The role of computational fluid dynamics tools on investigation of pathogen transmission: Prevention and control

Applications of Quantitative Microbial Risk Assessment to Respiratory Pathogens and Implications for Uptake in Policy: A State-of-the-Science Review

BACKGROUND

Respiratory tract infections are major contributors to the global disease burden. Quantitative microbial risk assessment (QMRA) holds potential as a rapidly deployable framework to understand respiratory pathogen transmission and inform policy on infection control.

OBJECTIVES

The goal of this paper was to evaluate, motivate, and inform further development of the use of QMRA as a rapid tool to understand the transmission of respiratory pathogens and improve the evidence base for infection control policies.

METHODS

We conducted a literature review to identify peer-reviewed studies of complete QMRA frameworks on aerosol inhalation or contact transmission of respiratory pathogens. From each of the identified studies, we extracted and summarized information on the applied exposure model approaches, dose-response models, and parameter values, including risk characterization. Finally, we reviewed linkages between model outcomes and policy.

RESULTS

We identified 93 studies conducted in 16 different countries with complete QMRA frameworks for diverse respiratory pathogens, including SARS-CoV-2, Legionella spp., Staphylococcus aureus, influenza, and Bacillus anthracis. Six distinct exposure models were identified across diverse and complex transmission pathways. In 57 studies, exposure model frameworks were informed by their ability to model the efficacy of potential interventions. Among interventions, masking, ventilation, social distancing, and other environmental source controls were commonly assessed. Pathogen concentration, aerosol concentration, and partitioning coefficient were influential exposure parameters as identified by sensitivity analysis. Most (84%, n = 78 ) studies presented policy-relevant content including a) determining disease burden to call for policy intervention, b) determining risk-based threshold values for regulations, c) informing intervention and control strategies, and d) making recommendations and suggestions for QMRA application in policy.

CONCLUSIONS

We identified needs to further the development of QMRA frameworks for respiratory pathogens that prioritize appropriate aerosol exposure modeling approaches, consider trade-offs between model validity and complexity, and incorporate research that strengthens confidence in QMRA results. https://doi.org/10.1289/EHP12695.

Semi-surrogate modelling of droplets evaporation process via XGBoost integrated CFD simulations

The applications of machine learning (ML) based approach are emerging as possible tools to accelerate CFD simulations. This study proposed a semi-surrogate model for CFD with integration of the cutting-edge ML algorithm, eXtreme Gradient Boosting (XGB), which enlightened a possible pathway to effectively and efficiently solve and predict those costly but highly repetitive fluid dynamics-related problems. Droplet evaporation, a complex but essential phenomenon in respiratory droplets transport, was studied as the practical case using the proposed model. Droplets evaporation and dynamic size distributions were firstly tracked under various combinations of indoor humidity and temperature using traditional Eulerian-Lagrangian CFD framework, followed by generating several datasets for XGB training. The trained XGB was then used to interpret the evaporated droplets size over time under new combinations of indoor conditions. Outcomes revealed that well-trained XGB-base semi-surrogate model was capable of interpreting complex non-linear relationships between droplets dynamic parameters (diameter and time) and indoor parameters (humidity and temperature). For each specific parameter, the predictive error of well-trained XGB could retain below 5 % and its prediction speed was found nearly 1 million times faster than that of new CFD simulations. Successful applications of XGB in conjunction with CFD demonstrated its great potential on providing rapid and more efficient predictions of complex, costly and repetitive fluid dynamics-related phenomenons (e.g. droplets evaporation). Also, the XGB predicted droplets evaporation data from this study could be further applied as initial conditions into new simulations via the User-defined function (UDF).

