sustainable laboratories: a global perspective · 2013. 9. 20. · engineering | architecture |...

44
Engineering | Architecture | Design-Build | Surveying | GeoSpatial Solutions September 5, 2013 Sustainable Laboratories: A global Perspective Paul Langevin, P.Eng Merrick Canada [email protected] LIFE SCIENCES

Upload: others

Post on 26-Jan-2021

1 views

Category:

Documents


0 download

TRANSCRIPT

  • Engineering | Architecture | Design-Build | Surveying | GeoSpatial Solutions

    September 5, 2013

    Sustainable Laboratories: A global Perspective Paul Langevin, P.Eng

    Merrick Canada

    [email protected]

    LIFE SCIENCES

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 2

    Discussion Points

     What are the definitions relating to Laboratory Sustainability?   how does this support business continuity

      Is it consistent between countries

      How can we accommodate national and national interests

     What global influences are being applied to support lab sustainability? (focus on Microbiological Laboratories)

     What examples beyond North America’s approach are available for sustainable laboratories in under-developed countries?

     How do risk assessments support design solutions that are not comparable to North America codes and standards?

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 3

    Definition “Sustainability is the capacity to endure”  For humans, sustainability is

    the potential for long-term maintenance of well being, which has ecological, economic, political and cultural dimensions.

     Sustainability requires the reconciliation of environmental, social equity and economic demands: also referred to as the "three pillars" of sustainability or (the 3 E’s).

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 4

    Sustainable Laboratory Requirements

     Environmentally safe  Occupationally safe  Scientifically viable program  Reduced energy foot-print  Reduced carbon foot-print  Business continuity based on risk  Financially viable  Technically viable  Operationally viable

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 5

    Reasons to support global sustain-LABS

     Biological Threat Reduction  Pathogen Storage Initiative

    for Biosecurity  Emerging and sustaining

    diseases  Global immigration and

    agriculture socio-economic issues

     African Diagnostic Laboratory Initiative

     Current global weakness & awareness for change

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 6

    Affordability?

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 7

    Recent O&M Studies

     Two studies confirm that managing BSL3 facilities in developed countries average between $53-89/ft2

     Country comparisons are difficult due to in-country influences of currency, labor rates, temperatures, cost of utilities, organizational models and various approaches to containment designs

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 8

    Training  (3.1%)  

    Computer  Support    (2.7%)  

    Occupa:onal  Medical  PPE  (10.7%)   U:li:es  (20.1%)  

    Surveillance  Security    (4.7%)  

    Labor  (44.8%)  

    Total  Opera+ng  Cost  -‐  $/GSF/Year  =  103.6  

    Equipment  Maintenance  Contracts  (6.6%)  

    Building  O&M  Supplies  (6.0%)  

    Steriliza:on  &  Decon  Supplies  (1.7%)  

    High Containment Facility Cost Operating Distribution

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 9

    Cost (US$/ft2 @ 0.653 £/$ )

    9

    Site Location M&E Costs Unadjusted US$/m2

    M&E Costs Unadjusted US$/ft2

    M&E Cost Adjusted US$/m2)

    M&E Costs Adjusted US$/ft2

    IAH Pirbright, UK 273 25 273 25

    HPA Porton Down 348 32 322 30

    AAHL Geelong, Australia 118 11 103 10

    Reims (Griefswald) Germany 77 7 78 7

    IVI Berne Switzerland 98 9 116 11

    USDA, Ames, Iowa 172 16 136 13

    BRI-KSU Manhattan, Kansas 67 6 58 5

    CSCHAH Winnipeg, Canada 274 25 256 24

    AVERAGE: 178 17 168 16

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 10

    Challenge of Sustainable Labs

     Upfront costs  ROI- return on investments  Short-term perspectives vs.

    long-term environmental benefits

     Perception of risks  Effectiveness in developing

    countries where water, food and living essentials are compromised and indigenous health risks are high

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 11

    Challenges in Developing Countries

     Capital funding is heavily subsidized however it does not typically address sustainable operational costs

     Infrastructure is not available and there is heavy reliance on SOP

     Indigenous infectious diseases are more prevalent in the community challenging the need for expensive technical containment laboratories

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 12

    Sustainable Lab Promotion

     Design affordable laboratories based on real risks, local indigenous capacities and sustainable operations that are less resource/technical based and relying more on human capital and training

     Developing simple technical solutions  Review ventilation energy requirement for consideration of

    options including natural ventilation, air recirculation, air-change/hr. reductions based on risk, sensing technologies

     Consider simple validation techniques for scientific and technical equipment

     Not all developed country solutions are appropriate for developing country problems

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 13

    What is Risk? What does Wikipedia Say?

