COVID-19: Reduction of airborne transmission needs paradigm shift in ventilation

How much natural ventilation rate can suppress COVID-19 transmission in occupancy zones?

Background

Previous research has emphasized the importance of efficient ventilation in suppressing COVID-19 transmission in indoor spaces, yet suitable ventilation rates have not been suggested.

Materials and Methods

This study investigated the impacts of mechanical, natural, single-sided, cross-ventilation, and three mask types (homemade, surgical, N95) on COVID-19 spread across eight common indoor settings. Viral exposure was quantified using a mass balance calculation of inhaled viral particles, accounting for initial viral load, removal via ventilation, and mask filtration efficiency.

Results

Results demonstrated that natural cross-ventilation significantly reduced viral load, decreasing from 10,000 to 0 viruses over 15 minutes in a 100 m2 space by providing ~1325 m3/h of outdoor air via two 0.6 m2 openings at 1.5 m/s wind speed. In contrast, single-sided ventilation only halved viral load at best.

Conclusion

Natural cross-ventilation with masks effectively suppressed airborne viruses, lowering potential infections and disease transmission. The study recommends suitable ventilation rates to reduce COVID-19 infection risks in indoor spaces.

Airborne SARS-CoV2 virus exposure, interpersonal distance, face mask and perceived risk of infection

Participants judged the risk of an infection during a face to face conversation at different interpersonal distances from a SARS-CoV-2 infected person who wore a face mask or not, and in the same questionnaire answered questions about Corona related issues. Keeping a distance to an infected person serves as a protective measure against an infection. When an infected person moves closer, risk of infection increases. Participants were aware of this fact, but underestimated the rate at which the risk of infection increases when getting closer to an infected person, e.g., from 1.5 to 0.5 m (perceived risk increase = 3.33 times higher, objective = 9.00 times higher). This is alarming because it means that people can take risks of infection that they are not aware of or want to take, when they approach another possibly virus infected person. Correspondingly, when an infected person moves away the speed of risk decrease was underestimated, meaning that people are not aware of how much safer they will be if they move away from an infected person. The perceived risk reducing effects of a face mask were approximately correct. Judgments of infection risk at different interpersonal distances (with or without a mask) were unrelated to how often a person used a mask, avoided others or canceled meetings during the COVID-19 pandemic. Greater worry in general and in particular over COVID-19, correlated positively with more protective behavior during the pandemic, but not with judgments of infection risk at different interpersonal distances. Participants with higher scores on a cognitive numeracy test judged mask efficiency more correctly, and women were more worried and risk avoiding than men. The results have implications for understanding behavior in a pandemic, and are relevant for risk communications about the steep increase in risk when approaching a person who may be infected with an airborne virus.

Classroom aerosol dispersion modeling: experimental assessment of a low-cost flow simulation tool

The purpose of this study was to assess the utility of a low-cost flow simulation tool for an indoor air modeling application by comparing its outputs with the results of a physical experiment, as well as those from a more advanced computational fluid dynamics (CFD) software package. Five aerosol dispersion tests were performed in two different classrooms by releasing a CO2 tracer gas from six student locations. Resultant steady-state concentrations were monitored at 13 locations around the periphery of the room. Subsequently, the experiments were modeled using both a low-cost tool (SolidWorks Flow Simulation) and a more sophisticated tool (STAR-CCM+). Models were evaluated based on their ability to predict the experimentally measured concentrations at the 13 monitoring locations by calculating four performance parameters commonly used in the evaluation of dispersion models: fractional mean bias (FB), normalized mean-square error (NMSE), fraction of predicted value within a factor of two (FAC2), and normalized absolute difference (NAD). The more sophisticated model performed better in 15 of the 20 possible cases (five tests at four parameters each), with parameters meeting acceptance criteria in 19 of 20 cases. However, the lower-cost tool was only slightly worse, with parameters meeting acceptance criteria in 18 of 20 cases, and it performed better than the other tool in 3 of 20 cases. Because it provides useful results at a fraction of the monetary and training cost and is already widely accessible to many institutions, such a tool may be worthwhile for many indoor aerosol dispersion applications, especially for students or researchers just beginning CFD modeling.

