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COVID-19 Research |
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COVID-19 Ventilation FAQ
These COVID-19 Ventilation Frequently Asked Questions (FAQ) are based on COVID-19 research from a systems perspective that started in 2020.
After you read this FAQ go to the COVID-19 Ventilation Survey.
Background
A. Ventilation Background
B. Ventilation Summary
C. A Paradigm Shift to Combat Indoor Respiratory
Infection
D. Ventilation Research
Questions
1. Is COVID-19 Airborne?
2. Was the CDC compromised during the Trump administration and
what does that mean?
3. Should I be doing deep cleaning beyond normal janitorial
practices in my public areas?
4. What is the issue with ventilation?
5. So how do I deal with ventilation?
6. How bad is the ventilation issue in a small public room?
7. What does the CDC recommend for room ventilation rates?
8. What does the World Heath Organization (WHO) recommend for
room ventilation rates?
9. What did the Philadelphia Health Department Restaurant Program
recommend for room ventilation rates?
10. What is my likely room ventilation rate?
11. What is my likely room ventilation rate if I properly manage
the system?
12. So what is happening with the vaccine?
13. Is this bad and what does this mean?
14. Now that we have a vaccine, does facility ventilation need
to improve?
15. What are my alternatives to improve ventilation?
16. So what is wrong with portable air room air cleaners?
17. So what is wrong with Photocatalytic Oxidizer (PCO) / Ionizer
systems?
18. What does the CDC say about Ceiling Level UV-C systems?
19. Do in-duct UVGI systems increase the room ACH?
20. Why did the CDC couple Upper-room UVGI systems with In-duct
systems in the same sentence?
21. I don't want to pay for a classroom / in room ventilator,
what can I do?
22. How much more will ventilation cost if I use HVAC fans?
23. Am I irresponsible if I ignore the ventilation issues in
my public space as one in a position of authority?
24. So the vaccine made everything okay and I don't need to
address facility ventilation?
25. I live in a home owners association (HOA) with a clubhouse,
what should I do?
A. Ventilation Background
Buildings must comply with local building codes and many assume that establishes the ventilation performance requirements that must be met. However, that is an incorrect assumption. The building codes only establish the minimum ventilation requirements that must be met and buildings can exceed those minimum ventilation performance requirements. The other issue is the building codes do not represent what is needed for airborne contagions except for hospitals. So elite buildings will have great ventilation equal to or exceeding hospital ventilation performance levels.
Some buildings exceed the minimum ventilation performance requirements and they are buildings that were built in the 1920's, 30's, 40', 50's and 60's that were retrofitted with HVAC systems. Their performance levels are high and they exceed local building codes. There are also newer buildings that exceed local building codes with very high levels of ventilation performance requirements and they are elite buildings.
When the energy crisis happened in the last century, there was a massive push to reduce energy consumption and this resulted in significantly reduced ventilation levels. With the rise of sustainability in this century there is an additional push to reduce energy consumption and this is resulting in a further push to reduce ventilation in buildings. Many are now advocating that a building ventilation system just provide enough ventilation to prevent CO2 poisoning. It is known that just maintaining the CO2 levels is an extremely low level of ventilation where airborne contagions will make people sick.
A building ventilation system is a life support system and if it does not work properly people will be harmed.
Currently there is a battle behind the scenes between engineers and scientists that want proper ventilation performance requirements placed into all building codes and those that are fighting this effort. Those that are fighting the effort for updating the codes to reflect airborne contagion threats in buildings are: (1) the building owners that quickly realized during the energy crisis in the last century that they could save significant amounts of money and (2) those pushing for reduced energy consumption to reduce the effects of global warming. Those pushing for reduced energy consumption have impacted local building codes and now older buildings with high levels of ventilation performance are being forced to lower their ventilation system performance levels. This is a serious battle and it is a challenge for this generation in this century.
This database is for two user groups:
The third group fighting this critical need do not want transparency and will continue to obscure and hide this information.
