Coronavirus Technology Solutions
February 8, 2021

Congressmen Urge Biden to Provide N95 Masks for Everyone

Reinfection is Increasingly Documented

Face Masks and HVAC have to be Considered  as Part of a Total Solution

UK Schools Need New Ventilation Guidelines for Schools

Vermont HVAC Contractors Did Well in 2020

Denver Schools Adding Room Air Purifiers

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Congressmen Urge Biden to Provide N95 Masks for Everyone

Vermont Sen. Bernie Sanders and a handful of his Democratic colleagues are urging President Joe Biden to explore options for making higher quality masks available to the public through the U.S. Postal Service to help stop the spread of COVID-19.

Calls have been growing from public health experts for the federal government to provide updated guidelines on the use of better quality masks and rollout a national effort to get high-filtration face coverings, like N95s, to the public as the pandemic continues to rage. 

In a letter sent to Biden  Sanders, Reps. Adam Schiff and Ro Khanna, both of California, and Sen. Brian Schatz of Hawaii asked that the new administration prioritize educating Americans about higher quality masks. They also encouraged the president to examine options for using the USPS to distribute medical masks and for making them available for pick up at locations in local communities. 

“Wearing a cloth face mask is still the official recommendation of the CDC, but there has been little education or outreach about what kind of masks are most effective,” the politicians wrote. “While many Americans understand that wearing a mask can help prevent transmission of the disease, many don’t realize that a high quality mask can make it far less likely that the wearer will contract the disease, even if exposed to an infectious person. The White House has recognized this fact by requiring staff to wear N95 masks on the premises. Other nations, including Germany and France, have provided their citizens higher quality masks, or reimbursed them for the purchase.”

The lawmakers also called on Biden to consider invoking the Defense Production Act to increase the available supply of higher quality masks.

“As more Americans are vaccinated each day, there is a light at the end of the tunnel,” they wrote to the president. “But with over 150,00 Americans still being infected each day, thousands are dying, and there is rising concern about variants of the virus that may be significantly more infectious. We must do more to reduce the spread of this virus. We have no time to waste.”

Experts who have been pushing for such moves by the federal government hailed the letter as a big step forward for getting more people wearing higher quality masks.

“The momentum is seriously shifting,” Dr. Abraar Karan, a physician at Brigham and Women’s Hospital, wrote of the letter. 

Karan, with his Brigham and Women’s colleague Dr. Ranu Dhillon, has been pushing for a national high-filtration mask program in the United States that would have medical masks, like N95s, distributed to households across the country. 

Joseph Allen, an associate professor and the director of the Healthy Buildings program at the Harvard T.H. Chan School of Public Health, also hailed the development. In an op-ed for The Washington Post last week, Allen presented the case for why “everyone” should be wearing an N95 mask at this point in the COVID-19 pandemic.

Reinfection is Increasingly Documented

Evidence is mounting that having COVID-19 may not protect against getting infected again with some of the new variants. People also can get second infections with earlier versions of the coronavirus if they mounted a weak defense the first time, new research suggests.

How long immunity lasts from natural infection is one of the big questions in the pandemic. Scientists still think reinfections are fairly rare and usually less serious than initial ones, but recent developments around the world have raised concerns.

In South Africa, a vaccine study found new infections with a variant in 2 percent of people who previously had an earlier version of the virus.

In Brazil, several similar cases were documented with a new variant there. Researchers are exploring whether reinfections help explain a recent surge in the city of Manaus, where three-fourths of residents were thought to have been previously infected.

In the United States, a study found that 10 percent of Marine recruits who had evidence of prior infection and repeatedly tested negative before starting basic training were later infected again. That work was done before the new variants began to spread, said one study leader, Dr. Stuart Sealfon of the Icahn School of Medicine at Mount Sinai in New York.

“Previous infection does not give you a free pass,” he said. “A substantial risk of reinfection remains.”

