$2 Billion Plan to Reopen Schools in California

Small Room Air Purifiers are Important  for the Safe Bubble Initiative

AHAM has Directory of Air Purifier Manufacturers

CTS has Extensive Information on Room Air Purifiers

Biden to Release Nearly All Available Vaccine Doses

Failure to Distinguish Between Good and Bad Masks Continues to be the Greatest COVID Failure

Boston Doctors Call for National High Efficiency  Mask Distribution Program to Prevent COVID-19 Spread

___________________________________________________________________________

$2 Billion Plan to Reopen Schools in California

Upgrading ventilation systems is a key way schools can reduce the spread of the coronavirus when campuses reopen, but some districts in California are finding the cost of those upgrades to be insurmountable reports EDSOURCE.

Some districts have recently been able to upgrade their HVAC systems using local bond money. Others hope a newly introduced California Assembly bill will pass and allot extra funding for school facilities. Others are hoping President-elect Joe Biden will push through infrastructure legislation that includes money for schools. But few funding streams are guaranteed, and they may not be sufficient to cover the regular inspections and filter replacements that HVAC systems require.

Because the coronavirus is primarily spread through air droplets, teachers unions and state authorities are urging schools to improve their indoor air quality by installing modern air filters or air purifiers, or replacing their outdated heating, cooling and air ventilation (HVAC) systems entirely. But the costs can exceed hundreds of thousands of dollars, depending on the region, the condition of the existing buildings and the size of the school.

After roofing, it can be the most expensive project for a school,” said Joe Dixon, retired facilities chief for Santa Ana Unified and a consultant who helps school districts with facilities projects. “But ventilation is important. It keeps kids’ minds fresh, it keeps them healthy. It’s a big issue for any district.”

The state does not keep records of the ventilation systems in California’s 10,000 public schools or which schools might need additional support in funding their HVAC.

In the Woodland District, there is currently over $10 million in unresolved HVAC-related expenses spanning over nine campuses, according to the 2011 Woodland Joint Unified School District Facility Master Plan.

At Whitehead Elementary, $35,000 was needed for new controls for their HVAC system. At Rhoda Maxwell Elementary, $142,436 was estimated for a multipurpose HVAC. Dingle Elementary School had a potential bill of $410,480 for a replacement HVAC at the permanent campus building, and Plainfield Elementary School needed around $539,140 to replace their HVAC throughout the campus.

Campus-wide HVAC interventions were and continue to be needed at Woodland Prairie Elementary for a cost of $1.338,708, Sci-Tech Academy for a cost of $554,344, Douglass Middle School for $1,446,075, Woodland High School for a total of $4,252,276, and Cache Creek High School for $476,448.

It should be noted that these cost estimates given in the plan are nearly 10 years old and not an accurate estimation of current costs.

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According to Woodland Superintendent Tom Pritchard, implementation is still ongoing toward completing the next master facility plan. The Board of Trustees has approved moving forward with hiring a firm, but the pandemic has made that difficult. There is still no estimate as to when the updated plan will be completed.

The district is looking at ways to support the facilities during the pandemic and beyond.

“Nick Baral is working with his team to do what we can, including making minor repairs and maintenance of our current HVAC systems as well as pursuing higher quality filters,” Pritchard stated late last year. “While we wait for possible Assembly Bill 841 funds, the district will be using its maintenance and operations budget to address any acute needs in the area of HCAV repair.”

While those were short-term solutions, the newly passed Bond Measure Y, which was on the ballot in November, figures to address those air quality concerns in the long-term.
 

Last week, Gov. Gavin Newsom announced a $2 billion plan to reopen schools, beginning as soon as February for younger students and gradually phasing in older grades. His plan, which is optional for schools but includes incentives to participate, calls for widespread testing, contact tracing, masks and other safety measures, including ventilation upgrades.

While ventilation improvements are not required under Newsom’s plan, research shows that well-ventilated, clean air can lessen the spread of the coronavirus as well as other contaminants, including wildfire smoke, dust, and air pollution. Clean air can also improve students’ academic achievement, reduce absenteeism and boost health overall for students and staff, according to the Environmental Protection Agency.