B. Ventilation Summary
It is clear that COVID-19 is spread by inhaled aerosols. Outdoors, dilution of aerosols are infinite although the time it takes to dilute clouds of aerosol depends on air movement. Imagine how a cloud of cigarette smoke lingers or dissipates depending on whether there is a breeze. Indoors, aerosols linger much longer than outdoors, often long enough to be inhaled by someone sharing the same space. If you breath in an indoor setting where other people are also breathing, if the ventilation is poor, you will breath in some of the air that someone else exhaled.
Ventilation is the way that the risk of indoor airborne infection is reduced.
One ACH (air change per hour) happens when a volume of air equal to that of the room enters and leaves over a period of one hour. For hospital procedure rooms, the CDC recommends 6 to 15 ACH with infection free outdoor air, or air that has been filtered or decontaminated. For rooms with airborne contagions the CDC recommendation is 12 ACH. We know that people will be infected in rooms where the ventilation is 0 or 1 ACH. We also know most existing ventilation systems are on demand systems, which means there is no ventilation (0 ACH) until the system turns on to either cool or heat a room. Most systems have a fan mode but no one is turning on the fan mode on these systems. We also know that most systems are sized to be 4 ACH which is a marginal ventilation performance level.
High efficiency air filters (99.9%) are used in building ventilation systems to minimize contagions from being recirculated back into rooms. This converts the recirculated air into the equivalent of infection free outdoor air. The options for enhanced in room air decontamination include increased ventilation, portable room-air cleaners, upper-room germicidal UV systems, and whole-room Far UV systems. Ion generators also can be used in rooms, but the evidence for efficacy is far less than for other approaches.
Natural and Mechanical ventilation performance is measured in terms of ACH. Upper-room germicidal UV systems and the new Far UV systems ventilation performance is measured in terms of equivalent-ACH or eACH. Upper-room germicidal UV systems can have a performance level of 24 eACH. The Far UV systems ventilation performance level is similar to the Upper-room germicidal UV systems. Ion generators are more difficult to assess performance. They have a mechanical component based on ACH and an eACH component but the eAUC level is not typically reported. Instead these systems report how long it takes to inactivate a virus, such as 3 minutes. If 3 minutes is divided into 60 minutes that translates into an eAUC of 20. The issue is that the 3 minute performance level is not typically associated with real room conditions.
C. A Paradigm Shift to Combat Indoor Respiratory Infection
In May of 2021, 39 scientists published "A Paradigm Shift to Combat Indoor Respiratory Infection" calling for a paradigm shift in how citizens and government officials think about the quality of the air we breathe indoors.
A Paradigm Shift to Combat Indoor Respiratory Infection, University of LEEDS, White Rose Research Online, published 14 May 2021, online August 27, 2021. webpage https://eprints.whiterose.ac.uk/177405/3/Paradigm%20Shift%20AAM.pdf, https://eprints.whiterose.ac.uk/177405/, December 2021. A paradigm shift to combat indoor respiratory infection, University of LEEDS . PDF.
A Paradigm Shift to Combat Indoor Respiratory Infection
ABSTRACT
There is great disparity in the way we think about and address different sources of environmental infection. Governments have for decades promulgated a large amount of legislation and invested heavily in food safety, sanitation, and drinking water for public health purposes. By contrast, airborne pathogens and respiratory infections, whether seasonal influenza or COVID-19, are addressed fairly weakly, if at all, in terms of regulations, standards, and building design and operation, pertaining to the air we breathe. We suggest that the rapid growth in our understanding of the mechanisms behind respiratory infection transmission should drive a paradigm shift in how we view and address the transmission of respiratory infections to protect against unnecessary suffering and economic losses. It starts with a recognition that preventing respiratory infection, like reducing waterborne or foodborne disease, is a tractable problem.
The following are key extracts from the paper, A Paradigm Shift to Combat Indoor Respiratory Infection.