Reinfections pose a public health concern, not just a personal one. Even in cases where reinfection causes no symptoms or just mild ones, people might still spread the virus. That's why health officials are urging vaccination as a longer-term solution and encouraging people to wear masks, keeping physical distant and wash their hands frequently.

“It’s an incentive to do what we have been saying all along: to vaccinate as many people as we can and to do so as quickly as we can,” said Dr. Anthony Fauci, the U.S. government’s top infectious disease expert.

“My looking at the data suggests ... and I want to underline suggests ... the protection induced by a vaccine may even be a little better” than natural infection, Fauci said.

Doctors in South Africa began to worry when they saw a surge of cases late last year in areas where blood tests suggested many people had already had the virus.

Face Masks and HVAC have to be Considered as Part of a Total Solution

The problem with COVID-19 and ventilation is counterintuitive. With most inactive airborne contaminants like volatile organic compounds and carbon dioxide, we achieve an acceptable level of dilution to maintain an acceptable threshold limit for these common contaminants through prescribed quantity of outside air in the supply air based on occupancy or over time.

Generally, higher than code ventilation and overall airflow rates flush out contaminants in the occupied space more efficiently, though at greater energy usage versus code ventilation rates. For biological contaminants, specialized HVAC systems and room arrangements, e.g., positive and negative pressure isolation rooms, direct airflow from clean to contaminated and exhausted without recirculation in the space. The relative location of the patient and health care workers determine whether it’s an isolation or protection room. Most HVAC engineers understand this well.

The challenges with COVID-19 are twofold. First, aerosolized COVID-19 generally behaves like other airborne contaminants and tends to diffuse within a space and moves with air drafts. Unlike inactive contaminants however, repeated doses of exhalated virus being circulated throughout the space on drafts can infect people far away from the source. Although greater ventilation and airflow will dilute the concentration, they also increase recirculation of the virus in the breathing zone through drafts.

Second, unlike the negative or positive pressure isolation room described above, large numbers of unidentified, infected persons moving about freely in an enclosed space poses an immensely greater design challenge.

Before COVID-19, the free movement of people with a potentially deadly respiratory diseases were relatively rare in public spaces. Sick people were generally symptomatic before they were highly contagious and easier to identify and isolate through the public health system. Now, we are seeing that a majority of people who are COVID-19 infected and contagious are unknown, even to themselves and asymptomatic carriers. As such, the infection control isn’t occurring in an engineered health care facility isolation room.

Instead, we now have public spaces like office buildings, retail outlets, schools, restaurants and other public buildings that were never designed to control the person-to-person spread of respiratory virus laden air in the same space.

Additionally, the COVID-19 infected person is typically moving about freely within the public space. That makes the engineered removal of the airborne virus contaminants virtually impossible. To make matters even more complicated, the current research indicates there is a significant risk of spreading the disease through aerosolized virus particles which remain suspended in the occupied space.

Within all enclosed spaces, the first line of defense against the spread of the virus is wearing a face mask according to public health agencies like the Centers for Disease Control and Prevention and World Health Organization. Whether layered cloth, surgical or N95, masks specifically limit the spread of exhaled respiratory virus particles in droplets and even aerosol form. If a mask can significantly limit the release of the virus into the ambient conditioned air with negligible viral load, then there is very little concern the HVAC system will spread the airborne virus particles past the masks to adjacent or nearby people. Although this concept has been communicated clearly by health experts, there has been resistance due to external social factors that are causing a significant portion of the population from regularly wearing a mask in public. This is unfortunately causing the infection rate to explode across the country. Thus, we are back to engineers trying to come up with work arounds in public spaces.

Due to the variability of space layout and relatively high occupant density of conventional office spaces, the risk of spreading the infection can be very high. A problem with the majority of conventional office HVAC design and construction is that it assumes the only contaminants in offices are benign gases and particulates that can freely mix throughout the space and be diluted safely through a thorough mixing of the ambient air and fresh air in the breathing zone. The more the ambient air is mixed and replaced, the better the IAQ is assumed to be. Engineers aspire to design and have installed HVAC systems with no stagnant air pockets and a uniform temperature distribution.