For many districts, HVAC upgrades are just one more expense on a long list of needed repairs, said Jeff Vincent, director, and co-founder of public infrastructure initiatives at the Center for Cities + Schools at UC Berkeley. Fixing a ventilation system is only the beginning of the investments California needs to make in its aging school buildings, he said.

“Once a vaccine is widespread, it doesn’t mean our school facilities are all of a sudden going to be in wonderful and perfect shape or adequate shape…with many inequities,” Vincent said. “What our research has been showing is that there’s a long-term and persistent underfunding of school facilities.”

Low-income students are more likely to attend schools with poor air quality and with facilities in poor condition, complicating efforts to reopen schools in ways that make them equally safe and all students and staff are protected from virus transmission, he said. As a result, students, and staff at those schools face a greater risk of contracting Covid at school, he wrote in a recent report on mitigating Covid transmission in schools.

“Reopening is riskier for low-income students because their facilities tend to be in disrepair and particularly their HVAC,” Vincent said.

Even schools with new HVAC equipment can still have ventilation problems. A study published in January 2020 showed that out of 104 classrooms in 11 California schools, only about 15% met the state’s ventilation standards. The classrooms, surveyed in a joint study by UC Davis and UC Berkeley, were retrofitted with new HVAC equipment within the three years prior to the study. The researchers found that the systems were intact, but the required inspections to keep them in good shape were not regularly completed at each school.

Vincent said the state needs to assess building conditions at every school in order to begin the process of making campuses safe for students and staff.

“Even if we all have vaccines and the virus is almost totally eradicated, there are still thousands and thousands of children going to school every day and sitting in classrooms that have really unhealthy air, or don’t have drinking fountains that all work, or have peeling paint, or are too cold or too hot, or have mold in the walls,” he said. “Those are still negatively affecting children.”

In addition to funds Newsom announced last week, other state and federal funding is available for schools to make ventilation upgrades, but experts say it’s not adequate to fix all the antiquated or broken ventilation systems in California’s 10,000 schools, said Ian Padilla, a legislative advocate for California’s Coalition for Adequate School Housing.

“(The new funding sources) are good news, but it’s not nearly enough. It’s not a solution,” Padilla said. “It’s a down payment.”

As some districts have discovered, replacing an HVAC system can be a lot more complicated than just installing a new model. Often, an outdated electrical system must be rewired, asbestos removed, or a new roof installed to support the new ventilation equipment.

“Unless you already have a newer school, it’s never just the HVAC,” said Julie Boesch, superintendent of the Maple Elementary District in Shafter in Kern County. “Upgrading the HVAC triggers all these other issues, which can be very expensive.”

Some districts have used their money from the federal CARES Act — a $2 trillion economic relief package passed in March — to make ventilation improvements. San Bernardino City Unified, for example, recently bought 3,700 air filters and purifiers for classrooms in all 72 schools in the district.

Modoc Joint Unified School District, in rural northeastern California, used $60,000 of its CARES Act funds to buy air filters and air purifiers for every classroom, where students have been attending in-person since August. The filters have a Minimum Efficiency Reporting Value (MERV) of 7, on a scale of 1-16, based on the size of particles the filter can block. The Environmental Protection Agency recommends MERV-13 filters — the equivalent of an N-95 face mask — for minimizing the spread of the coronavirus, but the district could not afford those, said Superintendent Tom O’Malley. Although the MERV-7 filters are not as effective at blocking coronavirus, they are adequate in filtering wildfire smoke, dust, and other contaminants.

The filters and purifiers “have definitely made the classrooms more comfortable,” O’Malley said, although he worries about the long-term costs. Replacement filters and higher electric bills will be ongoing expenses that he’s not sure how to pay once the CARES Act money runs out. O’Malley is hoping for more federal or state grant money to come through.

“It’s expensive, but we don’t have a choice,” he said. “Right now, it looks like we’ll have to cut something else. Unfortunately, someone’s going to lose out.”

Many districts are hoping for money for HVAC upgrades from Assembly Bill 841, which Newsom signed in September. The law sets aside $600 million for public school energy improvements, including HVAC systems.

