Coronavirus Technology Solutions
February 5, 2021


Breaking News in the Mask Webinar Today

Administration Considering Plan to Send Masks Directly to American Households

Observed Face Mask Use at Six Universities — United States, September–November 2020 

Masks Are Needed After Vaccination

Safe Dining Program in Michigan

African COVID Cases Surge

Philadelphia Trying to Solve HVAC Challenge With Fans

West Virginia County to Buy More Bipolar Ionizers

CDC Position on Bipolar Ionization is That it is Emerging Rather Than Proven

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Breaking News in the Mask Webinar Today

There was a very useful exchange of information in the webinar today. It includes some breaking news.  

Dave Rousse of INDA reported that ASTM has surmounted the obstacles and will approve and issue the mask standard in early March. The structure remains as we have reported with two efficiency levels.

Monica Ghandi of UCSF said “CDC told me yesterday I am allowed to announce their MMWR report is coming on Monday but didn’t share it with me so I actually am not clear yet on what it will say – but I think it is original research on masks and advising which masks to use with a variety of options to fit different situations. Thanks to her tip, we are reporting below on the University mask study released by CDC today.

There were also comments during the discussions that the Biden Administration is going to take steps to insure that efficacious masks are available.

All of these developments could indicate that there are going to be ways to guide the individual to choose the right mask. There is going to be an effort by the government to see that efficacious masks are used, and that is all happening quickly.

Devabhaktuni Srikrishna of Patient Knowhow provided details on a very valuable study showing which masks are used and how they are used in the U.S. His conclusion is that 85% of the people are not using masks safely. By not wearing masks safely outside their bubble they bring back COVID to everyone in the bubble. This study was covered in the Alert yesterday with a link to the entire report.

There was a good exchange of information relative to the availability of media and masks. Dave Rousse told the group that the large expenditures by media manufacturers assure  substantial production of meltblowns. He pointed out that other non wovens are also available and can meet a very large media demand. 

Lloyd Armbrust of Armbrust American  described testing they have done on KN95 masks.  The media was very inferior. However imported surgical mask media was of higher quality.  Lloyd is optimistic about the surgical mask brace combination.

Per Lindblom of Hollingsworth & Vose is also optimistic about the surgical mask-brace combination.  His company has expanded its meltblown capacity

The size of the market was discussed based on a slide McIlvaine presented showing that the public needs will be three times greater than the medical needs even though the consumption per capita is a fraction of the need by medical workers.

The concept of masks and vaccines working in tandem to create herd immunity was explored. In the next six months in the U.S. masks can play an even more important role than vaccines. Most people will have been vaccinated in the U.S. by autumn. So in the near term masks play the dominant role but longer term they play a subsidiary role to vaccinations.

For the 50% of the world with weaker economies, vaccines will not be fully effective until possibly 2024.  So masks can play the dominant role for the next several years

The webinar can be viewed at: https://youtu.be/tCij_ZiEOiE


Administration Considering Plan to Send Masks Directly to American Households

The Biden White House is considering sending masks directly to American households, according to three people familiar with the discussions, an action the Trump administration explored but scrapped.

The Covid-19 Response Team is evaluating the logistics of mailing out millions of face coverings, but no decision has been made, and the proposal hasn't yet reached President Joe Biden for final approval, a White House official said.

The idea has been raised in several meetings among Biden's top health experts in recent days, particularly as Biden continues to urge Americans to use masks as a primary defense against the spread of the coronavirus.

Biden has asked all Americans to wear masks for the first 100 days of his term, and he has signed several executive actions that mandate wearing face coverings on federal property and aboard public transit, moves President Donald Trump never enacted.

It's unclear when the masks would go out to the public, how many would be included per residence and whether they would be disposable or made of cloth. It's also not yet clear what the cost could be.

"There are a range of options on the table to help protect more Americans from the coronavirus and encourage people to mask up, but no decision has been made," White House press secretary Jen Psaki said.

A decision memo hasn't gone through the policy process yet, a White House official said.

NBC News reported that the Trump White House scrapped a plan last year to deliver cloth masks to every U.S. household, opting instead to send them to nonprofit organizations and state agencies, according to an internal email from a senior administration official at the time.