     The ISO 31000 (2009) /ISO Guide 73:2002 definition of risk is the 'effect of uncertainty on objectives'. In this definition, uncertainties include events (which may or not happen) and uncertainties caused by ambiguity or a lack of information. It also includes both negative and positive impacts on objectives. Many definitions of risk exist in common usage, however this definition was developed by an international committee representing over 30 countries and is based on the input of several thousand subject matter experts.

     OHSAS (Occupational Health & Safety Advisory Services) defines risk as the product of the probability of a hazard resulting in an adverse event, times the severity of the event

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 14

    Risk-based Approaches

     Risk Decision making process & who is involved in risk assessment

     Role and application of CWA 15793

     Process to achieve end goals & desired performance

     SOPs vs. engineering solutions

     In-country technical operational support implications Severity of Consequence

    Like

    lihoo

    d of

    Con

    sequ

    ence

    High

    Low High

    If the likelihood and severity of a consequence is high, risk must be well managed with engineering controls and SOPs.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 15

    Risk Assessments

     Varied approaches summarily assess probability (likelihood) and consequences (impacts) to assess risk

    Risk Assessment Matrix

    Probability of the Event Occurring

    Severity of the Outcome

    Frequent

    Likely

    Occasional

    Seldom

    Unlikely

    Catastrophic Extremely High

    Extremely High

    High

    High

    Moderate

    Critical Extremely High

    High

    High

    Moderate

    Low

    Marginal

    High

    Moderate

    Moderate

    Low

    Low

    Negligible

    Moderate

    Low

    Low

    Low

    Low

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 16

    Risk Classification Method: Sample 2

    SEVERITY How likely is it to be that bad? (PROBABILITY) How severely could it hurt someone or how ill could it make someone?

    ++ Very likely

    could happen anytime

    + Likely

    could happen at some time

    = Unlikely

    could happen but very rarely

    -– Very unlikely

    may happen but probably wont

    Kill or cause permanent disability or ill health

    1 1 2 3

    Long term illness or serious injury

    1 2 3 4

    Medical attention and several days off work

    2 3 4 5

    First aid needed 3 4 5 6

    1 and 2 The hazard has a high risk of creating an incident. It requires immediate executive management attention to rectify the hazard. Control action must be immediately implemented before working in the area or carrying out the work process.

    3 and 4 The hazard has a moderate risk of creating an incident. It requires management attention in a reasonable timeframe to prevent or reduce the likelihood and severity of an incident. Control action of a short term nature would need to be taken immediately so that work could still be carried out with further long term action taken to ensure that the hazard was fully controlled.

    5 and 6 The hazard has a low risk of creating an incident. It requires supervisor and employee attention in a reasonable timeframe to prevent or reduce the likelihood and severity of an incident.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 17

    Risk Classification Method: Sample 3

    FINANCIAL RISK Available Costs to build

    Available Costs to Operate

    LOW MODERATE HIGH

    LOW 1 2 2

    MODERATE 2 2 3

    HIGH 2 3 4

    1 Need to rely on simple technical solutions and SOP; use of primary containment systems such as non-connect Class IIA cabinets; SOP training and monitoring of staff is high

    2 and 3 Need to ensure capital investment is supported with increased costs of operations costs. If high operational costs are available, 3rd Party capital financing may be available (ESCO). Reliance on SOP are necessary. Look for energy recovery or power supply replacement opportunities.

    4 Plan projects for need, redundancy and operational efficiencies in accordance with functional needs and safety requirements ; Reliance on biosafety is a combination of SOP and good engineering controls

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 18

    RISK ASSESSMENTS (ANSI Z9.14)

    Factors to consider in performing a Risk Assessment

    1. Facility layout

    2. Containment boundaries

    3. Site specific risks, (e.g. natural hazards, proximity to public, proximity to other facilities or hazards which can introduce risk to the facility or its operational response).