Los Angeles Unified, the second-largest school district in the nation, has so far spent approximately $6 million on HVAC upgrades and new air filters in response to the pandemic, and expects to pay about $1.7 million a month for ongoing inspections and filter replacements.

Classroom air filters were upgraded at over 1,300 schools from MERV-8 to MERV-13, and inspections have been increased from once every four months to monthly. In all, the district has more than 130,000 filters to regularly inspect.

But the changes will continue only as long as public health officials determine they are necessary to fight the coronavirus on school campuses, a district spokeswoman said.

“We will wait for guidance from public health officials to determine when it is safe to revert to using our standard MERV-8 air filters,” said Elvia Perez Cano, a public information officer for the district. “When we do revert to MERV-8 air filters, we will also rebalance and set fans to only come on when the systems call for conditioned air.”

Some districts in wealthier communities have gone to great lengths to improve their ventilation systems before welcoming back students and staff. Palo Alto Unified, for example, has installed MERV-13 filters in all classrooms as well as portable high-efficiency particulate air filters, and is adjusting the HVAC system to increase the amount of fresh air circulating in classrooms. The district plans to regularly monitor the filters and air circulation levels, and post results on classroom doors.

The Acalanes Union High School District east of Oakland has also installed MERV-13 filters in all classrooms, as well as “needlepoint bipolar ionization devices,” high-voltage air filtration machines that release ions that target airborne contaminants, as part of the HVAC system.

For smaller districts — especially those with older buildings and tight budgets — paying for HVAC upgrades is especially difficult. Minimizing the spread of the coronavirus is a priority, but many of those districts also face other urgent ventilation issues related to seasonal wildfires or increasingly hot weather.

At Mother Lode Union School District in El Dorado County, the old HVAC system at its only elementary school was so inefficient that students brought blankets and Snuggies to school to stay warm. But the cost to fix it — along with myriad other repairs — was so high that in 2016 the school board asked voters to approve a $7.5 million bond for campus repairs. Voters approved the measure, and Indian Creek Elementary now has a new roof, plumbing, HVAC and other amenities.

“Conditions matter,” Superintendent Marcy Guthrie said. “For family morale, for staff morale, for student safety. Schools are people-driven. People need to feel safe, respected, comfortable. We’re talking minimal stuff — heating and cooling.”

In some cases, it’s cheaper to replace an entire school rather than fix a decades-old HVAC system. That’s what happened at Maple Elementary School in Shafter, northwest of Bakersfield.

Until recently, Maple Elementary, a K-8 campus built in the early 1960s, was so dilapidated that rain water poured down the indoor walls from a leaky roof. Dry rot was pervasive. The fire alarm barely worked. The electrical system was antiquated and dangerous. Worst of all, the school — in the heart of the San Joaquin Valley — lacked air conditioning.

“I put 43,000 miles on my car in one year driving back and forth to Sacramento, trying to convince legislators to help us,” Boesch, the superintendent, said. “‘No’ is not the answer, because children should not have to go to school in these conditions.”

The district finally secured $11 million from the state’s hardship fund for schools and was able to build a new school in 2019. Boesch used CARES Act funding to buy two portables, masks, and sanitation supplies so students can return safely to school beginning in January. Combined with the new ventilation equipment, Boesch believes the school will be safe for students and staff.

“We feel pretty good, but there’s been a lot of frustration,” she said. “For some districts, you really have to move heaven and earth to make these improvements happen.”

 

Small Room Air Purifiers are Important  for the Safe Bubble Initiative

The clean bubble concept includes room air purifiers as a supplement to masks and HVAC. Large units are used in industrial and commercial settings. Small units can be effective in single residences but also in less traveled spaces within larger facilities.  These smaller units are often rated based  on CADR.

The Clean Air Delivery Rate (CADR) is an established standard defined by the independent Association of Home Appliance Manufacturers (AHAM) in the U.S. Certified and verified by an independent laboratory, AHAM uses CADR to assure consumers that an air purifier will perform according to the manufacturer’s product claims and helps shoppers easily identify which air cleaners work better than others.

