Wildfires and Pandemics will Continue to Coexist

Webinar with Coronavirus Taskforce Today Questions Texas Mask Decision

Ventilation and Filters Key to School Safety

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Wildfires and Pandemics will Continue to Coexist

Volcanoes, red tide, dust storms from Africa, inversions which cause high local air pollution levels and wildfires will all need to be addressed with a combination of masks and air filters.

The guidelines for staying healthy while big fires burn have long been simple: stay inside and, when possible, use air filters to capture those dangerous microparticles. But the coronavirus pandemic caused shortages of key air-quality supplies and has forced some difficult tradeoffs on indoor air safety.

Both fine smoke particles and the coronavirus can be captured by a class of air filters known as MERV-13, which can be installed in many existing heating and air conditioning systems. But because these filters weren’t in wide use before the pandemic, a sudden surge in demand has created ongoing MERV-13 shortages.

Mike Gallagher, president of HVAC contractor Western Allied, believes that’s going to catch commercial building managers by surprise once the current wave of fires dies down.

“Once the smoke clears, it smells okay outside, but you walk into the building and it smells like smoke. That’s when they realize they need new filters,” says Gallagher. But with waiting lists for MERV-13 filters as long as two months, Gallagher predicted that many buildings in smoke-affected areas would  be forced to temporarily resort to MERV-8 filters, which are not capable of clearing the coronavirus from the air. That could increase the infection risk in shared spaces including offices, restaurants, and movie theaters.

The coronavirus forces  a second difficult choice as the fires rage: whether to let in outside air to reduce the risk of infections, or seal buildings up tight to keep out smoke particles.

“For [protection against] COVID, you want to get the [outside air] ventilation rate as high as possible,” says HVAC veteran Tom Javins. “But with wildfire smoke, you want to have the ventilation rate as low as possible. Because the pollutant is in the outside air, not the inside air.”

Javins sits on a committee of the American Society of Heating Refrigerating, and Air-conditioning Engineers (ASHRAE), which is developing best practices for heating and ventilation under wildfire conditions. Though the double-bind of the coronavirus and smoke is challenging, his bigger concern is widespread indifference: “Most [commercial] building managers don’t do anything” to adjust for dangerous outside air quality, he says, and he frequently finds that the vents controlling outside air flow for big buildings have broken down entirely. Most often these vents, known as air dampers, are stuck closed, helping keep out fire particles but increasing COVID-19 risk for occupants.

A separate set of challenges comes with trying to protect private homes from wildfire smoke. According to Sarah Coefield, an air quality specialist with the Missoula, MT. county government, many homes in the west and Pacific Northwest don’t have central HVAC systems capable of filtering out smoke particles. That leaves them reliant on portable air filtration devices, which are often effective but can also be hard to find right now due to coronavirus-driven demand.

Even when they’re available, portable air filters can be expensive, easily costing up to several hundred dollars for a device big enough to clean the air in a single room. That highlights a larger issue: As seen with the coronavirus, the well-off are more able to protect themselves from the health impacts of wildfires. On top of the cost of filters, lower-end homes or apartments may have more leaks around windows and doors that let in contaminants. And, again as with COVID-19, not all workers are equally able to protect themselves—farmworkers, for instance, can’t work from home to get away from smoke.

Webinar with Coronavirus Taskforce Today Questions Texas Mask Decision

Here are excerpts from the meeting today which was primarily about the expanded vaccine production but also dealt with mask issues.

MODERATOR: Next we’ll going to Brenda Goodman with WebMD.

Q    Hi, good morning.  I have a question about Texas. Yesterday, Governor Greg Abbott said that he was going to lift the mask mandate and open the state up 100 percent, and we know that now that all the variants have been found in Houston, according to some researchers who were part of a large genomic sequencing effort there.  So, I’m wondering, do you agree with the Governor’s assessment that it’s time to open the state up 100 percent?

ACTING ADMINISTRATOR SLAVITT:  Well, let me begin with Dr. Walensky to talk about the CDC’s perspective, and then I’ll — I’ll add some comments.

DR. WALENSKY:  Thank you for the question.  I think, we, at the CDC, have been very clear that now is not the time to release all restrictions. I do think that, as I said in my remarks, the next month or two is really pivotal in terms of how this pandemic goes. As we scale up vaccination, we really do need to decrease the amount of virus that is circulating, as we’re trying to vaccinate all the public.