There is great disparity in the way we think about and address different sources of environmental infection. Governments have for decades promulgated a large amount of legislation and invested heavily in food safety, sanitation, and drinking water for public health purposes. By contrast, airborne pathogens and respiratory infections, whether seasonal influenza or COVID-19, are addressed fairly weakly, if at all, in terms of regulations, standards, and building design and operation, pertaining to the air we breathe.Most modern building construction has occurred subsequent to a decline in the belief that airborne pathogens are important. Therefore, the design and construction of modern buildings make few if any modifications for this airborne risk (other than for specialized medical, research, or manufacturing facilities, for example). Respiratory outbreaks have been repeatedly “explained away” by invoking droplet transmission or inadequate hand hygiene.
For decades, the focus of architects and building engineers was on thermal comfort, odor control, perceived air quality, initial investment cost, energy use, and other performance issues, whereas infection control was neglected. This could in part be based on the lack of perceived risk or on the assumption that there are more important ways to control infectious disease, despite ample evidence that healthy indoor environments with a substantially reduced pathogen count are essential for public health.
It is now known that respiratory infections are caused by pathogens emitted through the nose or mouth of an infected person and transported to a susceptible host.
Although the highest exposure for an individual is when they are in close proximity, community outbreaks for COVID-19 infection in particular most frequently occur at larger distances through inhalation of airborne virus laden particles in indoor spaces shared with infected individuals
There are ventilation guidelines, standards, and regulations to which architects and building engineers must adhere.
None of the documents provide recommendations or standards for mitigating bacteria or viruses in indoor air, originating from human respiratory activities. Therefore, it is necessary to reconsider the objective of ventilation to also address air pollutants linked to health effects and airborne pathogens.
There needs to be a shift in the perception that we cannot afford the cost of control, because economic costs of infections can be massive and may exceed initial infrastructure costs to contain them. The global monthly harm from COVID-19 has been conservatively assessed at $1 trillion ([internal ref]), but there are massive costs of common respiratory infections as well. In the United States alone, the yearly cost (direct and indirect) of influenza has been calculated at $11.2 billion; for respiratory infections other than influenza, the yearly cost stood at $40 billion.
We encourage several critical steps. First and foremost, the continuous global hazard of airborne respiratory infection must be recognized so the risk can be controlled. This has not yet been universally accepted, despite strong evidence to support it and no convincing evidence to refute it.
Comprehensive ventilation standards must be developed by professional engineering bodies. Organizations such as the American Society of Heating, Refrigerating and Air-Conditioning Engineers and the Federation of European Heating, Ventilation and Air Conditioning Associations have ventilation standards, and during the COVID-19 pandemic, they have proposed building and system-related control actions and design improvements to mitigate risk of infection. However, standards must be improved to explicitly consider infection control in their statements of purpose and definitions. New approaches must be developed to encourage implementation of standards (e.g., “ventilation certificates” similar to those that exist for food hygiene certification for restaurants).
The COVID-19 pandemic has revealed how unprepared the world was to respond to it, despite the knowledge gained from past pandemics. A paradigm shift is needed on the scale that occurred when Chadwick’s Sanitary Report in 1842 led the British government to encourage cities to organize clean water supplies and centralized sewage systems. In the 21st century, we need to establish the foundations to ensure that the air in our buildings is clean with a substantially reduced pathogen count, contributing to the building occupants’ health, just as we expect for the water coming out of our taps.
D. Ventilation Research
The following links contain research associated with ventilation:
Go to the COVID-19 Ventilation Survey
Questions
1. Is COVID-19 Airborne?
Yes. There was a massive disinformation effort on the part of the Trump administration to claim that the virus was not airborne and that the virus was transmitted primarily via surfaces. This lie was disclosed in taped interviews with journalist Bob Woodward on Feb. 7, 2020 but was not disclosed to the public by the New York Times until September 09, 2020.
2. Was the CDC compromised during the Trump administration and what does that mean?
Yes. It means that you must ignore the guidance provided during the Trump administration and start following the guidance provided after March 2021. It also means that the CDC still must be carefully watched but this is the case for all government and all times, citizens must be engaged. The mainstream science and engineering always must be accessed when accepting the CDC guidance. Lunatic fringe science and engineering must be avoided at all costs because that is what gripped the Trump administration that led to the COVID-19 disaster.