CADR measures an air cleaner's effectiveness based on room space and the volume of clean air produced per minute. This shows how well dust, pollen, and smoke, the three most common indoor air pollutants are removed from the air you breathe.

Once tested, results are converted to cubic meters per hour (m3/h). The higher the CADR test numbers, the better the unit’s overall ability to clean indoor air. For example, if an air purifier has a CADR of 388 for tobacco smoke particles, it will reduce smoke particle levels to the same concentration as would be achieved by adding 380 cubic feet of 100% clean air per minute.

Providing a direct comparison between top-rated air purifiers, CADR is the only air purifier standard that is recognized as an American National Standard, since it allows for consistent comparison between AHAM certified products. CADR is also endorsed by the U.S. Food and Drug Administration and the Environmental Protection Agency.

 

AHAM has Directory of Air Purifier Manufacturers

The Association of Home Appliance Manufacturers (AHAM) is the single voice providing the home appliance industry and consumers with leadership, advocacy and a forum for action in public policy, standards and business decisions. AHAM helps manufacturers bring efficient, high-performing home appliances into the homes of consumers in the United States, Canada and around the world.

AHAM represents manufacturers of a full spectrum of major, portable and floor care appliances, as well as suppliers to manufacturers.

AHAM Verification Programs have been an important part of AHAM services since the Association’s inception. The programs provide a uniform and practical verification of energy, volume and certain performance criteria for each product, with an independent laboratory performing the verification testing. AHAM is recognized by the EPA as an Administrative Body and approved to administer verification testing for purposes of the ENERGY STAR program. Products may be selected at any time for verification testing, ensuring the product’s energy consumption rating is consistent with the measured energy consumption. Since 1967, AHAM have used outside labs to test products, and today, manufacturers use AHAM ratings on a variety of appliances. This makes comparing products easier for consumers and gives them a consistent product standard they can trust.

The extra time at home because of COVID-19 restrictions has made it even more important to avoid the discomfort and potential health issues, like allergy symptoms, that can arise from poor indoor air quality. 

A room air cleaner can reduce allergens and make home environments more comfortable in a time when many are placing renewed emphasis on staying healthy. According to the U.S. Environmental Protection Agency, a portable air cleaner can also be part of your plan to stay healthy while COVID-19 remains a threat. 

“When used properly, air purifiers can help reduce airborne contaminants including viruses in a home or confined space,” the EPA stated in its Frequently Asked Questions about Indoor Air and Coronavirus. “However, by itself, a portable air cleaner is not enough to protect people from COVID-19.”  When used along with other best practices recommended by the Centers for Disease Control and Prevention, operating an air cleaner can be part of a plan to protect yourself and your family.”

Currently, there is no way to determine if an air cleaner is effective at removing viruses and bacteria from the air; however, some allergists recommend that their patients use air cleaners to reduce their allergy symptoms, based on their ability to remove common household pollutants like dust, smoke and pollen and outside pollution particles, known as PM 2.5. Dust, smoke, and pollen can trigger symptoms like coughing, wheezing and asthma. PM 2.5 is a significant enough issue for those with breathing difficulties that it is tracked in air quality reports and monitored by the EPA.

It only takes a few minutes of research for consumers to find an air cleaner model that meets their needs. The AHAM Verifide® Air Cleaner Directory allows those looking for an air cleaner to find a list of models appropriate for the size of the room in which the air cleaner will be used. Each listing carries the recommended room size for that unit, along with the air cleaner’s CADR – Clean Air Delivery Rate – showing its ability to filter tobacco smoke, dust and pollen. The U.S. EPA called CADR “The most helpful parameter for understanding the effectiveness of portable air cleaners".

Air cleaner models are assigned their CADR based on the results of rigorous testing conducted by independent laboratories. During testing, the air cleaners are exposed to specific quantities of tobacco smoke, dust, and pollen. After the air cleaner is operated for a certain duration, the amount of each pollutant in the air is measured. The higher the CADR, the greater its ability to filter that specific pollutant.

