancing) are difficult to enforce due to the memory problems of many residents and the frequently shared common spaces. It can also be difficult to prevent the spread of viral infections within long-term care because many residents are unable to tell their caregivers when they are feeling ill. Also, some elderly people do not show typical symptoms of infection (like fever), instead they may suddenly become confused or weak.

This study will test if a safe form of ultraviolet light (far-UVC) can be effective as an extra method of disinfection (in addition to usual manual cleaning) against airborne and surface viruses that can cause respiratory infections.

Detailed Description

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Background: Nova Scotia has the highest proportion of seniors in Canada. Investing in high quality and safe long-term care homes is considered an important healthy aging strategy both here and globally. COVID-19 has disproportionately affected the elderly population, especially those with underlying health conditions. Residents of long-term care (LTC) facilities have been particularly vulnerable during this pandemic in Canada and elsewhere. Several approaches have been mandated to mitigate the high transmissibility of the aerosolised SARS-CoV-2 coronavirus. These are guided by three key principles: minimize time of exposure, maximize distance from sources of virus and finally to shield self from virus. As demonstrated in emerging evidence, these can be effective measures provided ability for compliance and human behaviours. Following life-saving public health guidelines has proven monumentally challenging in LTC facilities, due to the high prevalence of dementia and frailty. These severe public health measures and common infection control measures have resulted in other negative consequences for LTC residents, such as an increased feeling of loneliness, depression, and mental illnesses.

A further challenge with this population is early recognition of RVI in LTC residents can be difficult due to non-specific symptoms and the possibility of atypical presentation and lack of fever in the elderly with influenza. In this population, RVI can present as sudden, unexplained deterioration in physical or mental ability or exacerbation of an underlying condition with no other known cause. Additionally, other underlying conditions could impair residents' abilities to verbalize their symptoms. This could result in delays to the implementation of control and treatment strategies.

Rational: Far-UVC is emerging as a safe form of ultraviolet light disinfectant to kill airborne viral transmissions, including SARS CoV-2 virus. Far-UVC light (207-222 nm) in low doses effectively kills pathogens without damaging exposed human tissues. Preliminary data suggests using the regulatory safe level of exposure of lower dose UVC light (far-UVC light) can inactivate \>95% of aerosolized H1N1 influenza virus and 90 percent of human coronaviruses in 8 minutes and almost 100 percent in 25 minutes. Despite growing evidence on far-UVC as a safe and viable infection control strategy, there is limited research on the feasibility, acceptability and efficacy of far-UVC in LTC settings.

Main Objective: To determine whether far-UVC light causes a reduction in the incidence of influenza-like illnesses, respiratory infections, and COVID-19 infections, among residents in long term care facilities.

Methodology: This is a cluster randomized control trial designed to identify superiority of the intervention. Residents of three LTC facilities, will be cluster-randomized based on the 'neighbourhoods' they live in (social groups of 18-36) with a 1:1 allocation ratio. Randomization will be stratified by the LTC facility. Neighbourhoods will be randomly assigned to have either 222 nm far-UVC lights installed in common areas (treated) or matching placebo lights without far-UVC capabilities (control). Both groups will still receive standard disinfecting procedures and are subject to Nova Scotia's COVID prevention measures. The far-UVC and fluorescent lights will be placed in high traffic areas (e.g. dining rooms, main corridors). Residents spend approximately 3-4 hours daily in these common areas. The far-UVC lamps will be kept at a wavelength of 222 nm and exposure times that have been demonstrated to be safe for use among elderly populations. The trial period will span over 2-3 flu seasons to allow for sufficient data and sample size to describe the efficacy and sustainability of the far-UVC intervention. To be responsive to key policy and planning needs during post pandemic times, findings will be presented routinely to advisory council members and to relevant stakeholders in the province.

Conditions

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COVID-19 Respiratory Infection Respiratory Virus Infection Influenza -Like Illness

Study Design

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Allocation Method

RANDOMIZED

Intervention Model

PARALLEL

Residents of three LTC facilities, will be cluster-randomized based on the 'neighbourhoods' they live in (social groups of 18-36) with a 1:1 allocation ratio. Randomization will be stratified by the LTC facility.
Primary Study Purpose

PREVENTION

Blinding Strategy

QUADRUPLE

Participants Caregivers Investigators Outcome Assessors
BIinding in this study involves the use of a placebo arm. The placebo lamps will look exactly like the active far-UVC lamps, but they will produce regular fluorescent light and have no disinfection properties.