I will also note that, you know, every individual has — is empowered to do the right thing here, regardless of what the states decide for personal health, for public health, for their health of their loved ones and communities. I would still encourage individuals to wear masks, to socially distance, and to do the right thing to protect their own health.

ACTING ADMINISTRATOR SLAVITT:  Let me just follow that up. You know, the President is committed to a few things. One is to follow the recommendation of the science and the scientists and wherever that goes, and so the President is 100 percent behind Dr. Walensky and the CDC’s recommendations. 

I don’t think you could be any — possibly be any clearer about the importance and the need for masks.  As a leader, it’s probably one of the topics he talks about most frequently.  He models that behavior.  He’s made the order on every possible area where we have federal control — all the federal sites and facilities, transportation.

And, of course, last week, we announced that we’re going to be distributing masks to community health centers and food banks. We think it’s critically important — critically important that, particularly over the next period of time — this is not forever, but the next period of time, when the President has called for this, we know that it can save tens of thousands of lives if people do this. And we strongly encourage people to continue to wear masks, and mayors, governors, and others recognizing that they have difficult decisions to make to keep the course.

Next question.

MODERATOR:  Next question, Sabrina Siddiqui at Wall Street Journal.

Q    Thank you as always for doing the briefing.  I wanted to ask if you have a sense of when Merck will actually be able to ramp up production in terms of helping with the J&J vaccine, given the time it will take for the company to convert its facilities. And do we know how many doses Merck will be able to help manufacture?

ACTING ADMINISTRATOR SLAVITT:  Yeah, thanks, Sabrina. I think the answer is May.  And, again, there are two elements: There is the substance of the vaccine itself, and then there’s the fill-finish.  So it’s a bit more of a complex answer, but over time, we believe that Merck will be able to double the capacity that we’ve seen from Johnson & Johnson heretofore.

Next question.

MODERATOR:  Next we’ll go to Kristen Welker at NBC.

Q    Hi, everyone.  Thank you so much for doing this call. I really appreciate it. I wanted to follow up on the question about Texas. It’s not just Texas that is easing restrictions, it’s also other states like Mississippi, Arkansas, North Carolina, Virginia. So is there anything that the federal government can do?  Is there anything that your team is looking to do to try to encourage, if not mandate, that these states reverse course? 

And also, in terms of the May benchmark, as it relates to distributing the vaccine, what are the potential headwinds that could derail that timeline? In other words, what are you concerned about most when you look to that end-of-May goal?

ACTING ADMINISTRATOR SLAVITT: Thank you, Kristen. I think we have the same answer with regard to what our view on masks and what the President is saying and doing on masks.  And so, you know, I think we are using the absolute full extent of all of the areas where we have federal control, and we are actively — actively being very, very clear on what we think needs to happen. And so we hope that other elected officials who have the authority in their domains will, in fact, listen.

We’re realistic enough to recognize that everybody is not going to pay attention everything we say, but we think this is very, very important.

In terms of Johnson & Johnson and Merck, I’m going to probably defer that question to the company.  You know, I think we have a good plan.  I will tell you we always worry about everything. I mean, that’s sort of part of our ethic around here — is execution mentality means that we are constantly worried. So anything that has yet to happen in the future, I can assure you we have world experts from manufacturing, from the Department of Defense, and from the companies all very focused on this.  I don’t know that I can point to one specific thing.

MODERATOR:  Last question will go to Raquel with TV Globo of Brazil.

Q    Thank you so much.  Can you hear me?

ACTING ADMINISTRATOR SLAVITT:  Yes.

Q    Thank you so much for this opportunity.  My question is to Dr. Fauci, because Brazil is now having the worst time of the pandemic, and scientists around the world are warning that the COVID outbreak in Brazil is a global threat that could risk the progress here and in other parts of the world. 

Dr. Fauci, do you agree with this assessment?  And also, do you believe Brazil could be doing anything different to respond to this crisis, especially when it comes to vaccination? Are you having conversation or working with authorities from Brazil?

DR. FAUCI:  Yeah. Well, thank you for that question. It is really a very difficult situation that Brazil finds themselves in because it is really difficult in the sense that even with infection from the original virus that was circulating — and recovery from that virus does not, in fact, protect you against reinfection from the circulating variant in Brazil. 