The effect of natural ventilation on airborne transmission of the COVID-19 virus spread by sneezing in the classroom

Since school classrooms are of vital importance due to their impact on public health in COVID-19 and similar epidemics, it is imperative to develop new ventilation strategies to reduce the risk of transmission of the virus in the classroom. To be able to develop new ventilation strategies, the effect of local flow behaviors in the classroom on the airborne transmission of the virus under the most dramatic conditions must first be determined. In this study, the effect of natural ventilation on the airborne transmission of COVID-19-like viruses in the classroom in the case of sneezing by two infected students in a reference secondary school classroom was investigated in five scenarios. Firstly, experimental measurements were carried out in the reference class to validate the computational fluid dynamics (CFD) simulation results and determine the boundary conditions. Next, the effects of local flow behaviors on the airborne transmission of the virus were evaluated for five scenarios using the Eulerian-Lagrange method, a discrete phase model, and a temporary three-dimensional CFD model. In all scenarios, immediately after sneezing, between 57 and 60.2 % of the droplets containing the virus, mostly large and medium-sized (150 μm < d < 1000 μm) settled on the infected student's desk, while small droplets continued to move in the flow field. In addition, it was determined that the effect of natural ventilation in the classroom on the travel of virus droplets in the case of Redh < 8.04 × 104 (Reynolds number, Redh=Udh/νu, dh and are fluid velocity, hydraulic diameters of the door and window sections of the class and kinematic viscosity, respectively) was negligible.

Energy efficient ventilation and indoor air quality in the context of COVID-19 - A systematic review

New COVID-19 ventilation guidelines have resulted in higher energy consumption to maintain indoor air quality (IAQ), and energy efficiency has become a secondary concern. Despite the significance of the studies conducted on COVID-19 ventilation requirements, a comprehensive investigation of the associated energy challenges has not been discussed. This study aims to present a critical systematic review of the Coronavirus viral spreading risk mitigation through ventilation systems (VS) and its relation to energy use. COVID-19 heating, ventilation and air conditioning (HVAC)-related countermeasures proposed by industry professionals have been reviewed and their influence on operating VS and energy consumption have also been discussed. A critical review analysis was then conducted on publications from 2020 to 2022. Four research questions (RQs) have been selected for this review concerning i) maturity of the existing literature, ii) building types and occupancy profile, iii) ventilation types and effective control strategies and iv) challenges and related causes. The results reveal that employing HVAC auxiliary equipment is mostly effective and increased fresh air supply is the most significant challenge associated with increased energy consumption due to maintaining IAQ. Future studies should focus on novel approaches toward solving the apparently conflicting objectives of minimizing energy consumption and maximizing IAQ. Also, effective ventilation control strategies should be assessed in various buildings with different occupancy densities. The implications of this study can be useful for future development of this topic not only to enhance the energy efficiency of the VS but also to enable more resiliency and health in buildings.

Assessment of aerosol persistence in ICUs via low-cost sensor network and zonal models

The COVID-19 pandemic raised public awareness about airborne particulate matter (PM) due to the spread of infectious diseases via the respiratory route. The persistence of potentially infectious aerosols in public spaces and the spread of nosocomial infections in medical settings deserve careful investigation; however, a systematic approach characterizing the fate of aerosols in clinical environments has not been reported. This paper presents a methodology for mapping aerosol propagation using a low-cost PM sensor network in ICU and adjacent environments and the subsequent development of the data-driven zonal model. Mimicking aerosol generation by a patient, we generated trace NaCl aerosols and monitored their propagation in the environment. In positive (closed door) and neutral-pressure (open door) ICUs, up to 6% or 19%, respectively, of all PM escaped through the door gaps; however, the outside sensors did not register an aerosol spike in negative-pressure ICUs. The K-means clustering analysis of temporospatial aerosol concentration data suggests that ICU can be represented by three distinct zones: (1) near the aerosol source, (2) room periphery, and (3) outside the room. The data suggests two-phase plume behavior: dispersion of the original aerosol spike throughout the room, followed by an evacuation phase where "well-mixed" aerosol concentration decayed uniformly. Decay rates were calculated for positive, neutral, and negative pressure operations, with negative-pressure rooms clearing out nearly twice as fast. These decay trends closely followed the air exchange rates. This research demonstrates the methodology for aerosol monitoring in medical settings. This study is limited by a relatively small data set and is specific to single-occupancy ICU rooms. Future work needs to evaluate medical settings with high risks of infectious disease transmission.

Perceived Corona virus exposure as a function of interpersonal distance and time of a conversation

BACKGROUND

During the COVID-19 pandemic people were asked to keep interpersonal distance, wash their hands and avoid gatherings of people. But, do people understand how much a change of the distance to a virus infected person means for the exposure to that person's virus? To answer this question, we studied how people perceive virus exposure from an infected person at different distances and lengths of a conversation.

METHOD

An online questionnaire was distributed to 101 participants drawn from the general US population. Participants judged perceived virus exposure at different interpersonal distances to an infected person in a face to face conversation of different lengths of time. A model based on empirical and theoretical studies of dispersion of particles in the air was used to estimate a person's objective virus exposure during different times and distances from a virus source. The model and empirical data show that exposure changes with the square of the distance and linearly with time.