The Department of Health and Human Services signed $640 million in contracts in May with a group of textile manufacturers to make masks under Project America Strong, according to federal purchase records. The largest contract went to Hanes, which made 450 million masks in May and July.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said Wednesday that the Biden administration is even weighing whether people should double-mask. He indicated that it will wait for science to guide its recommendations, but he said the key is to wear at least one.

"If you're talking about a physical barrier and as the CDC recommends, you want at least two layers within the mask as a physical barrier, and you feel maybe more of a physical barrier would be better, there's nothing wrong with people wearing two masks," Fauci said. "I often myself wear two masks."

 

Observed Face Mask Use at Six Universities — United States, September–November 2020  Early Release / February 5, 2021

During September–November 2020, mask use was directly observed at six universities with mask mandates. Among persons observed indoors, 91.7% wore masks correctly, varying by mask type, from 96.8% for N95-type masks and 92.2% for cloth masks to 78.9% for bandanas, scarves, and similar face coverings.

Approximately 41% of adults aged 18–24 years in the United States are enrolled in a college or university (1). Wearing a face mask can reduce transmission of SARS-CoV-2, the virus that causes coronavirus disease 2019 (COVID-19) (2), and many colleges and universities mandate mask use in public locations and outdoors when within six feet of others. Studies based on self-report have described mask use ranging from 69.1% to 86.1% among adults aged 18–29 years (3); however, more objective measures are needed. Direct observation by trained observers is the accepted standard for monitoring behaviors such as hand hygiene (4). In this investigation, direct observation was used to estimate the proportion of persons wearing masks and the proportion of persons wearing masks correctly (i.e., covering the nose and mouth and secured under the chin*) on campus and at nearby off-campus locations at six rural and suburban universities with mask mandates in the southern and western United States.

The participating universities included five public universities with student populations ranging from 29,000 to 52,000 and one private university with a student population of 2,300; five universities were in the South U.S. Census region (two in East South Central and three in South Atlantic), and one was in the West. Approximately 10 student observers per university were trained by one CDC staff member who conducted training for all participating universities using a standard protocol. Universities selected approximately 10 observation locations where mask use was mandated.§ Indoor mask use was mandated by all selected universities and their surrounding communities. Outdoor mask use was mandated when other physical distancing measures were difficult to maintain. Observation locations could be either indoors or outdoors; however, because determining whether persons observed outdoors should have been wearing a mask was not always possible, the analyses focused on indoor mask use. For up to 8 weeks (range: 2 to 8 weeks across universities), observers tracked mask use on varying days and times from fixed sites on campus (e.g., libraries, classroom buildings, dining facility entrances, student centers, and lobbies of recreation centers and workout facilities) and, at five universities, at nearby off-campus, public locations frequented by students (e.g., grocery stores, pharmacies, and cafes). Observers modeled correct mask wearing, remained inconspicuous, and refrained from interacting with the persons they were observing. Each observer was instructed to record 40 observations at a single location or to observe for 1 hour, whichever came first, for a total of approximately 400 observations per week per university by the 10 observers. Correct mask use was recorded if the mask completely covered the nose and mouth and was secured under the chin. Observers were advised to record only what they could see; for example, if a person’s face could not be observed but mask straps were visible behind the person’s head or ears, mask use was recorded as “unknown.” Observers were asked to remain stationary and record 1) whether a mask was worn, 2) whether the mask was worn correctly, and 3) the type of mask worn (cloth, surgical, gaiter, masks that appeared to be N95 respirators [referred to as N95 type], or other) for every third person passing a prespecified location, such as a building entrance. If foot traffic was too high to observe every third person, observers were asked to select every tenth person for the entire observation period (5). Observation times varied during the mornings and afternoons and at night and occurred on weekdays and weekends. Because social groups might exhibit more similar mask use behaviors, only one person from a social group (e.g., an easily identifiable family unit, group of friends, or sports team) was sampled to avoid the effects of clustering. Observers were instructed to observe the first person in the group who corresponded to the third person following the preceding observation and then skip remaining group members and resume counting every third person after the group passed. Observations were restricted to persons who appeared to be aged ≥12 years and were not limited to students. One participating university released weekly media reports highlighting their data from this assessment to encourage mask use in their community. A second university released a single media report after 3 weeks of data collection. The remaining four universities did not publicize this investigation.