The best thing one can do is to get people vaccinated as quickly as possible and as many people as possible. You have to get your scientists and your public health officials to take a close look at the match between the antibodies that are induced by the vaccine that you are using and what its efficacy against the P1 and P2 variant that is dominant in Brazil.

So that’s something that you — that I would imagine — and I’d be happy to be discussing this with your officials, if you’d like, to talk about what kind of options you might have.

The issue with the impact of what goes on in Brazil and the rest of the world: Obviously, when you have a variant that is in a particular country — and we already have the Brazil variant in a limited extent in our own country — that’s the reason why, as I mentioned literally just a few minutes ago, in our vaccination program we aim to get the highest titer of vaccination that would then be able to give a cushion of protection even against the variants. 

And as I mentioned, the recent paper that came out from Dr. David Ho’s laboratory in New York indicated that there’s a diminution in the capability of vaccine-induced antibodies to protect, but it is a modest diminution, which means that it is likely that the cushion that you get from two doses of an mRNA vaccine would likely be able to protect reasonably well against that.

 

Ventilation and Filters Key to School Safety

On February 27, the Alabama Educators Rank-and-File Safety Committee hosted an online meeting titled “The CDC vs. Science: What teachers, parents & students need to know.” The meeting was organized after the release of  what some claim to be the politically motivated guidelines on school reopenings released by the Centers for Disease Control and Prevention (CDC) on February 12.

An Alabama public school teacher chaired the meeting, which was attended by educators from across that state as well as California, Georgia, Hawaii, Florida, Illinois, Massachusetts, Michigan, New Mexico, Ohio, Pennsylvania, Tennessee, Texas and Virginia. The featured speaker was World Socialist Web Site health care writer Dr. Benjamin Mateus, who gave a report on “The critical role of ventilation and infection control in classrooms” and answered questions.

Students work on an art project during class at the Sinaloa Middle School in Novato, California on March 2, 2021. (AP Photo/Haven Daily)

The following is an edited transcript of Dr. Mateus’s report and the Q&A.

Dr. Benjamin Mateus: I want to focus my report on the critical role of ventilation and infection control in classrooms, because it’s glaringly absent in the CDC guidelines. And I think once we get into it, it’ll be clear why it’s important. Given a respiratory pathogen like SARS-CoV-2, it becomes imperative to ensure that school heating, ventilation, and air conditioning systems are constantly running and meticulously maintained.

On the National Air Filtration Association website, in the section on air filtration for school, it quotes the American Public Health Association: “Every child and school employee should have the right to an environmentally safe and healthy school that is clean and in good repair.” It emphasizes the fact that schools are even more densely populated than a typical commercial building, making the “bio-burden” much more significant and leading to some of the worst air conditions in any environment.

The US Government Accountability Office (GAO) report published in June 2020 found that 54 percent of public-school districts require the overhaul or replacement of multiple building systems or features in their schools. Specifically, 41 percent of school districts, or 36,000 schools across the country, need to update their HVAC systems.

The same report explains that in 2019, before the pandemic, California did a study of its schools’ HVAC systems. These were 94 newly installed HVAC systems in K-12 schools. It found that 85 percent of them didn’t provide adequate ventilation, meaning fresh outdoor air was not coming into the rooms. So even though they’re putting in these $100,000 or $1,000,000 units into their school systems, they don’t know how to run them. They don’t have the expertise.

The GAO report also notes that a recent inspection of 21 schools in New Haven, Connecticut, found that two-thirds had dirty or poorly maintained ventilation systems. The inspection revealed years of neglect that predated the pandemic.

In an article published earlier this month, on February 12, Christopher Ruch, the director of training at the National Energy Management Institute, said that “poor ventilation is an age-old problem that predates the current COVID-19 crisis. Many classrooms did not have HVAC units operating at the minimum required ventilation rates even before the pandemic. The benefits of adequate ventilation, including reduced absenteeism, improved cognitive retention, and improved productivity, have been well documented in multiple publications. This issue needs to be addressed regardless of the COVID-19 pandemic.”

The term “aerosolization” becomes a critical factor in our discussion here. Dr. Kevin Fennelly wrote in July 2020 in the Lancet, “data show that infectious aerosols from humans exist in a wide range of particle sizes that are strikingly consistent across studies, methods, and pathogens. There is no evidence to support the concept that most respiratory infections are associated with primarily large droplet transmission. In fact, small particle aerosols are the rule, rather than the exception, contrary to current guidelines.”