RESULTS

A majority (78%) of the participants underestimated the effects on virus exposure following a change of interpersonal distance. The dominating bias was assuming that exposure varies linearly with distance. To illustrate, an approach to a virus source from 6 to 2 feet was judged to give a 3 times higher exposure but, objectively it is 9 times. By way of contrast, perceptions of exposure as a function of the duration of a conversation were unbiased. The COVID-19 pandemic caused by the SARS-CoV2 virus is likely to be followed by other pandemics also caused by airborne Corona or other viruses. Therefore, the results are important for administrators when designing risk communications to the general public and workers in the health care sector about social distancing and infection risks.

CONCLUSIONS

People quite drastically underestimate the increase in virus exposure following an approach to a virus infected person. They also overestimate exposure after a move away from an infected person. For public health reasons, the correct function connecting distance with virus exposure should be communicated to the general public to avoid deliberate violations of recommended interpersonal distances.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s44155-022-00027-9.

Integrated system of exhaust air heat pump and advanced air distribution for energy-efficient provision of outdoor air

A large outdoor air supply is required to control the airborne infection risk of respiratory diseases (e.g., COVID 19) but causes a high energy penalty. This study proposes a novel integrated system of the exhaust air heat pump and advanced air distribution to energy-efficiently provide outdoor air. The system energy performances are evaluated by the experimentally validated thermodynamic model of heat pump and heat removal efficiency model of advanced air distribution. Results show the exhaust air heat pump with advanced air distribution can save energy because of three mechanisms. First, the exhaust air heat pump reuses the exhaust air to reduce the condensation temperature, thereby improving the coefficient of performance. Second, advanced air distribution reduces ventilation load. Third, advanced air distribution reduces the condensation temperature and enhances the evaporation temperature, thereby improving the coefficient of performance. The exhaust air heat pump saves energy by 18%, advanced air distribution saves energy by 36%, and the integrated system of the exhaust air heat pump and advanced air distribution can save energy by 45%. As a specific application, compared with the conventional system (i.e., the outdoor air heat pump with mixing ventilation), the exhaust air heat pump with stratum ventilation saves energy by 21% - 35% under various outdoor air ratios and outdoor air temperatures. The proposed integrated system of the exhaust air heat pump and advanced air distribution contributes to the development of low-carbon and healthy buildings.

A review of strategies and their effectiveness in reducing indoor airborne transmission and improving indoor air quality

Airborne transmission arises through the inhalation of aerosol droplets exhaled by an infected person and is now thought to be the primary transmission route of COVID-19. Thus, maintaining adequate indoor air quality levels is vital in mitigating the spread of the airborne virus. The cause-and-effect flow of various agents involved in airborne transmission of viruses has been investigated through a systematic literature review. It has been identified that the airborne virus can stay infectious in the air for hours, and pollutants such as particulate matter (PM10, PM2.5), Nitrogen dioxide (NO2), Sulphur dioxide (SO2), Carbon monoxide (CO), Ozone (O3), Carbon dioxide (CO2), and Total Volatile Organic Compounds (TVOCs) and other air pollutants can enhance the incidence, spread and mortality rates of viral disease. Also, environmental quality parameters such as humidity and temperature have shown considerable influence in virus transmission in indoor spaces. The measures adopted in different research studies that can curb airborne transmission of viruses for an improved Indoor Air Quality (IAQ) have been collated for their effectiveness and limitations. A diverse set of building strategies, components, and operation techniques from the recent literature pertaining to the ongoing spread of COVID-19 disease has been systematically presented to understand the current state of techniques and building systems that can minimize the viral spread in built spaces This comprehensive review will help architects, builders, realtors, and other organizations improve or design a resilient building system to deal with COVID-19 or any such pandemic in the future.

Energy, economic, and environmental impacts of enhanced ventilation strategies on railway coaches to reduce Covid-19 contagion risks

In the last years, the Covid-19 outbreak raised great awareness about ventilation system performance in confined spaces. Specifically, the heating, ventilation, and air conditioning system design and operating parameters, such as air change per hour, air recirculation ratio, filtration device performance, and vents location, play a crucial role in reducing the spread of viruses, moulds, bacteria, and general pollutants. Concerning the transport sector, due to the impracticability of social distancing, and the relatively loose requirements of ventilation standards, the SARS-COV-19 outbreak brought a reduction of payload (up to 50%) for different carriers. Specifically, this has been particularly severe for the railway sector, where train coaches are typically characterized by relatively elevated occupancy and high recirculation ratios. In this framework, to improve the Indoor Air Quality and reduce the Covid-19 contagion risk in railway carriages, the present paper investigates the energy, economic and environmental feasibility of diverse ventilation strategies. To do so, a novel dynamic simulation tool for the complete dynamic performance investigation of trains was developed in an OpenStudio environment. To assess the Covid-19 contagion risk connected to the investigated scenarios, the Wells-Riley model has been adopted. To prove the proposed approach's capabilities and show the Covid-19 infection risk reduction potentially achievable by varying the adopted ventilation strategies, a suitable case study related to an existing medium-distance train operating in South/Central Italy is presented. The conducted numerical simulations return interesting results providing also useful design criteria.