The trial will be blinded to everyone involved in the study except for one member of the lead coordinating team who must remain unblinded to provide lamp allocation guidance to the installing electricians. This person will not be involved in data collection or analysis, nor will they have access to participant identifying information, only their deidentified study ID.

Study Groups

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Intervention

Far-UVC light as an additional method of disinfection

Group Type ACTIVE_COMPARATOR

Far-UVC light as an additional method of disinfection

Intervention Type OTHER

Far-UVC light is a form of ultraviolet light with an extremely short wavelength (222 nm)

Placebo

"Inactive" fluorescent light (no additional disinfection)

Group Type PLACEBO_COMPARATOR

Placebo fluorescent light

Intervention Type OTHER

"Inactive" fluorescent light (no additional disinfection)

Interventions

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Far-UVC light as an additional method of disinfection

Far-UVC light is a form of ultraviolet light with an extremely short wavelength (222 nm)

Intervention Type OTHER

Placebo fluorescent light

"Inactive" fluorescent light (no additional disinfection)

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

Exclusion Criteria: LTC residents who do not consent to data collection
Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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Department of Health, Nova Scotia

OTHER

Sponsor Role collaborator

Research Nova Scotia

UNKNOWN

Sponsor Role collaborator

Nova Scotia Health Authority

OTHER

Sponsor Role collaborator

Kenneth Rockwood

OTHER

Sponsor Role lead

Responsible Party

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Kenneth Rockwood

Geriatrician

Responsibility Role SPONSOR_INVESTIGATOR

Principal Investigators

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Kenneth Rockwood, MD

Role: PRINCIPAL_INVESTIGATOR

Nova Scotia Health Authority

Locations

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Northwood Halifax Campus

Halifax, Nova Scotia, Canada

Site Status

The Cove Guest Home

Sydney, Nova Scotia, Canada

Site Status

Windsor Elms Village

Windsor, Nova Scotia, Canada

Site Status

Countries

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Canada

References

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Andrew M, Searle SD, McElhaney JE, McNeil SA, Clarke B, Rockwood K, Kelvin DJ. COVID-19, frailty and long-term care: Implications for policy and practice. J Infect Dev Ctries. 2020 May 31;14(5):428-432. doi: 10.3855/jidc.13003.

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Reference Type BACKGROUND
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Buonanno M, Welch D, Shuryak I, Brenner DJ. Far-UVC light (222 nm) efficiently and safely inactivates airborne human coronaviruses. Sci Rep. 2020 Jun 24;10(1):10285. doi: 10.1038/s41598-020-67211-2.

Reference Type BACKGROUND
PMID: 32581288 (View on PubMed)

Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci. 2009 Aug 7;4:50. doi: 10.1186/1748-5908-4-50.

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PMID: 19664226 (View on PubMed)

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Reference Type BACKGROUND
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Moberg J, Kramer M. A brief history of the cluster randomised trial design. J R Soc Med. 2015 May;108(5):192-8. doi: 10.1177/0141076815582303. No abstract available.

Reference Type BACKGROUND
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Pallmann P, Bedding AW, Choodari-Oskooei B, Dimairo M, Flight L, Hampson LV, Holmes J, Mander AP, Odondi L, Sydes MR, Villar SS, Wason JMS, Weir CJ, Wheeler GM, Yap C, Jaki T. Adaptive designs in clinical trials: why use them, and how to run and report them. BMC Med. 2018 Feb 28;16(1):29. doi: 10.1186/s12916-018-1017-7.

Reference Type BACKGROUND
PMID: 29490655 (View on PubMed)

Welch D, Buonanno M, Grilj V, Shuryak I, Crickmore C, Bigelow AW, Randers-Pehrson G, Johnson GW, Brenner DJ. Far-UVC light: A new tool to control the spread of airborne-mediated microbial diseases. Sci Rep. 2018 Feb 9;8(1):2752. doi: 10.1038/s41598-018-21058-w.

Reference Type BACKGROUND
PMID: 29426899 (View on PubMed)

Kirk MA, Kelley C, Yankey N, Birken SA, Abadie B, Damschroder L. A systematic review of the use of the Consolidated Framework for Implementation Research. Implement Sci. 2016 May 17;11:72. doi: 10.1186/s13012-016-0437-z.