To achieve that, engineers depend on traditional overhead office HVAC to take advantage of the coanda effect to have supply air hug the ceiling and gradually diffuse and drop as the airflow velocity drops to where the effect no longer exceeds the gravity effect on the colder, denser air and it drops to the occupied zone and offsets the heat sources of the space.

In perimeter zones, the distribution gets trickier due to the need to push air down along the perimeter fenestration and “curl” back up along the interior. That circular pattern is the start of problems in the post COVID-19 world. To identify the problem, let’s discuss how we currently know the virus to spread in enclosed spaces. The virus spreads from infected people through respiratory droplets and aerosol and the virus from these vectors can linger in the air for hours while larger droplets that precipitate can survive on some types of surfaces for days. Unlike in an engineered space like a health care isolation room, it can be spread by multiple people at the same time in an enclosed space with no specific dispersal pattern from the exhaled breath of mobile and static people.

https://www.csemag.com/articles/making-iaq-better-with-covid-19-in-the-air/

UK Schools Need New Ventilation Guidelines for Schools

Schools urgently need guidelines on how to improve ventilation in classrooms to reduce the risk of coronavirus transmission, scientists have said.

Improving air quality in classrooms should be as important as social distancing, wearing masks and washing hands, according to a new paper, written by doctors from Imperial College London and a secondary school headteacher in Middlesex. 

The authors said schools could look towards the airline industry, saying the risk of catching coronavirus on a flight was currently lower than in a classroom. 

Dr Kaveh Asanati, the lead author, said a “multi-layer risk reduction strategy” appears to be “working efficiently” in this industry.

While few school buildings have HEPA filtration, school could look at using portable HEPA filtration units, the new paper in the Journal of the Royal Society of Medicine suggested

To keep schools open, there is an urgent need to implement more effective on-site mitigation strategies, with particular attention to ventilation and testing,” Dr Asanati from the National Heart & Lung Institute, Imperial College London, said.

Vermont HVAC Contractors Did Well in 2020

Vermont HVAC installers say 2020 was one of their biggest years ever — with homes and businesses across the state scrambling to upgrade heating, ventilation and air conditioning systems to meet the unique demands of the pandemic.

“I don’t remember a time we’ve ever been that busy before,” said Max Balderas, office manager at Red Rock Mechanical in Burlington. “Our installation guys were booked three or four months out at one point.”

Even service technicians were booked three or four weeks out over the summer, which he said is practically unheard of in this line of work. 

Commercial building owners sought to upgrade ventilation systems to improve indoor air quality and reduce the spread of Covid.

The boom didn’t start immediately after Covid-19 hit in March. Initially, contractors said work slowed way down — much as it did for everyone else.

“At the beginning of Covid, all our calls stopped,” said Jay Ferguson, operations manager at Jay Mechanical Inc. in Burlington. “People were more afraid of the virus I think, than dealing with no heat or a leak in a faucet or something.”

All of that changed in the span of a few weeks when warm weather arrived. People who weren’t used to being trapped inside at home in the summer wanted air conditioning.

Mark Stephenson, a manager at Vermont Energy in Williston, said companies had to adapt to how people were using space during the pandemic.

“Offices closed, homes became offices, retail spaces did everything they could to bring people back, as did schools and other meeting places, everything was different,” he said.

Many commercial spaces in Vermont already have rooftop HVAC units that bring in air from outside, which he said is what is needed for appropriate airflow indoors to reduce the risk of coronavirus transmission. Most new buildings have energy efficient HVAC systems installed, which are also great for air flow. But many older buildings don’t have adequate ventilation. 

“We did a project recently at a housing facility in Burlington where their common areas where they cook and have meetings, didn’t have that type of equipment,” Stephenson said. “They had a 10 or 15 year old building, and they wanted to ensure the health of their residents, who are older, so they spent the money and got a high-efficiency ventilation system.”

He said he’s seen a lot of businesses make those kinds of investments this past year. Vermont companies had been slowly adapting to higher air quality standards, he said but once the pandemic hit, clean air became a top priority in a way he’d never seen before.