Overview of the Role of Spatial Factors in Indoor SARS-CoV-2 Transmission: A Space-Based Framework for Assessing the Multi-Route Infection Risk

The COVID-19 pandemic has lasted from 2019 to 2022, severely disrupting human health and daily life. The combined effects of spatial, environmental, and behavioral factors on indoor COVID-19 spread and their interactions are usually ignored. Especially, there is a lack of discussion on the role of spatial factors in reducing the risk of virus transmission in complex and diverse indoor environments. This paper endeavours to summarize the spatial factors and their effects involved in indoor virus transmission. The process of release, transport, and intake of SARS-CoV-2 was reviewed, and six transmission routes according to spatial distance and exposure way were classified. The triangular relationship between spatial, environmental and occupant behavioral parameters during virus transmission was discussed. The detailed effects of spatial parameters on droplet-based, surface-based and air-based transmission processes and virus viability were summarized. We found that spatial layout, public-facility design and openings have a significant indirect impact on the indoor virus distribution and transmission by affecting occupant behavior, indoor airflow field and virus stability. We proposed a space-based indoor multi-route infection risk assessment framework, in which the 3D building model containing detailed spatial information, occupant behavior model, virus-spread model and infection-risk calculation model are linked together. It is also applicable to other, similar, respiratory infectious diseases such as SARS, influenza, etc. This study contributes to developing building-level, infection-risk assessment models, which could help building practitioners make better decisions to improve the building's epidemic-resistance performance.

A post-occupancy study of ventilation effectiveness from high-resolution CO2 monitoring at live theatre events to mitigate airborne transmission of SARS-CoV-2

Mass-gathering events were closed around the world in 2020 to minimise the spread of the SARS-CoV-2 virus. Emerging research on the transmission of SARS-CoV-2 emphasised the importance of sufficient ventilation. This paper presents the results of an indoor air quality (IAQ) monitoring study over 82 events in seven mechanically ventilated auditoria to support the UK government Events Research Programme. Indoor carbon dioxide concentration was measured at high resolution before, during, and after occupancy to allow for assessment of the ventilation systems. Generally, good indoor air quality was measured in all auditoria, with average IAQ found to be excellent or very good for 70% of spaces. In some auditoria, spatial variation in IAQ was identified, indicating poor mixing of the air. In addition, surface and air samples were taken and analysed for the presence of bacteria by culture and SARS-CoV-2 using RT-qPCR in one venue. SARS-CoV-2 RNA was detected on a small number of surfaces at very low copy numbers, which are unlikely to pose an infection risk. Under the ventilation strategies and occupancy levels investigated, it is likely that most theatres pose a low risk of long-range transmission of COVID-19.

Ventilating aged-care center based on solar chimney: Design and theoretical analysis

Natural ventilation is considered the first suggestion for COVID-19 prevention in buildings by the World Health Organization (WHO). Solar chimney's viability in aged care centers or similar facilities was analyzed numerically and theoretically. A new solar chimney design was proposed to reduce the cross-infection risk of COVID-19 based on an airflow path through window, ceiling vent, attic, and then chimney cavity. Solar chimney performance, quantified by the natural ventilation rate, presented power function with window area, ceiling vent area, cavity height, and solar radiation. The ceiling vent is suggested to be closer to the corridor to enhance the performance and ventilation coverage of the room. A cavity gap of 1.0 m is recommended to balance the ventilation performance and construction cost. A theoretical model was also developed for aged care centers with multiple rooms and a joint attic. Its predictions obey reasonably well with the numerical results. Solar chimney's viability in aged care center is confirmed as a 7.22 air change per hour (ACH) ventilation can be achieved even under a low solar radiation intensity of 200 W/m², where its performance fulfills the minimal ventilation requirement (i.e., 6 ACH) suggested by the WHO for airborne infection isolation rooms. This study offers a new design and a guideline for the future implementation of solar chimney in aged care centers or similar facilities.