Mask mandates have been shown to decrease SARS-CoV-2 case transmission,†† and widespread mask use is a core intervention for curbing the COVID-19 pandemic (6,7). Direct observation at six universities indicated that mask use was high on campuses in locations where masks were mandated. Mask use was similarly high at nearby, indoor off-campus locations where masks were mandated. Mask use was lower outdoors in areas where use was mandated only when physical distancing could not be maintained. These data provide evidence that adherence to university mask mandates is high (5). However, correct mask use varied by mask type.

Universities have several opportunities to enforce policies such as mask mandates. For example, universities could impose sanctions for noncompliance with university policy. Universities also could use multimodal education and messaging to reinforce mask use, as well as messaging specific to mask type and that is focused on correct use. One university found that having students sign a compact agreeing to mask use, physical distancing, and testing might also be effective in promoting these behaviors (8).

Observational investigations can provide rapid feedback to universities on the prevalence and type of mask use in their population. Using trained student volunteers, participating universities can quickly organize and collect substantial amounts of data weekly at low to no cost and review the data quickly to assess and report on mask use. Universities and their communities can use these data to tailor and evaluate the effectiveness of messages and education to reinforce and increase mask use and to identify locations with lower adherence for policy enforcement.

The findings in this report are subject to at least three limitations. First, because the period of observation ranged from 2 to 8 weeks among universities, overall percentages are influenced by the universities with more data. However, all six universities are continuing to collect data during the 2021 spring semester. Second, observations were sampled without recording information about the persons observed and were not limited to university students, staff members, or faculty members. Off-campus locations likely included more persons not affiliated with the university, and off-campus percentages should be considered a measure of community mask use. Finally, none of the universities mandated outdoor mask use, unless physical distancing could not be maintained. Observers did not record whether physical distancing was or was not maintained.

Compliance with CDC’s recommended COVID-19 mitigation strategy of mask wearing exceeded 80% at six U.S. universities. Mask use is likely to remain a critical COVID-19 mitigation strategy, and CDC has made the training materials used in this study available for universities that would like to monitor mask use on their campuses. However, in addition to mask mandates, universities have implemented multicomponent strategies that included reduced residential density; surveillance and entry testing; educational campaigns; and other campus and community mitigation strategies. Monitoring mask use, tailoring messages to promote healthy behaviors (e.g., mask use, handwashing, and physical distancing) on and off campus, and developing measures to enforce or ensure compliance with healthy behaviors have the potential to improve implementation and effectiveness of public health strategies to protect persons on campus and in the surrounding communities by preventing the spread of SARS-CoV-2.

www.cdc.gov/mmwr/volumes/70/wr/mm7006e1.htm?s_cid=mm7006e1_w

Corresponding author: Lisa C. Barrios, LBarrios@cdc.gov.

 

Masks Are Needed After Vaccination

David Cennimo, an infectious disease specialist for the Rutgers New Jersey Medical School, said the most “pessimistic” reason why residents who have been inoculated should continue wearing a mask while in public and unable to social distance is because they could be in the minority of people for whom the vaccines are not effective.

The Pfizer-BioNTech vaccine has been found to prevent 95% of cases of the virus, and the Moderna vaccine, 94.5% effective.

Beyond this reason, Cennimo said that it’s significant to note that medical experts don’t know that people who have been given the vaccine can’t still transmit the coronavirus.

“I’m vaccinated, but I don’t know that I am not infected with COVID,” Cennimo said. “I know that I feel well; I know that I don’t have a fever. But I could be harboring the coronavirus in my nose right now; I could be breathing it out … so because of that it’s still my responsibility to wear a mask, because I don’t know that I’m infection-free.”

“And that’s one of the hardest things to explain to people, because if you got it in your head that I just needed to get the vaccine and then everything was going to be good, then we’re just going to go back to normal, we don’t have the data to tell you can go back to normal yet,” Cennimo said.