“Air is not something you can see, and if you can’t see the problem, it’s hard to muster up enthusiasm about,” he said. “But now, people really feel the problem.”

For the past few months though, business has begun returning to normal.

“Gradually as summer ended and winter started to come around, we started to slow down,” Balderas said. “We’re obviously still doing boilers and furnaces, but we’re not even close to how busy we were over summer.”

Denver Schools Adding Room Air Purifiers

As school districts begin their second semester trying once again to bring students into classrooms, more are adding new layers of protection — this time looking to address airborne transmission of the coronavirus.

They’re adding filters to catch smaller particles and retrofitting heating and air conditioning systems. And some are trying newer methods to treat indoor air — although experts caution against unproven technologies. 

The Denver school district, the largest in Colorado, is working with university researchers to place and track the effectiveness of air purifiers in classrooms across 17 schools. 

The Adams 14 district, a smaller district serving students from more low-income families, has spent $1.1 million on new devices for every classroom. The money came from a grant to help schools reopen buildings. The device pulls oxygen and moisture out of the air and pushes out dry hydrogen peroxide that can kill viruses in the air.

In Mapleton, classrooms and buildings have had portable air purifiers since August. Officials are evaluating which rooftop units might need replacing if more money becomes available.

Officials in other school districts including Jeffco and Aurora have said they are reconfiguring heating, ventilation, and air conditioning systems to pull in more outside air to dilute particles indoors. A spokesperson for Jeffco also said the district has one school piloting ultraviolet lights but did not provide more information. Some districts have also replaced HVAC filters with higher-rated ones that may trap smaller particles. Others, like Westminster, haven’t made any upgrades.

Several researchers said that improving ventilation and air quality are important factors in making school buildings safer, and that administrators are better off sticking with tried and true methods like bringing in more outside air and using higher-quality air filters. 

“The way to get the virus out of our indoor air and to make it safer, is to dilute the air and clean the air,” said Shelly Miller, professor of mechanical engineering at the University of Colorado Boulder. “For schools, the easiest thing to do is to buy HEPA air cleaners.”

That’s the idea behind a pilot project in Denver schools. Mark Hernandez, a professor of civil engineering at the University of Colorado Boulder, has spent decades studying how to create public spaces with clean and safe air to breathe.

Because of his previous work, months ago philanthropists contacted him to see how to apply his research to help schools reopen safely. With their donations, Hernandez purchased portable air filters and reached out to Denver schools.

“This was: get it to you there, now,” Hernandez said, “with a high probability of success. It’s about protecting public health now — with the tools we have now.”

Around November, when most school buildings were closing for the second time as cases of COVID spiked, Hernandez and about a dozen students and graduates went into schools that DPS identified as having the oldest air quality systems.

Then, when buildings were empty, the team filled schools with carbon dioxide and placed sensors in all classrooms to track how fast the existing systems were able to clear the air.

The team identified the classrooms with the least effective air systems. They also mapped out the optimal locations to place air filters and placed about 120 filter units in 17 city schools. 

The district estimates it would take about $2.5 million to provide all of its classrooms with such filters.

But Hernandez believes that many classrooms wouldn’t need any filters. Some rooms he encountered, he said, “had air exchange as good as CDC recommends for medical exam rooms.”

The classrooms that Hernandez targeted also got new sensors to monitor particles. He created a dashboard that tracks that data live. That will enable district officials to monitor and make adjustments when they see that a unit is not effectively filtering. In such a case, they could increase the motor speed of the unit, change the filters, or move the unit to a more central location in the room.

“High efficiency filtration has been around,” Hernandez said. “It just hasn’t been used in high-density classrooms as much as it could be.”

Mapleton district officials looked into air purifiers in their classrooms following guidance from a Harvard report this summer that described it as one layer of protection in addition to mask wearing and social distancing.

“We looked at what is it going to take to get us back,” said Mapleton Superintendent Charlotte Ciancio. “We used all of the research. And when we researched air quality, really, they talked about air filtering systems.”