Ventilation strategies and design impacts on indoor airborne transmission: A review

The COVID-19 outbreak has brought the indoor airborne transmission issue to the forefront. Although ventilation systems provide clean air and dilute indoor contaminated air, there is strong evidence that airborne transmission is the main route for contamination spread. This review paper aims to critically investigate ventilation impacts on particle spread and identify efficient ventilation strategies in controlling aerosol distribution in clinical and non-clinical environments. This article also examines influential ventilation design features (i.e., exhaust location) affecting ventilation performance in preventing aerosols spread. This paper shortlisted published documents for a review based on identification (keywords), pre-processing, screening, and eligibility of these articles. The literature review emphasizes the importance of ventilation systems' design and demonstrates all strategies (i.e., mechanical ventilation) could efficiently remove particles if appropriately designed. The study highlights the need for occupant-based ventilation systems, such as personalized ventilation instead of central systems, to reduce cross-infections. The literature underlines critical impacts of design features like ventilation rates and the number and location of exhausts and suggests designing systems considering airborne transmission. This review underpins that a higher ventilation rate should not be regarded as a sole indicator for designing ventilation systems because it cannot guarantee reducing risks. Using filtration and decontamination devices based on building functionalities and particle sizes can also increase ventilation performance. This paper suggests future research on optimizing ventilation systems, particularly in high infection risk spaces such as multi-storey hotel quarantine facilities. This review contributes to adjusting ventilation facilities to control indoor aerosol transmission.

Model and Validation Study for Optimizing Students’ Positions in Classrooms to Limit the Spread of Infectious Diseases Such as COVID

Classrooms at any educational institution have become high-risk sites for contagion during past and present pandemic periods caused by the SARS-CoV-2 (COVID-19) viral siege, given the prolonged time educators and students spend in joint activity. Among the several strategies employed by educational institutions to minimize the outbreak of contagion are regulating classroom capacity and studying the optimal spatial arrangement of students. The architectural features of each classroom, which include corridors, ventilation components, total volume, and maximum capacity, among other factors, have a direct impact on the risk of human contagion. This work is a proposal to optimize the spatial arrangement of students to minimize the risk of contagion, considering not only the distance between them, but also the different architectural features in the classrooms. The analyses conducted in the different scenarios conclude with a comparison of risk in terms of the arrangement of students that various educators would have used at different education levels in their classrooms based solely on intuitive criteria. The results indicate that in some situations, the locations chosen by educators can double the risk of infection compared to optimal arrangements.

A numerical evaluation of a novel recovery fresh air heat pump concept for a generic electric bus

Since the outbreak of the worldwide COVID-19 pandemic, public transportation networks have faced unprecedented challenges and have looked for practical solutions to address the rising safety concerns. It is deemed that in confined spaces, operating heating units (and cooling) in non-re-circulation mode (i. e., all-fresh air mode) could reduce the airborne transmission of this infectious disease, by reducing the density of the pathogen and exposure time. However, this will expectedly increase the energy demand and reduce the driving range of electric buses. To tackle both the airborne transmission and energy efficiency issues, in this paper a novel recovery heat pump concept, operating in all-fresh air mode, was proposed. The novelty of this concept lies in its potential to be applied to already manufactured/in-service heat pump units as it does not require any additional components or need for redesigning the heating systems. In this concept, the cabin exhaust air is directed to pass through the evaporator of the heat pump system to recover part of the waste heat from the cabin and to improve the efficiency of the system. In this paper, a 0D/1D coupled model of a generic single-deck cabin and a heat pump system was developed in the Simulink environment of MATLAB (R2020b) software. The model was run in two different modes, namely the all-fresh air (as a baseline and a recovery heat pump concepts), and the air re-circulation mode (as a conventional heat pump concept with a 50% re-circulation ratio). The performance of these concepts was investigated to evaluate how an all-fresh air policy could affect the performance of the system, as well as the energy-saving potential of the proposed recovery concept. The performance of the system was studied under different ambient temperatures of -5 °C, 0 °C, and 5 °C, and for low and moderate occupancy levels. Results show that implementing the all-fresh air policy in the recovery and baseline concepts significantly improved the ventilation rate per person by at least 102% and at most 125%, compared to the air-re-circulating heat pump. Moreover, adopting the recovery concept reduced the power demand by at least 8% and at most 11%, compared to the baseline all-fresh air heat pump, for the selected fan and blower flow rates. The presented results in this paper along with the applicability of this concept to in-service mobile heat pumps could make it a feasible, practical, and quick trade-off solution to help the bus operators to protect people and improve the energy efficiency of their service.

Airborne transmission of COVID-19 virus in enclosed spaces: An overview of research methods

Since the outbreak of COVID-19 in December 2019, the severe acute respiratory syndrome coronavirus 2 (SARS CoV-2) has spread worldwide. This study summarized the transmission mechanisms of COVID-19 and their main influencing factors, such as airflow patterns, air temperature, relative humidity, and social distancing. The transmission characteristics in existing cases are providing more and more evidence that SARS CoV-2 can be transmitted through the air. This investigation reviewed probabilistic and deterministic research methods, such as the Wells-Riley equation, the dose-response model, the Monte-Carlo model, computational fluid dynamics (CFD) with the Eulerian method, CFD with the Lagrangian method, and the experimental approach, that have been used for studying the airborne transmission mechanism. The Wells-Riley equation and dose-response model are typically used for the assessment of the average infection risk. Only in combination with the Eulerian method or the Lagrangian method can these two methods obtain the spatial distribution of airborne particles' concentration and infection risk. In contrast with the Eulerian and Lagrangian methods, the Monte-Carlo model is suitable for studying the infection risk when the behavior of individuals is highly random. Although researchers tend to use numerical methods to study the airborne transmission mechanism of COVID-19, an experimental approach could often provide stronger evidence to prove the possibility of airborne transmission than a simple numerical model. All in all, the reviewed methods are helpful in the study of the airborne transmission mechanism of COVID-19 and epidemic prevention and control.

