The answer to infections is blowing in the wind

An innovative technology firm is bringing fresh air into hospital wards, making them safer for patients. Simon Evans reports
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The Independent Online

There's a simple way to avoid contracting swine flu, says David Macdonald, the man behind Mid-States, the AIM-listed medical sciences firm. "It's hardly practical but scientists call it 'social distancing' – don't get closer than 10ft to anyone and don't meet them unless it's in the open air because in the open air the virus is killed quickly," says Macdonald.

For those looking for a more practical way to avoid viruses such as the H1N1 strain of flu, MRSA or C difficile, Macdonald claims to have the answer. "It was always a mystery why in field hospitals there were relatively low rates of infection among patients," says Macdonald.

"Remember that in the past we used to wheel out hospital patients to aid recuperation, but we don't anymore. Based on research developed at the Government's Porton Down facility in the 1960s, we realised that the answer was rather simple."

Dubbed the "open-air factor" by the original researchers, the science centres on the hydroxyl radical compound, naturally created in the open air when ozone merges with olefins, a type of carbon molecule. This mixture acts as a natural disinfectant against pathogens or germs that lurk in the atmosphere.

Putting this science to work, Mid-States has launched AD – Atmospheric Disinfection – a machine that helps to mimic the infection-busting characteristics of the outside, indoors. "You could argue you could do exactly the same thing with a 14-pound sledge hammer and take the windows out," says Macdonald. "And it would work because as a species we haven't adapted to working in enclosed spaces. We've only been inside for 20 or so generations and we haven't fully adapted that quickly."

Standing about 2ft tall, the AD looks like an innocuous heater plugged into a wall. It spews hydroxyl radicals into the air which collide with harmful pathogens, without any noise, smell or colour.

"We have to let the science do the talking because when you look at it as a layperson, it sounds like snake oil," says Glenn Cooper, a City financier famed for bringing Manchester United to market in the 1990s, who is a non-executive director at Mid-States. "My role is to put some infrastructure around the firm. We found an engineering company that used to be part of Lucas and into that David put the intellectual property of the device."

Mid-States in its current incarnation was created when it was bought by a cash shell company run by the activist investor Christopher Mills of JO Hambro Capital Management, and then listed on AIM. Mills remains an investor in the company, which also boasts the Irish tycoon Dermot Desmond as a shareholder. He owns nearly 16 per cent – the second-largest holding – through his Bottin investment firm. The company also boasts an impressive advisory board including Professor Hugh Pennington, a leading authority on bacteriology.

With infrastructure and investment in place, Mid-States is now rolling its product out to the NHS, which will act as way to validate the AD's effects to wider commercial markets. "Nobody ever got rich dealing solely with the NHS," says Cooper. "We are using the market as a validating tool. Already there are plenty of trusts taking them and getting remarkable results."

The longest user of Mid-States' product is Sunderland Royal Hospital where machines have been installed in the C difficile treatment ward. "We've monitored the air and surface contamination since we put the units in," says Macdonald. The hospital's chief microbiologist told him the ward has a lower level of pathogens than a basic operating theatre 98 per cent of the time. "In theory, at least, it seems safer to have open heart surgery in the C diff ward with all the patients watching you."

Mid-States lent Hereford General Hospital 80 machines last year to help battle an outbreak of norovirus, a vomiting and diarrhoea bug. The spread was rapidly contained and a contract was subsequently signed between the company and the hospital.

"The NHS market is difficult because it is set up to deal with the cure of illness rather than the prevention," says Macdonald. "There is no budget for prevention and there is no centralised way to sell to the NHS, which is the other problem."

Mid-States recently installed a number of machines into the Fat Duck restaurant in Bray run by the celebrity chef Heston Blumenthal after it was hit by an outbreak of norovirus. Hundreds of guests were left with the bug.

"There is the assumption that an outbreak of something like the norovirus is down to a lack of cleanliness, which is wrong because people bring in these bugs," says Macdonald. "For example, if you are deep-cleaning hospitals, the effects only lasts for a few hours. Even the studies financed by deep-cleaning companies admit that at absolute best you are back where you started after four days."

Mid-States is currently working on a new product to replace the largely ineffective handwashing process supposed to reduce infections spread on wards. For a 30-second period, patients and ward visitors put their hands under a machine that blows out hydroxyl radicals eliminating pathogens. "It's in development at present, but testing shows it's about as effective as soaking your hands in alcohol for three minutes," says Macdonald.

But it's the AD machine that remains the focus for Mid-States, with the lucrative US market the next step. "The US market for air quality is much more developed," says Macdonald. "You take something like the ionic breeze device, which had many problems, but still sold half a million units a year."

The group has already signed a distribution deal in the UK and one in Ireland, and Cooper says more are in the pipeline. "We are getting close to a point where hospitals will have to think of a reason why not to have our product on the wards," he says. "For the first time, we have heard of litigation lawyers turning up at MRSA support groups, so the pressure is building too.

This is potentially a huge market."

David MacDonald CV

David Macdonald with the Atmospheric Disinfection unit, which has reduced levels of C difficile in some UK hospitals.

Educated at Fettes College BSc in engineering

1963-67: Motherwell Bridge & Engineering

1968-72: Fokker VFW

1980-83: Consultant.

Advised Court of Protection on MJH Nightingale & Company

1983-85: AC Cars. Chief executive and technical director. Established funding for specialist sports car firm

1986-88: Lunn Industries. Arranged management buy-in to US Navy defence contractor

1988-90: Quadrax Corporation. Vice-president, engineering

1989-90: Advanced Materials. Chairman and technicaldirector

1990-94: Norton Group. Appointed chief executive to attempt survival strategy

1994-96: Infinite Machines Corporation

Since 1997: Involved in the development of hydroxyl radical chemistry, in particular the AD

2004: Acquired DT Assembly & Test Europe and restructured it to create Inov8, later purchased by Mid-States

Present: Chief science officer, Mid-States. Chairman, Inov8 Science. Chairman and chief executive, Managed Technologies