Virus-laden droplet nuclei in vortical structures associated with recirculation zones in indoor environments: A possible airborne transmission of SARS-CoV-2

Droplet nuclei dispersion patterns in indoor environments are reviewed from a physics view to explore the possibility of airborne transmission of SARS-CoV-2. This review analyzes works on particle dispersion patterns and their concentration in vortical structures in different indoor environments. Numerical simulations and experiments reveal the formation of the buildings' recirculation zones and vortex flow regions by flow separation, airflow interaction around objects, internal dispersion of airflow, or thermal plume. These vortical structures showed high particle concentration because particles are trapped for long periods. Then a hypothesis is proposed to explain why some medical studies detect the presence of SARS-CoV-2 and others do not detect the virus. The hypothesis proposes that airborne transmission is possible if virus-laden droplet nuclei are trapped in vortical structures associated with recirculation zones. This hypothesis is reinforced by a numerical study in a restaurant that presented possible evidence of airborne transmission by a large recirculating air zone. Furthermore, a medical study in a hospital is discussed from a physical view for identifying the formation of recirculation zones and their relation with positive tests for viruses. The observations show air sampling site located in this vortical structure is positive for the SARS-CoV-2 RNA. Therefore, the formation of vortical structures associated with recirculation zones should be avoided to minimize the possibility of airborne transmission. This work tries to understand the complex phenomenon of airborne transmission as a way in the prevention of transmission of infectious diseases.

Computational design and experimental analysis of a novel visor for COVID-19 patients receiving high-flow nasal oxygen therapy

The Covid-19 global pandemic has reshaped the requirements of healthcare sectors worldwide. Following the exposure risks associated with Covid-19, this paper aims to design, optimise, and validate a wearable medical device that reduces the risk of transmission of contagious droplets from infected patients in a hospital setting. This study specifically focuses on those receiving high-flow nasal oxygen therapy. The design process consisted of optimising the geometry of the visor to ensure that the maximum possible percentage of harmful droplets exhaled by the patient can be successfully captured by a vacuum tube attached to the visor. This has been completed by deriving a number of concept designs and assessing their effectiveness, based on numerical analysis, computational fluid dynamics (CFD) simulations and experimental testing. The CFD results are validated using various experimental methods such as Schlieren imaging, particle measurement testing and laser sheet visualisation. Droplet capturing efficiency of the visor was measured through CFD and validated through experimental particle measurement testing. The results presented a 5% deviation between CFD and experimental results. Also, the modifications based on the validated CFD results improved the visor effectiveness by 47% and 38% for breathing and coughing events, respectively.

A frontal air intake may improve the natural ventilation in urban buses

In this report we analyze the air flow across the open windows (natural ventilation) of an urban bus model and the consequent dispersion of aerosols emitted in the passengers area. The methods include computational fluid dynamics simulations and three ways to characterize the dispersion of passive tracers: a continuous concentration-based model, a discrete random model and a parametric scalar based on the so-called mean age of air. We also conducted experiments using a 1:10 scale bus model and [Formula: see text] as a passive tracer to assess the ventilation characteristics. We found that dispersion and expulsion of aerosols is driven by a negative pressure in the standard bus design equipped with lateral windows. Also, the average age of air is 6 minutes while the air flow promotes aerosol accumulation to the front (driver's area). To speed up the expulsion of aerosols and reduce their in-cabin accumulation, we propose a bus bodywork prototype having a frontal air intake. All the numerical models and experiments conducted in this work agreed that the expulsion of aerosols in this novel configuration is significantly increased while the average age of air is reduced to 50 seconds. The average air flow also changes with the presence of frontal air intakes and, as a consequence, the expulsion of aerosols is now driven by a frontal velocity field.

Analysis of occupants’ exposure risk of cough-expelled droplets in the workspace with various mixing ventilation layouts

This study numerically investigated the transport characteristics of the cough-expelled droplets and their corresponding exposure risk of each occupant under various mixing ventilation layouts. Transient simulations were conducted in a conference room, while pathogen-bearing droplets were released by a standing speaker. The results showed that droplet residues (< 40 μm) had a high potential to reach occupant’s breathing zone, among which the number fraction of aerosol residues (< 10 μm) could be nearly doubled compared with that of the rest droplet residues in the breathing zone. Occupants’ exposure risks were found very sensitive to the ventilation layouts. The strong ventilated flow could significantly promote droplet dispersions when those inlets were closely located to the infectious speaker, resulting in all occupants exposed to a considerable fraction of aerosols and droplets within a given exposure time of 300 s. The mixing ventilation layout did not have a consistent performance on restricting the pathogen spread and controlling the occupant’s exposure risk in an enclosed workspace. Its performance could be highly sensitive to the location of the infectious agent. Centralized vent layouts could provide relatively more consistent performance on removing droplets, whilst some local airflow recirculation with locked droplets were noticed.