Systematic summary and analysis of Chinese HVAC guidelines coping with COVID-19

Heating, Ventilation, and Air-Conditioning (HVAC) system that is almost indispensable service system of modern buildings is recognized as the most important engineering control measure against pandemics. However, the effectiveness of HVAC systems has been questioned on their ability to control airborne transmission. After the outbreak of COVID-19, China has controlled the spread within a relatively short period. Considering the large population, high population density, busy transportation and the overall underdeveloped economy, China's control measures may have some implications to other countries, especially those with limited resources. This paper intends to provide a systematic summary of Chinese ventilation guidelines issued to cope with COVID-19 transmission. The following three aspects are the main focus of these guidelines: (1) general operation and management schemes of various types of HVAC systems, (2) operation and management schemes of HVAC system in typical types of buildings, and (3) design schemes of HVAC system of makeshift hospitals. In addition, some important differences in HVAC guidelines between China and other countries/institutions are identified and compared, and the possible reasons are discussed. Further discussions are made on the following topics, including the required fresh air supply, the extended operation time, the use of auxiliary equipment, the limited capacity of existing systems, and the use of personalized systems.

Effects of location, classroom orientation, and air change rate on potential aerosol exposure: an experimental and computational study

This study examined the dispersion of potentially infectious aerosols in classrooms by means of both a CO₂ tracer gas, and multizone contaminant transport modeling. A total of 20 tests were conducted in three different university classrooms at multiple air change rates (4.4-9.7/h), each with two different room orientations: one with the tracer gas released from six student desks toward the air return, and one with the same tracer gas released away from it. Resulting tracer concentrations were measured by 19 different monitors arrayed throughout the room. Steady-state, mean tracer gas concentrations were calculated in six instructor zones (A-F) around the periphery of the room, with the results normalized by the concentration at the return, which was assumed to be representative of the well-mixed volume of the room. Across all classrooms, zones farthest from the return (C, D) had the lowest mean normalized concentrations (0.75), while those closest to the return (A, F) had the highest (0.95). This effect was consistent across room orientations (release both toward and away from the return), and air change rates. In addition, all zones around the periphery of the room had a significantly lower concentration than those adjacent to the sources. Increasing the ventilation rate reduced tracer gas concentrations significantly. Similar trends were observed via a novel approach to CONTAM modeling of the same rooms. These results indicate that informed selection of teaching location within the classroom could reduce instructor exposure.

A spatiotemporally resolved infection risk model for airborne transmission of COVID-19 variants in indoor spaces

The classic Wells-Riley model is widely used for estimation of the transmission risk of airborne pathogens in indoor spaces. However, the predictive capability of this zero-dimensional model is limited as it does not resolve the highly heterogeneous spatiotemporal distribution of airborne pathogens, and the infection risk is poorly quantified for many pathogens. In this study we address these shortcomings by developing a novel spatiotemporally resolved Wells-Riley model for prediction of the transmission risk of different COVID-19 variants in indoor environments. This modelling framework properly accounts for airborne infection risk by incorporating the latest clinical data regarding viral shedding by COVID-19 patients and SARS-CoV-2 infecting human cells. The spatiotemporal distribution of airborne pathogens is determined via computational fluid dynamics (CFD) simulations of airflow and aerosol transport, leading to an integrated model of infection risk associated with the exposure to SARS-CoV-2, which can produce quantitative 3D infection risk map for a specific SARS-CoV-2 variant in a given indoor space. Application of this model to airborne COVID-19 transmission within a hospital ward demonstrates the impact of different virus variants and respiratory PPE upon transmission risk. With the emergence of highly contagious SARS-CoV-2 variants such as the Delta and Omicron strains, respiratory PPE alone may not provide effective protection. These findings suggest a combination of optimal ventilation and respiratory PPE must be developed to effectively control the transmission of COVID-19 in healthcare settings and indoor spaces in general. This generalised risk estimation framework has the flexibility to incorporate further clinical data as such becomes available, and can be readily applied to consider a wide range of factors that impact transmission risk, including location and movement of infectious persons, virus variant and stage of infection, level of PPE and vaccination of infectious and susceptible individuals, impacts of coughing, sneezing, talking and breathing, and natural and mechanised ventilation and filtration.