It’s equally important to recognize that immunity does not kick in immediately after becoming vaccinated. It takes a week after the second dose for the Pfizer-BioNTech vaccine to become 95% effective. For Moderna’s vaccine, efficacy reaches 94.5% two weeks after become fully vaccinated, The Washington Post reported.

“I even have friends in medicine who were like, ‘Oh, I want to go out to eat, I got my vaccine today.’ I was like, “Please tell me you’re joking,” Cennimo said. “You could go out to eat, but you could have gone out to eat yesterday. You got the vaccine in the last 24 hours; there’s nothing different happening in your body.”

At some point, but not in the immediate future. While initially projecting that 60% to 70% of the U.S. population must be inoculated to achieve herd immunity, Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases and presidential advisor, has since revised this language and said that it may take closer to 90 percent immunity to bring the coronavirus to a halt, The New York Times reported.

Until then — even if you’ve been fortunate enough to become vaccinated — wear a mask.

 

Safe Dining Program in Michigan

Many of the COVID-19 precautions restaurants can take are quite visible, like sanitizing, distancing and masking.

But a new state of Michigan program is pushing restaurants to implement a safeguard that’s harder for customers to see – improving ventilation.

The MI COVID-19 Safer Dining Program urges restaurants to get an HVAC inspection and make improvements to air filtration systems. COVID-19 is widely spread through airborne transmission, meaning good ventilation and circulation can help reduce the risk of spreading the virus.

The voluntary program launches just as indoor dining is set to reopen, starting Monday, Feb. 1. It’s been closed since Nov. 18 because of a second wave in the pandemic.

“We remain committed to helping businesses implement processes and techniques to maximize safety through layered mitigation strategies,” said Michigan’s COVID-19 Workplace Safety Director Sean Egan. “This program is another opportunity for businesses to do just that.”

Restaurants that meet ventilation standards will get a certificate to display publicly for customers to see.

Some of the standards include having a MERV-13 filter or stronger and having a system that does hourly air exchanges
 

A contractor must sign off for a restaurant to prove it meets the standards. Restaurants don’t have to redo an inspection if one was done recently, a state official said.

The businesses must cover the cost of the inspection and any necessary upgrades if it wants to get the voluntary certification. Gov. Gretchen Whitmer’s proposed state funding includes $10 million to pay for such inspections and HVAC upgrades – however, the package hasn’t been approved by the Legislature yet.


The question is how much safer is a diner if a contractor validates the restaurant compliance.  Here are items that need to be validated

 

African COVID Cases Surge

As African nations wait for hundreds of millions of COVID-19 vaccine doses to arrive, health officials are concerned about a general rise in coronavirus cases and deaths, especially in Southern Africa.
 
The stories, reported in local media and highlighted by aid groups, are chilling. In the tiny kingdom of eSwatini, medical aid group Doctors Without Borders says health facilities are seeing 200 new cases per day and a death rate four times higher than they saw in the first wave.  
 
In the coastal nation of Mozambique, case numbers are nearly seven times higher than they were at the peak of the first wave in 2020.  
 
And in the landlocked nation of Malawi, the poorest country in Southern Africa, new cases are doubling every four to five days, and the nation’s main COVID-19 facility is nearly full.
 
Dr. John Nkengasong, head of the Africa Centers for Disease Control and Prevention, tried to break down the continent’s trajectory as many nations enter a second wave without enough vaccine supplies.  
 
He said one indicator worth noting is that for about a third of the continent’s countries, the death rate has risen above the global average.  
 
“It used to be the reverse,” he told reporters via teleconference on Thursday. “During the first wave, the case fatality rate was about 2.2%, and now we are seeing 2.6%. In terms of the number of countries experiencing the second wave, 41 of them are currently experiencing the second wave on the continent. That is 41 of the 55 member states. Five countries accounted for about 70%.”

Those countries are South Africa, Morocco, Tunisia, Egypt and Ethiopia.

Africa escaped the worst of the pandemic last year. But health experts point out the continent now has many factors complicating the situation. Testing has lagged behind the rest of the world. Vaccine rollout has been slower, with just a handful of countries only recently launching vaccination campaigns.  
 