Airborne transmission of biological agents within the indoor built environment: a multidisciplinary review

The nature and airborne dispersion of the underestimated biological agents, monitoring, analysis and transmission among the human occupants into building environment is a major challenge of today. Those agents play a crucial role in ensuring comfortable, healthy and risk-free conditions into indoor working and leaving spaces. It is known that ventilation systems influence strongly the transmission of indoor air pollutants, with scarce information although to have been reported for biological agents until 2019. The biological agents' source release and the trajectory of airborne transmission are both important in terms of optimising the design of the heating, ventilation and air conditioning systems of the future. In addition, modelling via computational fluid dynamics (CFD) will become a more valuable tool in foreseeing risks and tackle hazards when pollutants and biological agents released into closed spaces. Promising results on the prediction of their dispersion routes and concentration levels, as well as the selection of the appropriate ventilation strategy, provide crucial information on risk minimisation of the airborne transmission among humans. Under this context, the present multidisciplinary review considers four interrelated aspects of the dispersion of biological agents in closed spaces, (a) the nature and airborne transmission route of the examined agents, (b) the biological origin and health effects of the major microbial pathogens on the human respiratory system, (c) the role of heating, ventilation and air-conditioning systems in the airborne transmission and (d) the associated computer modelling approaches. This adopted methodology allows the discussion of the existing findings, on-going research, identification of the main research gaps and future directions from a multidisciplinary point of view which will be helpful for substantial innovations in the field.

A numerical approach for preventing the dispersion of infectious disease in a meeting room

Airborne transmission of respiratory aerosols carrying infectious viruses has generated many concerns about cross-contamination risks, particularly in indoor environments. ANSYS Fluent software has been used to investigate the dispersion of the viral particles generated during a coughing event and their transport dynamics inside a safe social-distance meeting room. Computational fluid dynamics based on coupled Eulerian-Lagrangian techniques are used to explore the characteristics of the airflow field in the domain. The main objective of this study is to investigate the effects of the window opening frequency, exhaust layouts, and the location of the air conditioner systems on the dispersion of the particles. The results show that reducing the output capacity by raising the concentration of suspended particles and increasing their traveled distance caused a growth in the individuals' exposure to contaminants. Moreover, decreasing the distance between the ventilation systems installed location and the ceiling can drop the fraction of the suspended particles by over 35%, and the number of individuals who are subjected to becoming infected by viral particles drops from 6 to 2. As well, the results demonstrated when the direction of input airflow and generated particles were the same, the fraction of suspended particles of 4.125%, whereas if the inputs were shifted to the opposite direction of particle injection, the fraction of particles in fluid increased by 5.000%.

Impact of ventilation and avoidance measures on SARS-CoV-2 risk of infection in public indoor environments

BACKGROUND

The literature includes many studies which individually assess the efficacy of protective measures against the spread of the SARS-CoV-2 virus. This study considers the high infection risk in public buildings and models the quality of the indoor environment, related safety measures, and their efficacy in preventing the spread of the SARS-CoV-2 virus.

METHODS

Simulations are created that consider protective factors such as hand hygiene, face covering and engagement with Covid-19 vaccination programs in reducing the risk of infection in a university foyer. Furthermore, a computational fluid dynamics model is developed to simulate and analyse the university foyer under three ventilation regimes. The probability of transmission was measured across different scenarios.