Experimental evaluation of respiratory droplet spread to rooms connected by a central ventilation system

This article presents results from an experimental study to ascertain the transmissibility of the SARS-CoV-2 virus between rooms in a building that are connected by a central ventilation system. Respiratory droplet surrogates made of mucus and virus mimics were released in one room in a test building, and measurements of concentration levels were made in other rooms connected via the ventilation system. The paper presents experimental results for different ventilation system configurations, including ventilation rate, filtration level (up to MERV-13), and fractional outdoor air intake. The most important finding is that respiratory droplets can and do transit through central ventilation systems, suggesting a mechanism for viral transmission (and COVID-19 specifically) within the built environment in reasonable agreement with well-mixed models. We also find the deposition of small droplets (0.5-4 μm) on room walls to be negligibly small.

Prediction and control of aerosol transmission of SARS-CoV-2 in ventilated context: from source to receptor

Global spread of COVID-19 has seriously threatened human life and health. The aerosol transmission route of SARS-CoV-2 is observed often associated with infection clusters under poorly ventilated environment. In the context of COVID-19 pandemic, significant transformation and optimization of traditional ventilation systems are needed. This paper is aimed to offer better understanding and insights into effective ventilation design to maximize its ability in airborne risk control, for particularly the COVID-19. Comprehensive reviews of each phase of aerosol transmission of SARS-CoV-2 from source to receptor are conducted, so as to provide a theoretical basis for risk prediction and control. Infection risk models and their key parameters for risk assessment of SARS-CoV-2 are analyzed. Special focus is given on the efficacy of different ventilation strategies in mitigating airborne transmission. Ventilation interventions are found mainly impacting on the dispersion and inhalation phases of aerosol transmission. The airflow patterns become a key factor in controlling the aerosol diffusion and distribution. Novel and personalized ventilation design, effective integration with other environmental control techniques and resilient HVAC system design to adapt both common and epidemic conditions are still remaining challenging, which need to be solved with the aid of multidisciplinary research and intelligent technologies.

ArchABM: An agent-based simulator of human interaction with the built environment. CO2 and viral load analysis for indoor air quality

Recent evidence suggests that SARS-CoV-2, which is the virus causing a global pandemic in 2020, is predominantly transmitted via airborne aerosols in indoor environments. This calls for novel strategies when assessing and controlling a building's indoor air quality (IAQ). IAQ can generally be controlled by ventilation and/or policies to regulate human-building-interaction. However, in a building, occupants use rooms in different ways, and it may not be obvious which measure or combination of measures leads to a cost- and energy-effective solution ensuring good IAQ across the entire building. Therefore, in this article, we introduce a novel agent-based simulator, ArchABM, designed to assist in creating new or adapt existing buildings by estimating adequate room sizes, ventilation parameters and testing the effect of policies while taking into account IAQ as a result of complex human-building interaction patterns. A recently published aerosol model was adapted to calculate time-dependent carbon dioxide (CO2) and virus quanta concentrations in each room and inhaled CO2 and virus quanta for each occupant over a day as a measure of physiological response. ArchABM is flexible regarding the aerosol model and the building layout due to its modular architecture, which allows implementing further models, any number and size of rooms, agents, and actions reflecting human-building interaction patterns. We present a use case based on a real floor plan and working schedules adopted in our research center. This study demonstrates how advanced simulation tools can contribute to improving IAQ across a building, thereby ensuring a healthy indoor environment.

Design and in-vitro testing of a portable patient isolation chamber for bedside aerosol containment and filtration

The emergence of the SARS-CoV-2 pandemic has imposed a multitude of complications on healthcare facilities. Healthcare professionals had to develop creative solutions to deal with resource shortages and isolation spaces when caring for COVID positive patients. Among many other solutions, facilities have utilized engineering strategies to mitigate the spread of viral contamination within the hospital environment. One of the standard solutions has been the use of whole room negative pressurization (WRNP) to turn a general patient room into an infection isolation space. However, this has not always been easy due to many limitations, such as direct access to the outdoors and the availability of WRNP units. In operating rooms where a patient is likely to go through aerosol-generating procedures, other solutions must be considered because most operating rooms use positive pressure ventilation to maintain sterility. The research team has designed, built, and tested a Covering for Operations during Viral Emergency Response (COVER), a low-cost, portable isolation chamber that fits over a patient's torso on a hospital bed to contain and remove the pathogenic agents at the source (i.e., patient's mouth and nose). This study tests the performance of the COVER system under various design and performance scenarios using particle tracing techniques and compares its efficiency with WRNP units. The results show that COVER can dramatically reduce the concentration of particles within the room, while WRNP is only effective in preventing the room-induced particles from migrating to adjacent spaces.