Know the size of the room or rooms in which the air cleaner will be placed for maximum efficiency. Choosing one rated for a larger room may use unnecessary energy and generate excess noise.
  
CADR is a helpful guide to finding a room air cleaner that can be part of your toolkit to fight COVID-19.

Details on available room air purifiers are shown at

https://www.ahamdir.com/room-air-cleaners/

 

CTS has Extensive Information on Room Air Purifiers

Over 100 articles on room air purifiers can be accessed with the CTS search engine. Here is a search using room “and” purifier

In the September 3 Alert we covered  a blog which rated some air purifiers. The following air purifiers were selected with one criteria being the ability remove coronavirus.

 Some of the links to other artices are provided below

1.      16. McIlvaine Coronavirus Market Alert

2.      ... 11, 2020 KLC Kinglandclean Provides Elevator Air Purifying System with High Efficiency on the Coronavirus ... HEPAs as an Alternative or Supplement to Partitions Restaurants can Learn from Airlines Restaurants in Hong ...

3.      Terms matched: 2  -  Score: 242  -  12 May 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-05-11/Alert_202005011.html

4.      18. McIlvaine Coronavirus Market Alert

5.      ... Technology Solutions August 11, 2020 New Air Purifier Production Facility for EnviroKlenz® Air Purifiers ... to Measure the One Stop as Well as Direct Flight Path for Viruses Duke Researchers Observe ...

6.      Terms matched: 2  -  Score: 224  -  11 Aug 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-08-11/Alert_20200811.html

7.      19. McIlvaine Coronavirus Market Alert

8.      ... for Room Purifiers for Both COVID and Air Pollution Magneto Cleantech is Getting Good Press Coverage ... , 2020 IQAir 

9.      21. McIlvaine Coronavirus Market Alert

10.  ... a mechanism enabling it to take in air, imitating human breathing. In one experiment ... conditioning, there is the stationary air purifier OurAir SQ 2500 which is suitable for rooms ...

11.  25. McIlvaine Coronavirus Market Alert

12.  ... 2020 How Effective is the Automobile Cabin Air Filter? Large-Volume Mobile HEPA Air Filtration System ... viral particles present. A low-cost air purifier containing a HEPA filter can cost on the ...

13.  Terms matched: 2  -  Score: 206  -  29 Apr 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-04-07/20200407.html

14.  26. McIlvaine Coronavirus Market Alert

15.  ... Expanding Mask and Filter Activities Worldwide Well Air Supplies Plasma Treatment and Monitors Flexible Air Filtration ... Need PPE Camfil has New Room Air Purifier More Efficient Air Filtration Systems Needed for New ...

16.  Terms matched: 2  -  Score: 201  -  2 Jul 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-07-01/Alert_20200701.html

17.  27. McIlvaine Coronavirus Market Alert

18.  1. McIlvaine Coronavirus Market Alert

19.  ... Fibers Huadi Supplies HEPA H13 Meltblown Non-woven Air Filter Media and N95 Masks Welcron Supplying Filter ... HEPA and ULPA Filters TBH Supplies Air Purifiers for Dental Practices N95 Masks can be Recharged ...

20.  Terms matched: 2  -  Score: 195  -  9 Sep 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-09-09/Alert_20200909.html

21.  32. McIlvaine Coronavirus Market Alert

22.  ... Systems and Cabinets CRI has New Mobile Air Purifier Trane has Suite of Services to Allow ... to be Reopened Safely Johnson Controls Provides HVAC Systems and Filters to Fight COVID ____ ...

23.  34. McIlvaine Coronavirus Market Alert

24.  ... Mounted HEPA Filter Systems Reliance on Outdoor Air is Not a Good Solution Michigan has Switched ... . Ceiling-mounted enVerid filtration The ceiling-mounted air purifier units are superior to portable ones for a ...

25.  Terms matched: 2  -  Score: 184  -  23 Dec 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-12-22/Alert_2020

26.  36. McIlvaine Coronavirus Market Alert

27.  ... a Range of Particle Sizes Tri-Dim Room Air Purifier has HEPA Filter, UV, and ... Speed Fan Knorr Brake has Ionizing System for Railcars Comparison of Filter Efficiencies U.S. Could ...