FINDINGS

Estimates suggest that the Delta variant requires the air change rate to be increased >1000 times compared to the original strain, which is practically not feasible. Consequently, appropriate hygiene practices, such as wearing masks, are essential to reducing secondary infections. A comparison of different protective factors in simulations found the overall burden of infections resulting from indoor contact depends on (i) face mask adherence, (ii) quality of the ventilation system, and (iii) other hygiene practices.

INTERPRETATION

Relying on ventilation, whether natural, mechanical, or mixed, is not sufficient alone to mitigate the risk of aerosol infections. This is due to the internal configuration of the indoor space in terms of (i) size and number of windows, their location and opening frequency, as well as the position of the air extraction and supply inlets, which often induce hotspots with stagnating air, (ii) the excessive required air change rate. Hence, strict reliance on proper hygiene practices, namely adherence to face coverings and hand sanitising, are essential. Consequently, face mask adherence should be emphasized and promoted by policymakers for public health applications. Similar research may need to be conducted using a similar approach on the Omicron (B.1.1.529) variant.

Dynamics of SARS-CoV-2 spreading under the influence of environmental factors and strategies to tackle the pandemic: A systematic review

COVID-19 is deemed as the most critical world health calamity of the 21st century, leading to dramatic life loss. There is a pressing need to understand the multi-stage dynamics, including transmission routes of the virus and environmental conditions due to the possibility of multiple waves of COVID-19 in the future. In this paper, a systematic examination of the literature is conducted associating the virus-laden-aerosol and transmission of these microparticles into the multimedia environment, including built environments. Particularly, this paper provides a critical review of state-of-the-art modelling tools apt for COVID-19 spread and transmission pathways. GIS-based, risk-based, and artificial intelligence-based tools are discussed for their application in the surveillance and forecasting of COVID-19. Primary environmental factors that act as simulators for the spread of the virus include meteorological variation, low air quality, pollen abundance, and spatial-temporal variation. However, the influence of these environmental factors on COVID-19 spread is still equivocal because of other non-pharmaceutical factors. The limitations of different modelling methods suggest the need for a multidisciplinary approach, including the 'One-Health' concept. Extended One-Health-based decision tools would assist policymakers in making informed decisions such as social gatherings, indoor environment improvement, and COVID-19 risk mitigation by adapting the control measurements.

A TLBO-Tuned Neural Processor for Predicting Heating Load in Residential Buildings

Recent studies have witnessed remarkable merits of metaheuristic algorithms in optimization problems. Due to the significance of the early analysis of the thermal load in energy-efficient buildings, this work introduces and compares four novel optimizer techniques—the firefly algorithm (FA), optics-inspired optimization (OIO), shuffled complex evolution (SCE), and teaching–learning-based optimization (TLBO)—for an accurate prediction of the heating load (HL). The models are applied to a multilayer perceptron (MLP) neural network to surmount its computational shortcomings. The models are fed by a literature-based dataset obtained for residential buildings. The results revealed that all models used are capable of properly analyzing and predicting the HL pattern. A comparison between them, however, showed that the TLBO-MLP with the coefficients of determination 0.9610 vs. 0.9438, 0.9373, and 0.9556 (respectively, for FA-MLP, OIO-MLP, and SCE-MLP) and the root mean square error of 2.1103 vs. 2.5456, 2.7099, and 2.2774 presents the most reliable approximation of the HL. It also surpassed several methods used in previous studies. Thus, the developed TLBO-MLP can be a beneficial model for subsequent practical applications.

Impact of natural ventilation on exposure to SARS-CoV 2 in indoor/semi-indoor terraces using CO2 concentrations as a proxy