Reference Type BACKGROUND
PMID: 27189233 (View on PubMed)

Liu K, Chen Y, Lin R, Han K. Clinical features of COVID-19 in elderly patients: A comparison with young and middle-aged patients. J Infect. 2020 Jun;80(6):e14-e18. doi: 10.1016/j.jinf.2020.03.005. Epub 2020 Mar 27.

Reference Type BACKGROUND
PMID: 32171866 (View on PubMed)

Liu Y, Mao B, Liang S, Yang JW, Lu HW, Chai YH, Wang L, Zhang L, Li QH, Zhao L, He Y, Gu XL, Ji XB, Li L, Jie ZJ, Li Q, Li XY, Lu HZ, Zhang WH, Song YL, Qu JM, Xu JF; Shanghai Clinical Treatment Experts Group for COVID-19. Association between age and clinical characteristics and outcomes of COVID-19. Eur Respir J. 2020 May 27;55(5):2001112. doi: 10.1183/13993003.01112-2020. Print 2020 May.

Reference Type BACKGROUND
PMID: 32312864 (View on PubMed)

Armitage R, Nellums LB. COVID-19 and the consequences of isolating the elderly. Lancet Public Health. 2020 May;5(5):e256. doi: 10.1016/S2468-2667(20)30061-X. Epub 2020 Mar 20. No abstract available.

Reference Type BACKGROUND
PMID: 32199471 (View on PubMed)

Simard J, Volicer L. Loneliness and Isolation in Long-term Care and the COVID-19 Pandemic. J Am Med Dir Assoc. 2020 Jul;21(7):966-967. doi: 10.1016/j.jamda.2020.05.006. Epub 2020 May 8. No abstract available.

Reference Type BACKGROUND
PMID: 32505516 (View on PubMed)

El Haj M, Altintas E, Chapelet G, Kapogiannis D, Gallouj K. High depression and anxiety in people with Alzheimer's disease living in retirement homes during the covid-19 crisis. Psychiatry Res. 2020 Sep;291:113294. doi: 10.1016/j.psychres.2020.113294. Epub 2020 Jul 13.

Reference Type BACKGROUND
PMID: 32763552 (View on PubMed)

Falsey AR, Baran A, Walsh EE. Should clinical case definitions of influenza in hospitalized older adults include fever? Influenza Other Respir Viruses. 2015 Aug;9 Suppl 1(Suppl 1):23-9. doi: 10.1111/irv.12316.

Reference Type BACKGROUND
PMID: 26256292 (View on PubMed)

Sayers G, Igoe D, Carr M, Cosgrave M, Duffy M, Crowley B, O'Herlihy B. High morbidity and mortality associated with an outbreak of influenza A(H3N2) in a psycho-geriatric facility. Epidemiol Infect. 2013 Feb;141(2):357-65. doi: 10.1017/S0950268812000659. Epub 2012 Apr 17.

Reference Type BACKGROUND
PMID: 22672856 (View on PubMed)

Drinka PJ, Krause P, Nest L, Gravenstein S, Goodman B, Shult P. Delays in the application of outbreak control prophylaxis for influenza A in a nursing home. Infect Control Hosp Epidemiol. 2002 Oct;23(10):600-3. doi: 10.1086/501978.

Reference Type BACKGROUND
PMID: 12400890 (View on PubMed)

Mahmud SM, Thompson LH, Nowicki DL, Plourde PJ. Outbreaks of influenza-like illness in long-term care facilities in Winnipeg, Canada. Influenza Other Respir Viruses. 2013 Nov;7(6):1055-61. doi: 10.1111/irv.12052. Epub 2012 Nov 12.

Reference Type BACKGROUND
PMID: 23145997 (View on PubMed)

Nix HP, Meeker S, King CE, Andrew M, Davis IRC, Koto PS, Sim M, Murdoch J, Patriquin G, Theriault C, Reidy S, Rockwood M, Sampalli T, Searle SD, Rockwood K. Preventing Respiratory Viral Illness Invisibly (PRiVII): protocol for a pragmatic cluster randomized trial evaluating far-UVC light devices in long-term care facilities to reduce infections. Trials. 2024 Jan 26;25(1):88. doi: 10.1186/s13063-024-07909-0.

Reference Type DERIVED
PMID: 38279184 (View on PubMed)

Other Identifiers

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32906-UVC

Identifier Type: -

Identifier Source: org_study_id

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