28.  Terms matched: 2  -  Score: 181  -  4 Sep 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-09-04/Alert_20200904.html

29.  39. McIlvaine Coronavirus Market Alert

30.  ... governments to mitigate COVID and improve the air we breathe. He points out that a ... Carrier Now has a 1500 CFM Room Purifier for Schools ____ Interview with Nathaniel Nance ...

31.  Terms matched: 2  -  Score: 172  -  15 Jul 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-07-10/Alert_20200710.html

32.  41. McIlvaine Coronavirus Market Alert

33.  ... Mask with Unique Features M + H Air Purifier Used at Schools ____ New Mexico ... Only Some Schools From MERV 10 to 13 Due to COVID-19 New Mexico public health guidelines ...

34.  Terms matched: 2  -  Score: 170  -  9 Dec 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-12-08/Alert_20201203-08.html

35.  42. McIlvaine Coronavirus Market Alert

36.  55. McIlvaine Coronavirus Market Alert

37.  ... 2020 Aerosols for HEPA Filter Testing Austin Air Canada Struggling to Keep Up with Demand for ... Purifiers Delivery Dates of MERV 13 Filters Extended by Two Months Shortage of HVAC Filters Reported ...

38.  Terms matched: 2  -  Score: 140  -  8 Oct 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-10-08/Alert_20201008.html

39.  56. McIlvaine Coronavirus Market Alert

40.  ... EU Need PPE Camfil has New Room Air Purifier More Efficient Air Filtration Systems Needed for ... York Malls ____ Who is Going to Need an Efficient Mask? Most of the ...

41.  Terms matched: 2  -  Score: 140  -  1 Jul 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-06-30/Alert_20200630.html

42.  59. McIlvaine Coronavirus Market Alert

43.  ... Five in Asia Hong Kong Company Claims Air Purifier Removes 99.9% of COVD. Nanofiber ... and HVAC Filter Company off to Fast Start NXTNANO Supplies Media for Masks, HVAC, ...

44.  Terms matched: 2  -  Score: 134  -  17 Sep 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-09-17/Alert_20200917.html

45.  60. McIlvaine Coronavirus Market Ale

46.  ... interviewed on holistic approach to providing clean air solutions for COVID ____ NY Times Article ... for air hygiene. The mobile air purifiers of the OurAir product line are also part ...

47.  Terms matched: 2  -  Score: 131  -  20 Nov 2020  -  URL: http://www.mcilvainecompany.com/coronavirus/subscriber/Alerts/2020-11-19/Alert_20201119.html

48.  77. McIlvaine Coronavirus Market Ale

49.  ... Walk Through Infrared Body Temperature Scanners HEPA Air Filtration and UV Treatment in Elevators Battelle H2O2 ... been developed. TJHQ series of air purifiers can be installed in air conditioning or as ...

Biden to Release Nearly All Available Vaccine Doses

President-elect Joseph R. Biden Jr. plans to release nearly all available coronavirus vaccine doses “to ensure the Americans who need it most get it as soon as possible,” the Biden transition team said Friday, a move that represents a sharp break from the Trump administration’s practice of holding back some of the vaccine.

The announcement coincided with a letter from eight Democratic governors — including Andrew M. Cuomo of New York and Gretchen Whitmer of Michigan, both of whom have clashed with President Trump — imploring the current administration to release all available doses to the states as soon as possible.

“The failure to distribute these doses to states who request them is unconscionable and unacceptable,” the governors wrote in the letter, which was obtained by The New York Times and sent Friday to the secretary of health, Alex M. Azar II, and Gen. Gustave F. Perna, who is in charge of vaccine distribution. “We demand that the federal government begin distributing these reserved doses to states immediately,” the letter said.

Because both of the vaccines with emergency approval require two doses, the Trump administration has been holding back roughly half of its supply to ensure those already vaccinated receive the booster dose. The vaccine rollout has been troubled from the start.