Nowadays, it is necessary a better airborne transmission understanding of respiratory diseases in shared indoor and semi-indoor environments with natural ventilation in order to adopt effective people's health protection measures. The aim of this work is to evaluate the relative exposure to SARS-CoV 2 in a set of virtual scenarios representing enclosed and semi-enclosed terraces under different outdoor meteorological conditions. For this purpose, indoor CO₂ concentration is used as a proxy for the risk assessment. Airflow and people exhaled CO₂ in different scenarios are simulated through Computational Fluid Dynamics (CFD) modelling with Unsteady Reynolds-Averaged Navier-Stokes (URANS) approach. Both spatial average concentrations and local concentrations are analyzed. In general, spatial average concentrations decrease as ventilation increases, however, depending on the people arrangement inside the terrace, spatial average concentrations and local concentrations can be very different. Therefore, for assessing the relative exposure to SARS-CoV 2 it is necessary to consider the indoor flow patterns between infectors and susceptibles. This research provides detailed information about CO₂ dispersion in enclosed/semi-enclosed scenarios, which can be very useful for reducing the transmission risk through better natural ventilation designs and improving the classic risk models since it allows to check their hypotheses in real-world scenarios. Although CFD ventilation studies in indoor/semi-indoor environments have been already addressed in the literature, this research is focused on restaurant terraces, scenarios scarcely investigated. Likewise, one of the novelties of this study is to take into account the outdoor meteorological conditions to appropriately simulate natural ventilation.

A coupled Computational Fluid Dynamics and Wells-Riley model to predict COVID-19 infection probability for passengers on long-distance trains

Coupled Wells-Riley (WR) and Computational Fluid Dynamics (CFD) modelling (WR-CFD) facilitates a detailed analysis of COVID-19 infection probability (IP). This approach overcomes issues associated with the WR 'well-mixed' assumption. The WR-CFD model, which makes uses of a scalar approach to simulate quanta dispersal, is applied to Chinese long-distance trains (G-train). Predicted IPs, at multiple locations, are validated using statistically derived (SD) IPs from reported infections on G-trains. This is the first known attempt to validate a coupled WR-CFD approach using reported COVID-19 infections derived from the rail environment. There is reasonable agreement between trends in predicted and SD IPs, with the maximum SD IP being 10.3% while maximum predicted IP was 14.8%. Additionally, predicted locations of highest and lowest IP, agree with those identified in the statistical analysis. Furthermore, the study demonstrates that the distribution of infectious aerosols is non-uniform and dependent on the nature of the ventilation. This suggests that modelling techniques neglecting these differences are inappropriate for assessing mitigation measures such as physical distancing. A range of mitigation strategies were analysed; the most effective being the majority (90%) of passengers correctly wearing high efficiency masks (e.g. N95). Compared to the base case (40% of passengers wearing low efficiency masks) there was a 95% reduction in average IP. Surprisingly, HEPA filtration was only effective for passengers distant from an index patient, having almost no effect for those in close proximity. Finally, as the approach is based on CFD it can be applied to a range of other indoor environments.

Improvement of Airflow Distribution and Contamination Control for a Biotech Cleanroom

The biotech cleanroom industry presents a biological basis for living organisms or their components (bacteria or enzymes) to produce helpful medicine. However, biotech industries such as vaccine production need a clean critical environment and contamination control that is always a vital concern for the manufacturing process. This study investigates a biotech cleanroom through a comprehensive field measurement and numerical simulation. The field measurement test results conformed to the design specification to satisfactorily meet with the cleanroom standard of PIC/S and EU GMP. Furthermore, the field measurement data were used as a basic validation and boundary condition for numerical simulation. The numerical simulation results revealed that the concentration distribution in case 1 as a baseline case showed satisfactory results, with a removal efficiency of 75.2% and ventilation efficiency of 80%. However, there was still a high concentration accumulated in certain areas. The improvement strategy was analyzed through non-unidirectional flow ventilation with different face velocities and by adding one return air grille for case 2 and two return air grilles for case 3. The results revealed that case 2 presented the best results in this study, with a removal efficiency of 86.7% and ventilation efficiency of 82% when supplying air velocity at 0.2 m/s. In addition, increasing the supply air velocity to 0.3 m/s could enhance removal ventilation by around 19% and ventilation efficiency by around 5%.