    4. Primary containment BSC, caging systems etc.,

    5. Secondary containment (rooms, hoods, etc.),

    6. Tertiary containment (anteroom, shower, locker room, etc.)

    7. Specialized laboratory equipment and use particularly aerosol generating

    8. Access control

    9. Waste Management

    10. Current security threat /risk ‐ local, national, and international threats that could compromise the safety of the general public, the environment, the security of the personnel, the research, and the facility

    11. Building Utilities

    12. Work flow/Routing: internal and external

    13. Dependency upon outside sources for utilities, i.e. steam, electricity, gas, etc…. 14. Building systems 15. Ventilation systems including HEPA filtration, isolation valves, exhaust vs. supply duct locations 16. Building automation system 17. Existing system redundancies 18. Non containment building systems which could adversely impact containment including fire suppression systems 19. Agents used (to be used) including: 20. Quantity / Infectious Dose 21. Concentration 22. Route of Transmission 23. Availability of Treatment 24. History of spills or accidental releases 25. Area and surface decontamination methodology 26. Vaporized Hydrogen Peroxide (VHP) 27. Para Formaldehyde 28. Chlorine Dioxide 29. Other 30. Regulations/Standards/Guidelines 31. New or existing equipment related to ventilation systems including but not limited to, Biological Safety Cabinets, Class III cabinet, fume hoods, HEPA filters, etc. 32. Systems replacement /part availability 33. Facilities current maintenance and preventative maintenance program

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 19

    Finding the Right Balance: •  balance between engineering controls, equipment, practices

    and procedures •  IFBA BEWG identify practical solutions that are sustainable at

    the local level

    Long-term, cost-effective operation…

    Risk-Based Biocontainment

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 20

    Resource Issues for Labs & Equipment

    •  Lack of biosafety equipment, supplies, resources and funding •  Use limited resources towards a “rational” approach that is risk-

    based, cost-effective, practical and sustainable •  Identify the most effective technologies within country

    “context” – use of inappropriate technologies wastes resources and drains funds from more effective interventions

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 21

    IFBA Biocontainment Survey

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 22

    WG 2 – Biocontainment Engineering

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 23

    WG 2 – Biocontainment Engineering

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 24

    Planning & Design Decision Trees

    •  A Decision Tree is provided to assist verifying issues associated with deciding what design “solution” is required to resolve a requirement

    •  Decision trees require reflection and consideration of •  Local Risk Assessments •  Local Site Conditions •  Funding conditions •  Cost to build •  Cost to operate •  Technical capacity to maintain •  Life-cycle cost to repair and replace •  Local Codes and Regulations •  Technical Options •  Size of the requirement •  Intended SOP

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 25

    Define User Requirements

    What is intended program

    Function Diagnostics, Research,

    Animals, other?

    Risk level 1-4? Code requirements

    Local risk Assessment

    Yes- what mitigations?

    Is Capital Funding

    available?

    Yes Proceed with best life-cycle

    solution

    No Review SOP and

    reconsider project

    Available Operational

    Funding

    Yes Proceed with best life-cycle

    solution

    No Review SOP and develop low tech

    solution

    Verify Site conditions

    Good Proceed with life-

    cycle best solution

    Poor Proceed based

    on available funding

    Verify Applicable Regulations

    Yes-Apply Per risk level

    No- compare Review, develop and apply

    Verify Applicable Testing

    Yes for certification

    Apply, document and submit

    Containment Planning Decision Tree- Master

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 26

    Architecture

    How much area is required based on function and staff

    Establish Budgetary Limits

    Apply Parametric cost modeling

    How many rooms are required and what

    size?

    Verify adjacencies Develop blocking and stacking Verify relationships with other functions