Several school buildings in Mapleton are newer and have HVAC systems that were able to be upgraded with the highest-rated filters, but a few of the older buildings, like where Ciancio’s office is, just got extra portable air purifiers.

Ciancio points to the low rates of COVID in Mapleton schools even as rates in the surrounding community soared as her assurance that everything is working.

Last fall, the approximately 9,000-student district had just two outbreaks, as defined by the state, at schools. The district’s dashboard last week identified 200 total positive cases among students and staff since the start of the school year.

In many school districts, the desire to create safer indoor spaces runs into the reality of older buildings that have been remodeled in less-than-ideal ways over the years.

Adams 14 buildings, for instance, can only accommodate HVAC filters up to a rating of 10, which is less effective than the 13 rating that experts suggest. Even the district’s newest building, Adams City High School, built in 2009, lacks an HVAC system that can accommodate a higher-rated filter, district officials said.

“Older buildings are much harder to deal with,” said Jim Malley, a professor of civil and environmental engineering at the University of New Hampshire. “Irregular-shaped classrooms are harder to deal with.

“When you have no way of getting outside airflow, that’s a real problem. I think it’s reasonable to think COVID transmission would be higher in those rooms. When possible, those need to be not used, but in some places that won’t be feasible.”

The Adams 14 school district initially focused on increasing the outside air coming into schools. But according to the district’s application for the grant that paid for the new hydrogen peroxide systems, filtering, heating, cooling or otherwise controlling that outdoor air resulted in “unsustainable” utility cost increases.

One company that was already working with the district on career opportunities for high school students recommended the Synexis hydrogen peroxide systems, which it sells. Adams 14 is one of the first school districts to roll out the devices districtwide. The Upper Rio Grande School District and a private school in Vail have already installed systems.

Experts say that the technology doesn’t have a long track record, despite the research that the company touts, and some experts worry that doing chemistry in the air could result in unintended consequences.

The company touts clients like professional sports teams, the Kansas State University, and St. Judes Hospital, though not the one in Colorado. Company officials say they have lots of research that shows their technology is safe.

CEO Eric Schlote said Synexis is presenting research to the FDA to get approval to make more extensive claims about its ability to rid the air of microbes.

Adams 14 officials said they have no concerns.

“We think we’re taking the right safety precautions,” said Ron Cabrera, Adams 14’s chief of staff.

Several researchers do not think it’s a good idea.

“I do not recommend hydrogen peroxide, spraying any cleaning chemicals into your air or any incense, all of this stuff, especially when the space is occupied,” Miller said. “I know some schools are doing it, but indoor air quality scientists do not recommend it.”

Delphine Farmer, an associate professor of chemistry at Colorado State University, said schools should be cautious about any technology that purports to use a chemical reaction to kill the virus in the air, since any chemical reaction will produce byproducts.

“I would be concerned and I would want to know: If you are using enough hydrogen peroxide to kill viruses, would you also be using enough to change the chemistry inside the building?” she said. “I have grave concerns that I haven’t seen any scientific literature on the efficacy or the other byproducts, which, as a chemist, would want to see studied before it was implemented.”

In particular, Farmer is concerned about the use of bleach fumigation, ion-generating systems, and ozone-generating systems. Some of these are in use in hospital settings, but she said that doesn’t make them appropriate for schools.

Synexis systems don’t generate ozone, Schlote said. Adams 14 did not respond to questions about the cost of maintaining the 427 devices. That ongoing maintenance includes changing a filter, the UV light, and a cartridge-like piece, every 90 days, on each device.

Daniel Stone, said that when he first learned about the district’s investment he was excited. But after looking into the devices and the research more, he was concerned.

“One of their own pages says something that it’s like magic,” Stone said. “I like magic, but not when it comes to my health.”

Stone has been able to continue teaching remotely, and said he wants to be hopeful, and for now he said he’s glad that students and some teachers had the choice to stay home.

“Hopefully, it’s harmless,” he said.