3. Should I be doing deep cleaning beyond normal janitorial practices in my public areas?
According to the CDC in 2021, since the virus is airborne, resources should be applied to ventilation rather than deep cleaning.
4. What is the issue with ventilation?
The concept is simple, when a person is infected they expel virus into the air where it stays airborne for some time. As they breathe, they start to fill the space around them and a virus cloud expands. In a small room, like a classroom or a public clubhouse room, the virus cloud fills the room in a very short amount of time and it is not diluted, it is highly concentrated. In a very large room, like a large big box retail store, it takes a very long time to fill the room and it is highly diluted. In an outside setting, the virus cloud is almost instantly diluted and dispersed into the massive outside space.
5. So how do I deal with ventilation?
The only alternative is to clean the air as quickly as possible before the virus builds up in the small room. The science and engineering goes back into the last century and it has been reduced to a simple number called Air Changes Per Hour (ACH) or Air Update Changes Per Hour (AUC).
6. How bad is the ventilation issue in a small public room?
It is very bad. Because of the energy crisis in the 1970's the forced air heating and cooling systems have reduced the ACH level to just prevent CO2 poisoning as people breathe. This translates to very small ACH levels that will instantly lead to infection in a small space without a mask and with a mask will likely lead to infection in 1 hour.
7. What does the CDC recommend for room ventilation rates?
For hospital rooms where there is an airborne contagion, the CDC recommends 12 ACH. This means the air in the room is exchanged 12 times per hour.
8. What does the World Heath Organization (WHO) recommend for room ventilation rates?
For hospital rooms where there is an airborne contagion, the WHO recommends 24 ACH. This means the air in the room is exchanged 24 times per hour. The WHO has published various information on natural ventilation where windows and doors are open and the ventilation rates can be as high as 37 ACH. When possible, the WHO recommends natural ventilation when there is airborne contagion because of the massive ACH levels.
9. What did the Philadelphia Health Department Restaurant Program recommend for room ventilation rates?
The Philadelphia Health Department established a restaurant program and for indoor dining the Philadelphia Restaurant Program recommended 15 ACH. This is higher than the CDC recommendation for a hospital room and matches the CDC recommendation for a hospital delivery room.
10. What is my likely room ventilation rate?
It is zero unless the forced air heating ventilation cooling system fans are turned on. It is also zero if the filters are not properly maintained because the virus particles will just pass through the system rather than be properly filtered. Any filter properly maintained is better than none. Per CDC guidelines, to properly manage the system turn on the fan mode 2 hours before opening the public space and turn it off 2 hours after closing the public space.
11. What is my likely room ventilation rate if I properly manage the system?
If you are managing the system properly then your likely ventilation rate is between 1 and 4 ACH. This is because of the changes that happened in the 1970s energy crisis. Facility managers soon realized they could save energy costs by turning down the ventilation rates. We know from empirical data that infection in classrooms will happen at 1 ACH.
12. So what is happening with the vaccine?
The vaccine works. However, because of massive disinformation, a large number of people in the USA have not been vaccinated. The vaccine became broadly available in June 2021. Between June 2021 and October 2021 there have been 103,162 deaths. These deaths have been caused by the unvaccinated. Some politicians have publicly made statements and passed legislation to discourage vaccination. Because of their positions of authority and public trust they are criminally coupable in these new deaths.
13. Is this bad and what does this mean?
Yes, this is all very bad. If you are in a position of authority that impacts a facility, you must ensure that you do everything possible to ensure a safe facility.
14. Now that we have a vaccine, does facility ventilation need to improve?
Yes. We see people behaving very badly. Now that we know sick building syndrome is real, all buildings must have their ventilation systems inspected and improved, if needed, to reduce the spread of illness. This is beyond the COVID-19 disaster and impacts the general health of the entire population that must live in these public buildings.
15. What are my alternatives to improve ventilation?
The first step is to perform a site survey of the existing Heating Ventilation and Cooling System (HVAC). This will include balance reports that will identify the ACH level for each room in a building. Once the ACH is known, then there are various approaches to deal with the ventilation issues.