    & buildings

    Develop area matrix Review net vs. gross area requirements Verify space

    availability and costs

    Verify SOP and processes

    Develop Layouts based on areas and

    process

    Renovation or new construction

    Renovation Conduct Building

    Assessment to verify required changes

    Equipment vs. infrastructure

    New Construction ENGAGE DESIGN

    TEAM: Integrate with structure and new

    engineering controls

    Ensure capital and operational funding is

    available

    What equipment is required

    Used Verify services,

    Repair, Relocate and Re-test

    New Verify services, install and test

    What surfaces are required

    Walls, floors, ceilings, windows, doors, benching

    Review alternatives and select best life

    cycle

    Apply new surfaces: tiles, epoxy,

    polyurethane, stainless steels

    What decontamination is required; impact on pipes, services,etc

    Topical disinfectants, Abrasive, gaseous

    Liquid disinfectants Formaldehyde, VHP,

    Chlorine O2

    Verify Applicable Testing Write test procedures

    Perform Tests, Document Result,

    Verify Conformance

    Architecture Planning Decision Tree

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 27

    Ventilation-HVAC

    Verify Program requirements

    Verify Air change rates: max, min, set-

    backs and task ventilation

    Calculate, size and select ventilation system based on

    requirements

    Consider free-energy alternatives such as wind, solar, biofuels

    Risk and Reliability and SOP

    Determines extent of system and component redundancy

    N N=1 2N

    Environmental- confirms need for air quality, separation

    and filtration

    Verify if HEPA filtration is required on supply and/or

    exhaust

    Verify if natural or recirculation ventilation is permissible

    Renovate or new build

    Renovation Conduct Building

    Assessment to verify required changes

    Upgrade system for new load and re-test

    New Construction ENGAGE DESIGN

    TEAM: Integrate with structure and new

    engineering controls

    Install new and re-test

    Verify and confirm available capital and

    operational costs

    Good Design solutions for

    redundancy and long-life-cycle

    Ensure staff is trained and systems are maintained and

    tested

    Poor Review existing and

    consider Primary Containment & SOP

    solutions

    Use of BSC as primary containment

    Review site parameters

    Building shape and air re-entrainment

    Review alternatives and select best life

    cycle Verify back-up and PM requirements

    Air quality, Exhaust, Noise

    Review codes, neighbors

    Develop mitigating solutions base on life-cycle costing

    Verify Applicable Codes & Testing

    Write test procedures Perform Tests,

    Document Result, Verify Conformance

    Maintain documentation for comparison testing and re-certification

    Verify codes for extent of HVAC control required

    Select HVAC controls based on

    accuracy and acceptance criteria

    Review options for best life-cycle

    solution

    Mechanical HVAC Containment Ventilation Planning Decision Tree

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 28

    Power

    Verify quality of site power

    Review frequency of failures

    Verify if emergency power or free-energy

    power is available

    Consider free-energy alternatives such as wind, solar, biofuels

    Review voltage levels

    Manage power surges and install voltage stabilizers

    Verify new load requirements

    Develop energy calculations Initial, use parametric

    Final, use actual load with factor of safety

    Verify extent of redundancy

    Verify allowable outages

    Verify is UPS is required

    Renovate or new build

    Renovation Conduct Building

    Assessment to verify required changes

    Upgrade system for new load and re-test

    New Construction ENGAGE DESIGN

    TEAM: Integrate with structure and new

    engineering controls

    Install new and re-test

    Verify and confirm available capital and

    operational costs

    Good Design solutions for

    redundancy and long-life-cycle

    Ensure staff is trained and systems are maintained and

    tested

    Poor Review existing and

    consider Primary Containment & SOP

    solutions

    Use of BSC as primary containment

    needs for training and certification

    Verify site restrictions

    Wind, solar, height Review alternatives and select best life

    cycle Verify back-up and PM requirements

    Exhaust, Noise Review codes, neighbors Develop mitigating solutions base on life-cycle costing

    Verify Applicable Testing Write test procedures

    Perform Tests, Document Result,

    Verify Conformance

    Maintain documentation for comparison testing and re-certification

    Electrical Power Planning Decision Tree

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 29

    BEWG Work Plan

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 30

    Simple Solutions- testing of BSC

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 31

    Simple Solutions: EDS System

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 32

    Scalable Ventilation Concepts

     Various models are presented which considers risk, cost to build/operate, redundancy, use of primary containment and country variation of regulations

     30% of containment laboratory costs are associated with HVAC systems

     Directional airflow is the primary objective

     Thermal comfort and humidity control are secondary benefits of mechanically controlled systems

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 33

    Sustainable Labs- Natural Ventilation Advantages of Natural Ventilation   Can provide high ventilation rates more economically than mechanical

    ventilation.

      Is more energy efficient, particularly if heating is not required.   Can be combined with daylighting to provide a pleasant low energy use

    facility.

    Disadvantages of Natural Ventilation  Ventilation rates are variable depending on outside weather

    conditions.  Difficult to control air flow direction.  Cannot be used with fine particulate air filtration.  Requires constant monitoring and control.  Noise, air pollution, insects and security need to be dealt with.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 34

    The Driving Forces of Natural Ventilation 1 Wind  Wind induces a positive

    pressure on the windward face of a building and a negative pressure on the leeward face.

     Wind flow around buildings is complex, but these forces can be estimated for simple buildings and openings designed to provide the design air flow at a particular wind direction and velocity.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 35

    The Driving Forces of Natural Ventilation 2

    Thermal Buoyancy  Buoyancy or stack pressure is

    generated by the air density difference due to temperature and humidity between the indoor and outdoor air. (Hot air rises.)