This was a tremendous leap forward in our understanding of the pandemic. It confirmed that preventative measures had to address this critical issue: the ventilation of indoor spaces. The concept of contaminated surfaces and respiratory droplets dates back to 100 years ago. It’s only recently that we’ve had the ability to identify how respiratory pathogens really work.

An article published in October 2020 in USA TODAY titled “ Ventilation and air filtration play a key role in preventing the spread of COVID-19 indoors “ includes a lot of important information from experts like Dr. Shelly Miller, professor of mechanical engineering at University of Colorado Boulder, as well as representatives from the American Society of Heating Refrigeration and Air-Conditioning Engineers (ASHRAE) Epidemic Task Force.

The article states that most HVAC systems cycle in about 20 percent fresh air, and the remaining 80 is recirculated air. This is done for energy efficiency. However, some aerosolization scientists recommend moving the air out completely and bringing in 100 percent fresh air. That means a greater energy burden. But the safety of children and teachers is more important than the extra cost of running these HVAC systems.

As the article further explains, minimum ventilation rates depend on the type of activity occurring in that room. So, we need to ask not only how many people are in that classroom, and how big is it, but also, is this wood shop? Is it a gym class? And what season is it? Because the temperature and humidity will be different.

For the school nurse’s office, having a negative pressure room is critical. And being able to isolate students and having some method by which to take students or a teacher from a class to the nurse’s office is also critical.

ASHRAE recommends that in one hour, the HVAC system should provide six complete changes, and it recommends ventilating the room one hour to two hours before classes are opened, and one to two hours after classes are finished.

There have been a lot of studies that have looked at infectious disease outbreaks and the use of ventilation. There’s one study from an outbreak of tuberculosis in 2019 at Taipei University in Taiwan. They noticed that rooms were under-ventilated. And they found out that the CO2 levels in these rooms were running around 1,200 to 2,000 parts per million. It’s supposed to be somewhere between 500 to 600 parts per million.

They increased the ventilation by 20-fold, and the outbreak ended. Before the ventilation, the CO2 reading was at 3,200 parts per million. Once the ventilation was improved, the CO2 readings went down to 600 parts per million.

“ CO2 Sensor Helps to Reduce the Risk of COVID Transmission Indoors “ is the title of an article in the November 2020 edition of Electronic Engineering Times. It explains that in conjunction with improving and having appropriate HVAC systems, it is critical to have CO2 sensors in your room. People spend 90 percent of their time indoors, which means concentrations of pollutants indoors are often two to five times higher than outdoors.

CO2 concentration is a key indicator of air quality. When your CO2 level reaches 1,000 parts per million, you can get headaches. You can get drowsy, and it can affect your concentration. When you get to 2,000 parts per million, it can actually have an impact on your cognitive abilities, and it can lead to health risks. If you have asthma, it can exacerbate that.

Exhaling CO2 into a room can be a proxy for potential aerosolization of COVID-19 particles. And that means if your sensor goes off, you probably have a problem. If that happens, then you need to evacuate the room and ventilate before you bring students back into that classroom.

In conjunction with running an appropriate HVAC system, it’s critical to use Minimum Efficiency Reporting Value Filters, or MERV filters. Many of you have already heard of these. The higher the value, the fewer particulates get through, but it puts more strain on your ventilation. So MERV-13 has been the agreed minimum standard. And the reason for that is because COVID particles tend to be in the range of 0.5 microns to 50 microns, and mainly between 1 and 5 microns. MERV-13 removes about 95 percent of the particulates in this range. That’s why it’s very important to have these filters in place.

Another thing that teachers need to know is that acrylic dividers in classrooms are probably not a good thing. Dr. Shelley Miller, who’s done research on this, especially with music classes, found out that plexiglass barriers change the aerodynamics in the room, and it can create dead zones where aerosols build up. She tweeted on September 9, 2020, “We do not recommend acrylic room dividers for reducing risk of airborne transmission. At best it does NOTHING, at worse it changes the airflow patterns in the room and can cause pooling of air, hot-spots, and reduced ventilation effectiveness.”