And the continent’s chronic problems with infrastructure and capacity mean that health systems, social safety nets, transportation networks and economies are struggling to meet the challenge posed by this pandemic.   
 
This, said Dr. Matshidiso Moeti, the World Health Organization's (WHO) regional director for Africa, is exactly what African health officials have been talking about when they warned against letting vaccine acquisition play out in the open market, a situation that gives wealthier nations advantages like having more power to negotiate for cheaper vaccines in larger quantities.  
 
Moeti told journalists Thursday she was still optimistic.
 
“Clearly, global solidarity is still a work in progress,” she said. “It was our ambition. It was our hope. It has not delivered to the extent that we had hoped, but it is still a work in progress. We are still doing our advocacy for donations from countries that have secured more vaccine to cover the entire population.”
 
Moeti said once African nations secure vaccine doses, they face another challenge: convincing people to take them. She emphasized that the vaccines approved by WHO are safe and effective, and said the organization is being proactive about dispelling the growing tide of false information about vaccines.   
 
“What encourages me is that we know in the African region that in general, people have been positive about having their children vaccinated,” she said. “It is only lately that some of the anti-vaccine sentiments, messaging, initiatives and campaigns have started to land here. We need to build on African people's belief in vaccines for their children to help them to understand that something extraordinary was done to develop these vaccines. And of course, to be very factual about the fact that we are learning about the vaccines as we go along, but we know enough about their efficaciousness.”
 
Moeti advised people who can take a WHO-approved vaccine to do it. She and other experts reiterated their best advice on containing the coronavirus — stay at home, if possible, wear a mask, wash hands and keep a safe distance.

 

Philadelphia Trying to Solve HVAC Challenge with Fans

The following report on the status of ventilation in Philadelphia elementary schools is not encouraging. They will rely on 3000 window fans. It is well known that dilution is not a very robust solution. In fact blowing virus from one child to another even in a diluted quantity is dangerous.

More than 30 public schools in Philadelphia have either no ventilation system or a faulty one that needs fixing, and some of those schools will be part of a Feb. 22 planning reopening for 9,000 elementary school students.

The district will utilize window fans as the main component at those schools to ventilate the air in classrooms, and Superintendent William Hite Jr. on Thursday defended the reopening. He cited federal guidelines that approve of the air flow provided by those fans and promised daily monitoring in every classroom.

The 9,000 students returning to schools later this month will be in kindergarten and the first and second grades. It's the beginning of what Hite hopes will be a phased return of all students this school year even as the coronavirus pandemic continues.

"It’s a temporary solution while we are getting systems fixed and up and running again," Hite said. "It goes back to the good faith efforts to introduce fresh air into these spaces, particularly those without ventilation."

Experts have said the fans proved able to ventilate a classroom at standards set by the U.S. Centers for Disease Control that allow for up to 18 students in the room, Hite said.

"To date we’ve spent about $4 million on this effort to get classrooms ventilated" and the district is confident everyone will be safe," Hite said.

He pointed to other school districts, without mentioning any by name, that have already reopened in-person learning by simply opening windows in classrooms.

Some parents and the city teachers' union is not as convinced.

"Right now with those fans? One is risking it all to send them to school," Philadelphia parent Elizabeth Torres Pacheco told station Telemundo 62, who translated her remarks for this article.

She said she is not ready to send her sons back to in-person learning yet.

Hite and other district officials have said reopening will help students who have struggled with digital learning and may feel isolated.

It is unclear exactly how many students have failed to attend daily virtual learning classes, but Hite said on Thursday that attendance is similar to the first few weeks of the school year in September when that figure stood at about 80%.

In letters to parents, Hite said the district hired ventilation experts who tested the air flow levels in "nearly every room in every school district building."

The district is setting occupancy limits in classrooms based on those tests, which measure the volume of air circulating in the room in cubic feet per minute. The rooms will follow a safety standard of 15 cubic feet of outdoor air, per person, per minute. The district says the fans were tested to pump 270 cubic feet of air per minute into rooms, allowing for 18 people in a room.

Some other schools have had HVAC systems repaired and can circulate enough air without needing window fans installed, according to the district's webpage.