     When the air inside a building is hotter and/or more humid than the outdoor air, air will flow through low level and out of high level openings.

     The flow rate can be calculated from the temperature difference, the difference in height and area of the openings.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 36

    Designing Natural Ventilation Systems

    Climate  What works in London, England will not work the same

    way in Johannesburg, South Africa.  Traditional architecture, anywhere in the world, evolved to

    make the most appropriate use of natural ventilation.  Modern materials and construction techniques open up

    more possibilities for natural ventilation design.  For buildings housing infectious material, traditional

    construction may not be the best option.  Natural ventilation works best in mild climates where

    outside temperatures are lower than the most desired room temperature, but can be effective in hotter climates where building mass can be used effectively.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 37

    Natural Ventilation

    Typical Natural Ventilation Designs Hybrid Ventilation

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 38

    Objectives of the Ventilation System

    For a Biologically Safe Laboratory  Protect room occupants by reducing the number of

    airborne pathogens in the room.  Protect room occupants by maintaining steady air flow

    pattern at the face of biological safety cabinets.  Protect adjacent room occupants from contaminated air

    flowing from the biological safety laboratory.  Protect the external environment from the release of

    pathogens.  Provide a comfortable working environment in the

    laboratory.  Provide thermal comfort recognizing equipment heat

    gains

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 39

    HVAC OPTION 1- Natural Ventilation

    Natural Ventilation Designs Suitable for Biologically Safe Laboratories

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 40

    What is Merrick Doing?

     With the support of IFBA and other organizations, we are coordinating a project for a HYBRID (natural ventilated with mechanical assistance) using solar, wind and building geometry for a developing country.

     Simple systems are being considered

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 41

    BEWG-006

    Interna'onal  Federa'on  of  Biosafety  Associa'ons

    BEWG-‐Biocontainment  Engineering  Working  Group  –Plan  Ac'vity  006  –  Exploring  innova've  ven'la'on  solu'ons  for  biocontainment  laboratories  including  natural  ven'la'on  as  appropriate

    Natural Ventilation Opportunities for Infectious Disease Diagnostic Laboratories

    Version 1.0 July 31, 2013

    1.  Introduction 2.  Terminology & Definitions 3.  Objective/Goals 4.  Project Methodology and Approach 5.  Relevant Natural Ventilation References 6.  Natural Ventilation Risk Assessment for Infectious

    Disease Diagnostic Laboratories 7.  Design Assumptions for BSL2/BSL3 laboratories 8.  Operational Influences 9.  Design Options 10. Option Analysis 11.  Recommended Option 12. Design Details of Recommended Option 13.  Implementation Opportunities and Site Selection 14. Extrapolation Considerations to Other Sites 15. Test and Validation Requirements 16. Monitoring and Support 17. Appendices

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 42

    Potential of Natural Ventilation

    * unsatisfactory performance ** fair performance *** acceptable performance but compromised thermal comfort **** good performance for both ventilation and thermal comfort ***** very good performance for both ventilation and thermal comfort From WHO Natural Ventilation for Infection Control in Health-Care Settings.

    Natural Ventilation Hybrid Ventilation

    Mechanical Ventilation

    Courtyard

    Climate Single Sided Corridor

    Stack Outer Corridor

    Inner Corridor Wind Tower

    Hot and Humid ** * ** ** * *** **** Hot and Dry *** * *** *** *** **** **** Moderate *** *** *** *** *** **** **** Cold * ** * * * ** ****

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 43

    Natural Ventilation Sustainable Solutions

     Successful natural ventilation strategies are climate and site dependent.

     Natural ventilation must be designed into a building from the beginning. A standard laboratory plan cannot just have natural ventilation added as an afterthought.

     Natural ventilated buildings require user involvement to operate satisfactorily.

     Naturally ventilated buildings can be built for less and operated for much less than air conditioned buildings.

     Hybrid ventilation may be a better option in many situations.

  • Copyright © 2012 Merrick & Company - All rights reserved.

    PREXXXX 44

    Closure: Sustainable Laboratories

     Global needs especially for developing countries need to adopt and apply principles of sustainability different from North America

     North America needs to continue challenging codes and guidelines that are not evidence-based

     Further opportunities for laboratories exist for including natural ventilation principles

     Developed countries must help developing countries with training, capital and operational support

     Sustainability of labs is not just about energy savings; its about the health of our planet and ourselves………..what can we do??

    Thank you