As of Thursday, the Trump administration had shipped more than 21 million vaccine doses, and millions more were already in the federal government’s hands. Yet only 5.9 million people had received a dose. State and local public health officials, already overwhelmed with rising infections, have been struggling to administer the vaccine to hospital workers and at-risk older Americans while most people remain in the dark about when they might be protected. Mr. Biden has promised that 100 million doses of the vaccine would be administered by his first 100th day in office.

Releasing the vast majority of the vaccine doses raises the risk that second doses would not be administered on time. Officials from the Food and Drug Administration — experts whose advice Mr. Biden has pledged to follow — have spoken out strongly against changing the dosing schedule, calling such a move “premature and not rooted solidly in the available evidence.”

A transition official, speaking anonymously to provide insight into the president-elect’s thinking, said would use the Defense Production Act, if needed, to ensure that enough doses are available.

However, the official also noted that the Biden team has “faith in our manufacturers that they can produce enough vaccines to ensure people can get their second dose in a timely manner, while also getting more people their first dose.”

A spokesman for Operation Warp Speed, the Trump administration’s vaccine initiative, released a statement sharply criticizing Mr. Biden’s approach.

“If President-elect Biden is calling for the distribution of vaccines knowing that there would not be a second dose available, that decision is without science or data and is contrary to the FDA’s approved label,” said the spokesman, Michael Pratt. “If President-elect Biden is suggesting that the maximum number of doses should be made available, consistent with ensuring that a second dose of vaccine will be there when the patient shows up, then that is already happening.”

A spokesman for the transition team, T.J. Ducklo, said Mr. Biden “believes we must accelerate distribution of the vaccine while continuing to ensure the Americans who need it most get it as soon as possible.”

“He supports releasing available doses immediately and believes the government should stop holding back vaccine supply so we can get more shots in Americans’ arms now,” Mr. Ducklo said. “He will share additional details next week on how his Administration will begin releasing available doses when he assumes office on January 20th.”

Dr. Leana Wen, an emergency physician and public health expert at the George Washington University School of Public Health, said she was surprised and concerned about the new strategy, which seemed to offer a solution incongruous with the biggest problems in the vaccine rollout. Distribution has sputtered in large part because of a lack of administering capacity and several logistical hurdles, rather than a severe shortage of doses.

“This is not the problem we’re trying to solve right now,” Dr. Wen said.

For such a plan to work, Dr. Wen added, the Biden administration will need to be confident in both improved distribution tactics and sufficient vaccine production, “so all who receive the first dose of the vaccine will receive the second in a timely manner.”

Should a high number of delayed second doses occur — ostensibly shirking the regimens laid out in clinical trials — “it runs the risk of substantially eroding public trust in vaccines,” Dr. Wen said. The recommended timeframe for administering the second dose for the Pfizer-BioNTech vaccine is 21 days later, and for the Moderna vaccine, 28 days.

Mr. Biden’s announcement came amid growing pressure to step up the slow pace of mass vaccinations.

Speaking at a news briefing on Friday, Dr. Stephen Hahn, the F.D.A. commissioner, urged states that have utilized only a small part of their supply to begin vaccinating lower-priority groups, while still observing government guidelines.

“We think that will go a long way toward using these vaccines appropriately and getting them into the arms of individuals,” he said.

 

Failure to Distinguish Between Good and Bad Masks Continues to be the Greatest COVID Failure

People are required to wear masks without any specification of mask quality. We have compared this  to the requirement to wear some sort of head covering in football. High quality helmets have been required. Despite evidence that good masks reduce COVID by as much as 70 times that of poor masks.  We continue to read about research which is very misleading. Here is one which compared poor masks to no masks and not surprisingly found little difference

Back in April, researchers split 6,000 Danish citizens into two roughly equal groups. The first group was asked to wear a paper surgical mask anytime they went out in public for the next month. Those masks are about 98% effective at screening small particles, but they don’t fit snugly to the face the way N95 masks do. There are still gaps where unfiltered air can reach the nose and mouth. (this can reduce the FFE to 60% or less).  A TE 90 mask will allow 10% of the virus to escape but if also worn by the recipient only 1% of the virus will be inhaled.  A 60% efficient mask allows 40% of the virus to reach the recipient who then inhales 16% of the total.  So there is a 16 x difference in virus transmission.