Teachers told Telemundo 62 of concerns about whether the fans will make classrooms cold, what will be done during inclement weather, and if the fans can last under constant use.

The district says it purchased 3,000 fans, including extras in case replacements need to be made later in the school year. The district requires classrooms to be at least 68 degrees and temperature tests have showed the room can hold that temperature with the fans blowing air in.

Other city leaders, including Councilmember Helen Gym, are concerned about ventilation at schools. The Philadelphia Federation of Teachers said late last month that the district was not keeping up with a memorandum of understanding the union sent. The union wants educators to be vaccinated before returning to buildings - but Health Commissioner Dr. Thomas Farley said Tuesday that educators haven't yet been called to receive the vaccine as the city works through Phase 1B.

"I was surprised to learn when I got into this that window fans can really make a big difference in the amount of ventilation that takes place," Farley told reporters in the city's news conference on the pandemic Tuesday. "We do think that this virus is spread in large part, not entirely but in large part, through the air, so if we increase ventilation that should lower the risk," Farley said. "...If we have an inexpensive solution, let’s use it."

 

West Virginia County to Buy More Bipolar Ionizers

Ohio County W.V.  has set forth plans to attach technology to ventilation in all school buildings that is 99.4-percent effective in preventing the spread of COVID 19 molecules in school facilities.

The bipolar ionization boxes already are in place at facilities receiving HVAC upgrades through the school districts bond projects. These include Wheeling Park High School, Triadelphia Middle School and Elm Grove, Middle Creek, Steenrod and West Liberty elementary schools.

This week, the Ohio County Board of Education approved a $100,000 expenditure with CMTA Energy Solutions to bring the technology to more facilities — Bridge Street Middle School, Bethlehem, Ritchie and Madison elementary schools, the Board of Education office and the school district’s operations center.

The work will be completed in the next two to three weeks, according to David Crumm, administrator of operations for Ohio County Schools.

Wheeling Middle School, the Warwood School and Woodsdale Elementary School will receive their bipolar ionization boxes moving forward as bond work progresses.

Crumm explained the process of bipolar ionization.

“What it does is it uses hydrolysis,” Crumm explained. “Ions are sent out and attach to the virus. That makes it so the receptors on the virus cannot attach to anything else.”

The process doesn’t kill the COVID virus, but it does make it inactive, he said. Research has found it is 99.4 percent effective after 30 minutes.

Each school facility will require a different number of the boxes, and Crumm isn’t certain as to the individual price per box. It is likely the school district will be reimbursed for the expense through funding from the most recent stimulus, he said.

 

CDC Position on Bipolar Ionization is That it is Emerging Rather Than Proven

ASHRAE does not currently have a Society position on bipolar ionization. However, the ASHRAE ETF did reach out to CDC for their position on the technology. The following is the response from CDC in its entirety:

Thank you for your question. Although this was pointed out in the earlier CDC responses, it is important for me to re-emphasize that CDC does not provide recommendations for, or against, any manufacturer or manufacturer’s product. While bi-polar ionization has been around for decades, the technology has matured and many of the earlier potential safety concerns are reportedly now resolved. If you are considering the acquisition of bi-polar ionization equipment, you will want to be sure that the equipment meets UL 2998 standard certification (Environmental Claim Validation Procedure (ECVP) for Zero Ozone Emissions from Air Cleaners) which is intended to validate that no harmful levels of ozone are produced. Relative to many other air cleaning or disinfection technologies, needlepoint bi-polar ionization has a less-documented track record in regards to cleaning/disinfecting large and fast volumes of moving air within heating, ventilation, and air conditioning (HVAC) systems. This is not to imply that the technology doesn’t work as advertised, only that in the absence of an established body of evidence reflecting proven efficacy under as-used conditions, the technology is still considered by many to be an “emerging technology”. As with all emerging technologies, consumers are encouraged to exercise caution and to do their homework. Consumers should research the technology, attempting to match any specific claims against the consumer’s intended use. Consumers should request efficacy performance data that quantitively demonstrates a clear protective benefit under conditions consistent with those for which the consumer is intending to apply the technology. Preferably, the documented performance data under as-used conditions should be available from multiple sources, some of which should be independent, third party sources.