On February 15 of this year, a group of scientists including Dr. Michael Osterholm signed a letter demanding that the Biden administration acknowledge that SARS-CoV-2 is an aerosolized pathogen as opposed to the current emphasis on respiratory droplets. The title of their letter is “Immediate action is needed to address SARS-CoV-2 inhalation exposure.”

They write, “For many months it has been clear that transmission through inhalation of small aerosol particles is an important and significant mode of SARS-CoV-2 virus transmission. ... Numerous studies have demonstrated that aerosols produced through breathing, talking, and singing are concentrated close to the infected person, can remain in air and viable for long periods of time, and travel long distances within a room and sometimes farther. Gatherings in indoor spaces without adequate ventilation place participants at particularly high risk, an important component of which is driven by asymptomatic and pre-symptomatic viral shedding of infected individuals.”

One new study of the coronavirus in buildings found that because of the viruses’ transmissibility and tendency to hang in the air over time, administrators may not be able to rely on the normal rate of air flow from their ventilation systems to clear virus particles from the air. A separate new study of Dutch schools found aerosols built up steadily in school gyms even when they had ventilation, but the combination of increased ventilation and the use of mobile air filters cut the concentration of aerosols in the rooms by 80 to 90 percent.

The CDC does recommend bolstering ventilation beyond opening doors and windows. But what if each fan costs $100, portable filters cost $500, and putting ultraviolet germicidal irradiation into your ventilation ducts could cost upwards of $1,500? This could run into hundreds of thousands to millions of dollars, depending on the school.

High-poverty school districts spend on average $300 less per student on capital projects like HVAC upkeep and replacement. There are more than 96,000 buildings nationwide ranging in size, age, and location, and according to the GAO, 36,000 of them have “sub-standard” HVAC systems. A Learning Policy Institute (LPI) article from December cites the GAO figure and adds that these systems could cost about a million dollars per building to upgrade, and even more for systems that have to be totally replaced. It estimates that about $72 billion would need to be spent to guarantee safe air quality in all classrooms.

But the funding for school facilities, as we know, primarily comes from local sources—about 82 percent of it, according to the LPI. State funding is about 18 percent, and federal support is less than 1 percent. The LPI writes that “Most states, for their part, are trying to fend off cuts to their K-12 education budgets and are not in a position to increase funding for facilities. In short, the federal government is the only entity that can provide the needed resources to ensure safe and healthy air quality in our schools.”

In its push to support the Biden administration’s efforts to open schools rapidly, the CDC has altogether ignored the aerosolization of the virus. Its guidelines make no mention of these transmission mechanisms. This is because the acknowledgment of airborne routes of spread would necessitate ensuring that physical conditions at schools were thoroughly assessed and addressed before approving any reopening plan. A national project to refurbish school districts’ facilities and bring them up to code would have to become the primary focus over the intervening months as schools shifted to complete remote learning until the fall or whenever it is deemed safe.

Teachers must realize that the science is with them. Their resistance isn’t based on fear, but the recognition that the pandemic is serious and the dangers are certain. It comes out of a deep consideration for the well-being of their students, their families, and communities. And it is for these reasons that they actually put up such a heroic fight.

The working class supports their fight. And the working class is the only class that can ensure that society’s resources are used in the rational manner that is required to stop this pandemic.

Thank you for allowing me to speak.

Questions & Answers

Q: The CDC said that if community spread of COVID was above a certain level, schools should not open, but now the government is pushing to open schools regardless. How should the level of community spread affect the decision to open schools?

Dr. Mateus: Well, first Biden said that all we’re looking for is just one school open at K-8, then suddenly they change it to all schools K-12 open five days a week. So, this is a moving target. And yes, they even said that as long as you can maintain every mitigation effort, it’s safe to open schools regardless of how high the community transmission is.

I would warn teachers that there’s a direct correlation between school openings and the development of community spread.

The data is clear that children can be infected, and they can spread the virus. And the belief that somehow there’s going to be 100 percent use of masks and appropriate social distancing in class five days a week for nine hours is ludicrous.

Even [CDC Director] Dr. Walensky had to admit that the compliance with mask usage in the United States among students was probably 50 to 60 percent, not the 100 percent that they’re looking for. And their guidelines say that if you can’t maintain these mitigation efforts, you have to close.

But it’s a moving target because they need to have kids back at school and parents back to work, and they need to get the economy rolling.