This is the order of ventilation improvements from Highest to Lowest effectiveness.
The details of these systems are found in the research. This includes possible vendors and industry associations.
16. So what is wrong with portable air room air cleaners?
They are too small for a typical commercial space like a classroom, and people do not realize this issue, so the ACH rate is too small after they make the purchase and install the systems. Multiple units are needed in a typical public space like a classroom. These units move between 300 and 500 cubic feet per minute (CFM). The following example is offered:
So to reach a room ACH level of 12 the lower limit of the CDC requirement, 4 units are needed in the classroom. All of the sudden noise becomes an issue. Also the WHO requirement of 24 ACH would translate into approximately 8 units. Not only is noise an issue but physical space limitations start to surface. That is why classroom / in room unit ventilators were designed. They address all these issues properly from an engineering perspective.
A portable room sanitizer may be effective in a small public office space where the space accommodates 2-5 people. Visualize a desk and 2 guest chairs with a few pictures on the wall.
17. So what is wrong with Photocatalytic Oxidizer (PCO) / Ionizer systems?
These systems are integrated with a room sanitizer subsystem but then they add the additional subsystem of the Photocatalytic Oxidizer. These units also move 300 and 500 cubic feet per minute (CFM) but then there is the claim that the Photocatalytic Oxidizer adds some level of mitigation. The problem is there is no data to identify how the Photocatalytic Oxidizer translates into Effective AUC or ACH (eAUC or eACH) like found in the UV-C systems. So there is no way to know how to size the system for different room sizes.
There are other issues associated with the Photocatalytic Oxidizer and they include:
So how many PCO / ionizer systems are needed for a typical commercial space like a classroom? Hard to say but if the analysis is based on the CFM subsystem at 300 CFM 4 units are not enough. If one were to consider the effects of the PCO / ionizer subsystem then 4 units may be appropriate, but this recommendation is not based on any traceable public engineering data. Basically the vendor must prove how they plan to achieve the CDC requirements of 12 ACH or the WHO requirement of 24 ACH. If they claim to assume liability without such proof, the assumption of liability is worthless.
18. What does the CDC say about Ceiling Level UV-C systems?
From the CDC: "Use ultraviolet germicidal irradiation (UVGI) as a supplemental treatment to inactivate SARS-CoV-2 when options for increasing room ventilation and filtration are limited. Upper-room UVGI systems can be used to provide air cleaning within occupied spaces, and in-duct UVGI systems can help enhance air cleaning inside central ventilation systems."
Do not confuse Upper-room UVGI systems with in-duct UVGI systems. They are not the same. In-duct UVGI systems do not increase ventilation, they only clean the equipment and help with filter effectiveness.
19. Do in-duct UVGI systems increase the room ACH?
No, they only clean the air inside the central ventilation systems. If the central ventilation system does not move air at a sufficient level of ACH (12 or 24) then the in-duct UV systems do nothing to clean the room air. In-duct UV systems keep the ducts clean from mold and bacteria. If the ducts are long enough they also help the filters as an additional cleaning agent. This is like adding more filters to the system without reducing the air flow. To be perfectly clear, in-duct UVGI systems do nothing to increase room ventilation. They only help the equipment to stay clean.
20. Why did the CDC couple Upper-room UVGI systems with In-duct systems in the same sentence?
This is an example of why government must always be checked with mainstream engineering and science. There is no excuse for the poor CDC communications. These are two different topics that are addressed in the same sentence allowing In-duct UVGI systems to be misunderstood as equivalent to Upper-room UVGI systems. There is just one phrase to make the distinction: "enhance air cleaning inside".
This is an example of political pressure to enhance the position of a stakeholder. In this case the HVAC industry is trying to sell In-duct UVGI systems. When HVAC maintenance staff are questioned in 2021 they reflect this disinformation and school districts have made these purchases erroneously thinking they solved their ventilation problem.