A Review on Applications of CFD Modeling in COVID-19 Pandemic

COVID-19 pandemic has started a big challenge to the world health and economy during recent years. Many efforts were made to use the computation fluid dynamic (CFD) approach in this pandemic. CFD was used to understanding the airborne dispersion and transmission of this virus in different situations and buildings. The effect of the different conditions of the ventilation was studied by the CFD modeling to discuss preventing the COVID-19 transmission. Social distancing and using the facial masks were also modeled by the CFD approach to study the effect on reducing dispersion of the microdroplets containing the virus. Most of these recent applications of the CFD were reviewed for COVID-19 in this article. Special applications of the CFD modeling such as COVID-19 microfluidic biosensors, and COVID-19 inactivation using UV radiation were also reviewed in this research. The main findings of each research were also summarized in a table to answer critical questions about the effectiveness levels of applying the COVID-19 health protocols. CFD applications for modeling of COVID-19 dispersion in an airplane cabin, an elevator, a small classroom, a supermarket, an operating room of a hospital, a restaurant, a hospital waiting room, and a children's recovery room in a hospital were discussed briefly in different scenarios. CFD modeling for studying the effect of social distancing with different spaces, using and not using facial masks, difference of sneezing and coughing, different inlet/outlet ventilation layouts, combining air-conditioning and sanitizing machine, and using general or local air-conditioning systems were reviewed.

Ventilation Performance Evaluation of a Negative-Pressurized Isolation Room for Emergency Departments

Due to the emergence of COVID-19 becoming a significant pandemic worldwide, hospitals are expected to be capable and flexible in responding to the pandemic situation. Moreover, as frontline healthcare staff, emergency department (ED) staff have a high possibility of exposure risk to infectious airborne. The ED isolation room will possibly and effectively isolate the infected patient, therefore safekeeping frontline healthcare staff and controlling the outbreak. However, there is still limited knowledge available regarding isolation room facilities specifically for the emergency department. In this study, field measurement is conducted in an ED isolation room located in Taiwan. CFD simulation is employed to simulate and investigate the airflow and airborne contaminant distribution. Instead of high air-change rates (ACH) that purposes for dilution, this study proposes the arrangement of exhaust air grilles to improve the contaminant removal. The results reveal that the exhaust air grille placed behind the patient’s head is optimized to dilute airborne contaminants.

A simplified tempo-spatial model to predict airborne pathogen release risk in enclosed spaces: An Eulerian-Lagrangian CFD approach

COVID19 pathogens are primarily transmitted via airborne respiratory droplets expelled from infected bio-sources. However, there is a lack of simplified accurate source models that can represent the airborne release to be utilized in the safe-social distancing measures and ventilation design of buildings. Although computational fluid dynamics (CFD) can provide accurate models of airborne disease transmissions, they are computationally expensive. Thus, this study proposes an innovative framework that benefits from a series of relatively accurate CFD simulations to first generate a dataset of respiratory events and then to develop a simplified source model. The dataset has been generated based on key clinical parameters (i.e., the velocity of droplet release) and environmental factors (i.e., room temperature and relative humidity) in the droplet release modes. An Eulerian CFD model is first validated against experimental data and then interlinked with a Lagrangian CFD model to simulate trajectory and evaporation of numerous droplets in various sizes (0.1 μm-700 μm). A risk assessment model previously developed by the authors is then applied to the simulation cases to identify the horizontal and vertical spread lengths (risk cloud) of viruses in each case within an exposure time. Eventually, an artificial neural network-based model is fitted to the spread lengths to develop the simplified predictive source model. The results identify three main regimes of risk clouds, which can be fairly predicted by the ANN model.

Investigation of Airflow Distribution and Contamination Control with Different Schemes in an Operating Room