The mask group watched a video explaining how to wear masks properly and got 50 free masks in the mail. The control group was assigned not to wear face masks. In fact, the researchers excluded people who wore masks for protection on the job. The control group was told to follow the advice of public health authorities. Before the study began, everyone was tested for antibodies to make sure they hadn’t already been infected with the virus. If they were positive, they were excluded from the trial.

The study was “powered” -- meaning that it included enough people -- to detect whether following the advice to wear a mask could cut the risk of catching COVID-19 by 50%, or half. It didn’t.

“That’s a big number in any clinical trial,” says F. Perry Wilson, MD, an associate professor at Yale University. Wilson writes the Methods Man blog, where he breaks down the findings of clinical trials. He was not involved in the current research.

In other words, the trial was designed to look for a big benefit for people who wear masks. It didn’t find that large benefit.

After 1 month, 42 people out of 2,392 in the group that wore masks, or 1.8%, developed a COVID-19 infection, compared to 53 people out of 2,470 in the group that didn’t wear masks, or 2.1%.

That’s a smaller benefit -- about a 16% reduction in infections, on average -- in people who said they wore their masks as they were told.

That result didn’t pass a test for statistical significance, though, meaning that it could have been due to chance

It is too bad the test comparison was not run with masks 16 x more efficient.  There may even be more difference because of the evaporation of droplets on the mask interior surface and then release.  So a mask which initially is 60% efficient may only be 40% efficient when evaporation and re-emission is taken into account.

 

Boston Doctors Call for National High Efficiency  Mask Distribution Program to Prevent COVID-19 Spread

Doctors at Brigham and Women’s Hospital are pressing for a national initiative to distribute high-filtration masks, such as N95s, to every household in the United States to prevent the out-of-control spread of COVID-19 that is claiming thousands of lives daily.
 

Dr. Abraar Karan and Dr. Ranu Dhillon laid out the case for a National Hi-Fi Mask Initiative in an op-ed in STAT on Thursday, co-authored with Devabhaktuni Srikrishna, founder of Patient Knowhow.

“More and better masks can help get us to that point with fewer infections and deaths,” the doctors wrote. “With validated designs already on the market, mass production of hi-fi masks could be done relatively quickly.”

Hi-fi masks are the best protection against the small particles that spread the virus, the doctors wrote. Reducing the spread of the virus by protecting against those droplets is essential as the nation waits for the general population to get vaccinated, they said.  

“Ideally, a set of masks would be mailed to each U.S. household every month — the costs of doing so pale in comparison to the pandemic’s toll on lives and the economy,” they wrote in the op-ed. “The use of such masks would, in combination with other risk-reduction strategies, create safer workspaces for essential workers, many who are not currently prioritized to get early vaccinations. Since the pandemic began, surgical and cloth masks have become widely available at pharmacies, grocery stores, hardware stories, online, and elsewhere. Hi-fi masks should also be made ubiquitously available through these same venues, some of which are already coordinating with the federal government to roll out COVID-19 vaccines.”

On Twitter, Karan explained that Americans could then use the masks any time they were outside their homes in indoor spaces. 

“As the pandemic surges, most of the cases I am now seeing in the hospital do not know where or how they were infected,” he wrote. “A number of them report wearing cloth masks regularly, and this is much better than no mask, but we know that not all masks are created equal. N95 masks that healthcare workers like myself use in the hospital offer the best protection.

Ten months into the pandemic, many people have been unable to obtain N95s on their own and many health care workers still do not have adequate supplies of the protective equipment, the doctor wrote. 

“Better masks should be a serious priority here,” Karan said, stressing that the equipment focuses on stopping the way the virus transmits and, unlike vaccines, isn’t tied specifically to a variant.  

Ensuring everyone has access to more protective masks is another way of protecting against the new variant of COVID-19, which experts believe is more easily spread. 

“As vaccines roll out over this year, we cannot afford continued spread as it is happening,” Karn said. “We cannot rely on incremental policy changes with exponential viral growth. We need to do everything we can do urgently – better masks are central”