21. I don't want to pay for a classroom / in room ventilator, what can I do?
Investigate natural ventilation and ceiling level UV-C systems.
22. How much more will ventilation cost if I use HVAC fans?
Running the HVAC fan(s) takes significantly less energy than to heat and cool the public space. A rule of thumb is 10% but each system is unique. Only monitoring the costs over a 1 year period will show the true cost differences. For example, a public clubhouse may be significantly less because the fan(s) only run in all locations during events at the clubhouse, which are limited to perhaps 5 hours. At other times the clubhouse is not fully occupied and these locations do not need the fan(s). For example, areas such as a ballroom area when not in use can be shutdown as people do not occupy the space, they just pass through the space.
23. Am I irresponsible if I ignore the ventilation issues in my public space as one in a position of authority?
Yes. There is no difference between you and the politicians engaged in practices that encourage people to not get vaccinated.
Because there is a vaccination, the criminal element is gone, but you are the cause of massive moral hazard and resulting damage if you ignore facility ventilation.
This is why once the vaccine was approved by the FDA, employers are requiring staff to be fully vaccinated before they enter a facility. The employer must guarantee the safety of all employees including the unvaccinated. The same applies to the travel industry with customers that must be vaccinated or show that they are not infected during the travel time window.
24. So the vaccine made everything okay and I don't need to address facility ventilation?
No. You must address facility ventilation because the COVID-19 disaster showed the link between our facilities and illness due to airborne infections. Also, it will be years before the COVID-19 virus load drops in the society where it is no longer a major cause of death in the USA.
25. I live in a home owners association (HOA) with a clubhouse, what should I do?
The HOA should have established a committee of residents with frequent meetings sometime in 2020. If this did not happen you need to understand that the board is behaving irresponsibly. If there is a COVID-19 committee then follow their meetings and findings, become involved, perhaps join the committee. The committee and board must always follow the CDC guidelines to avoid legal liability. The following are reasonable recommendations from a COVID-19 committee that the HOA should have implemented in 2020:
Open the windows and doors when the weather is nice.
Make sure the building ventilation fans are running 2 hours before and after the clubhouse opens and closes. If not, then the board is are violating CDC guidelines. The thermostats should have proper timers to have the fans on. If not buy and install new thermostats. Make sure they are tamper proof.
Contact the HOA HVAC service company and have them prepare a balance report that shows the ACH in each room in the clubhouse. Follow up with pulling the HVAC model numbers so that all the fan sizes can be verified. Also an investment in an anemometer than can be used by the maintenance committee would add further confirmation that the data was not compromised. They can use the device to take actual ventilation readings. In other words triple check the system because health and lives are at stake. Many will try to sell in-duct UV systems and they do not work to solve the ventilation problem. Purchasing these systems and claiming that the ventilation problem is solved is fraud and a source of liability risk.
The clubhouse probably will come in at 6 ACH, but it may be higher. If it is below 12 ACH other ventilation per CDC guidelines should be considered and that includes upper room UVGI systems. The CDC recommends 12 ACH, the Philadelphia restaurant program recommended 15 ACH, the WHO recommends 24 ACH. Obviously the higher the ACH the better.
Purchase electronic pool chemical monitoring sensors that provide information on a public electronic display in the pool area. Make sure the flow rate meter is working and that daily readings of the water flow rate are recorded. Make sure the pressure gauges are connected and that daily readings of the pressure are recorded. If any gauges are broken or missing, fix, replace, and or add them to the pool immediately.
It does not make sense to do the COVID-19 deep cleaning that was started in 2020. Redirect money and resources to make the clubhouse and pool areas safer with proper effective upgrades.
No one from outside the community should be permitted in the clubhouse or pool area until they show proof of vaccination. This is especially true for children who still have not been able to be vaccinated. Residents may be exempt from this, but they better have a reasonable explanation that is documented for future evidence when there is an event. There will be an event, because this is a long term problem.
It is not just about the clubhouse and pool. Investigate moving activities outside with appropriate outside fixtures like picnic tables, gazebos, designated green spaces, etc.
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