COVID-19 Impact on Operation and Energy Consumption of Heating, Ventilation and Air-Conditioning (HVAC) Systems

Heating, ventilation and air-conditioning (HVAC) system is favourable for regulating indoor temperature, relative humidity, airflow pattern and air quality. However, HVAC systems may turn out to be the culprit of microbial contamination in enclosed spaces and deteriorate the environment due to inappropriate design and operation. In the context of COVID-19, significant transformations and new requirements are occurring in HVAC systems. Recently, several updated operational guidelines for HVAC systems have been issued by various institutions to control the airborne transmission and mitigate infection risks in enclosed environments. Challenges and innovations emerge in response to operational variations of HVAC systems. To efficiently prevent the spread of the pandemic and reduce infection risks, it is essential to have an overall understanding of impacts caused by COVID-19 on HVAC systems. Therefore, the objectives of this article are to: (a) provide a comprehensive review of the airborne transmission characteristics of SARS-CoV-2 in enclosed spaces and a theoretical basis for HVAC operation guideline revision; (b) investigate HVAC-related guidelines to clarify the operational variations of HVAC systems during the pandemic; (c) analyse how operational variations of HVAC systems affect energy consumption; and (d) identify the innovations and research trends concerning future HVAC systems. Furthermore, this paper compares the energy consumption of HVAC system operation during the normal times versus pandemic period, based on a case study in China, providing a reference for other countries around the world. Results of this paper offer comprehensive insights into how to keep indoor environments safe while maintaining energy-efficient operation of HVAC systems.

An Overview of the Ship Ventilation Systems and Measures to Avoid the Spread of Diseases

This article presents a review of the main aspects regarding the current rules of classification societies, standards, and practice regarding the design and construction of ventilation and air conditioning systems for different compartments in different types of ships. In the context of the COVID-19 pandemic, this paper also presents the usual practice of the actual heating ventilation and air conditioning (HVAC) systems used on large ships, which recirculate the air between living compartments, in comparison with the new requirements to avoid the risk of spreading diseases. According to the rules, the technical compartments are provided with independent ventilation systems that ensure high air flow rates; therefore, the spread of diseases through this system is not an issue. The living spaces are provided with common ventilation and air conditioning systems that recirculate the air in all compartments served. The current practice of air recirculation in various living rooms leads to the spread of diseases, which should therefore be analyzed and improved by adding high-efficiency particulate air (HEPA) filters and UV disinfection or be replaced with individual systems that provide local heating or cooling without air recirculation between different rooms and fresh air supply with complete evacuation. For existing ships, different solutions should be analyzed such as reducing or cancelling recirculation and increasing filtration.

COVID-19, the Built Environment, and Health

BACKGROUND

Since the dawn of cities, the built environment has both affected infectious disease transmission and evolved in response to infectious diseases. COVID-19 illustrates both dynamics. The pandemic presented an opportunity to implement health promotion and disease prevention strategies in numerous elements of the built environment.

OBJECTIVES

This commentary aims to identify features of the built environment that affect the risk of COVID-19 as well as to identify elements of the pandemic response with implications for the built environment (and, therefore, for long-term public health).

DISCUSSION

Built environment risk factors for COVID-19 transmission include crowding, poverty, and racism (as they manifest in housing and neighborhood features), poor indoor air circulation, and ambient air pollution. Potential long-term implications of COVID-19 for the built environment include changes in building design, increased teleworking, reconfigured streets, changing modes of travel, provision of parks and greenspace, and population shifts out of urban centers. Although it is too early to predict with confidence which of these responses may persist, identifying and monitoring them can help health professionals, architects, urban planners, and decision makers, as well as members of the public, optimize healthy built environments during and after recovery from the pandemic. https://doi.org/10.1289/EHP8888.

Ventilation mode performance against airborne respiratory infections in small office spaces: limits and rational improvements for Covid-19

The Coronavirus disease (Covid-19), caused by the SARS-CoV-2 virus, has produced significant social and economic disruptions in different countries. Current evidence suggests a strong correlation between the infection and the cohabitation of indoor spaces. International organizations and experts consider that the airborne transmission through aerosols can occur in specific conditions and that inadequate ventilation increases the risk of infection. As a result, the increase in ventilation rates and air filtration efficiencies are recommended for public buildings in the context of Covid-19, with significant impacts on energy consumption, and a paradigm shift in the design of ventilation systems is necessary for this new context. Therefore, this study has assessed the comparative performance of the displacement ventilation and the mixed ventilation mode on reducing the risk of long-range airborne infection for the Covid-19 in a small office application. A coupled multizone-CFD (Computational Fluid Dynamics) software developed by the National Institute of Standards and Technology was used in this study to assess the relative performance of several design solutions related to different ventilation modes, filter efficiencies, and outdoor air flow rates. The results demonstrate that the displacement ventilation technique produces a better overall performance in reducing the SARS-CoV-2 airborne infection risk than the conventional mixed ventilation for all the studied cases.