Controlling contamination via proper airflow distribution in an operating room becomes vital to ensure the reliable surgery process. The heating, ventilation, and air conditioning (HVAC) systems significantly influence the operating room environment, including temperature, relative humidity, pressurization, particle counts, filtration, and ventilation rate. A full-scale operating room has been investigated extensively through field measurements and numerical analyses. Computational fluid dynamics (CFD) simulation was conducted and verified with the field measurement data. The simulation was analyzed with three different operating room schemes, including at-rest conditions (case 1), normal operational conditions with personnel (case 2), and actual conditions with personnel inside and some medical equipment blocking the return air (case 3). The concentration decay method was used to evaluate this study. The results revealed that the contamination concentration in case 1 could be diluted quickly with the average value of 404 ppm, whereas the concentration in case 2 slightly increased while performing a surgery with the average value of 420 ppm. The return air grilles in case 3, blocked by obstacles from some medical equipment, resulted in the average concentration value of 474 ppm. Other than that, the contaminant dilution could be obstructed dramatically, which revealed that proper and smooth airflow distribution is essential for contamination control. The ventilation efficiency of case 2 and case 3 dropped around 6% and 17.91% compared to case 1 in the unoccupied and ideal condition. Ventilation efficiency also decreased along with decreasing the air change rate per hour (ACH), while with increasing ACH, the ventilation efficiency in case 3 actually increased, approaching case 2 in the ideal condition.

What We Are Learning from COVID-19 for Respiratory Protection: Contemporary and Emerging Issues

Infectious respiratory diseases such as the current COVID-19 have caused public health crises and interfered with social activity. Given the complexity of these novel infectious diseases, their dynamic nature, along with rapid changes in social and occupational environments, technology, and means of interpersonal interaction, respiratory protective devices (RPDs) play a crucial role in controlling infection, particularly for viruses like SARS-CoV-2 that have a high transmission rate, strong viability, multiple infection routes and mechanisms, and emerging new variants that could reduce the efficacy of existing vaccines. Evidence of asymptomatic and pre-symptomatic transmissions further highlights the importance of a universal adoption of RPDs. RPDs have substantially improved over the past 100 years due to advances in technology, materials, and medical knowledge. However, several issues still need to be addressed such as engineering performance, comfort, testing standards, compliance monitoring, and regulations, especially considering the recent emergence of pathogens with novel transmission characteristics. In this review, we summarize existing knowledge and understanding on respiratory infectious diseases and their protection, discuss the emerging issues that influence the resulting protective and comfort performance of the RPDs, and provide insights in the identified knowledge gaps and future directions with diverse perspectives.

Spread of virus laden aerosols inside a moving sports utility vehicle with open windows: A numerical study

A three dimensional Computational Fluid Dynamics (CFD) model to study the dispersion of virus laden aerosols in a car moving with its windows open is reported. The aerosols are generated when a possibly infected passenger speaks. A sports utility vehicle having three rows of seats has been considered. As the vehicle moves forward, its interior will exchange air from the surroundings. The CFD model captures the flow patterns generated both outside and inside the vehicle. This internal aerodynamics will in turn dictate how aerosols will spread across the interior and whether or not they will be transported outside the vehicle. A Lagrangian approach is used to determine the transport of the aerosol particles and the effect of particle size on the simulation result has been studied. Four sets of scenarios of practical interest have been considered. The first set shows the effect of vehicle speed on aerosol transport, and the second set describes what happens when some of the windows are closed, while the third set describes how aerosol transport is affected by the location of the passenger speaking. The fourth set describes how a gush of cross wind affects aerosol transport. Simulation results reveal that when all windows are open, aerosols can go out of one window and then return back to the vehicle interior through another window. Results also reveal that when a passenger sitting in the second row speaks, the aerosols generated span across the entire volume of the car interior before going out through the open windows.

Risk assessment of airborne COVID-19 exposure in social settings

The COVID-19 pandemic has led to many countries oscillating between various states of lock-down as they seek to balance keeping the economy and essential services running and minimizing the risk of further transmission. Decisions are made about which activities to keep open across a range of social settings and venues guided only by ad hoc heuristics regarding social distancing and personal hygiene. Hence, we propose the dual use of computational fluid dynamic simulations and surrogate aerosol measurements for location-specific assessment of risk of infection across different real-world settings. We propose a 3-tiered risk assessment scheme to facilitate classification of scenarios into risk levels based on simulations and experiments. Threshold values of <54 and >840 viral copies and <5% and >40% of original aerosol concentration are chosen to stratify low, medium, and high risk. This can help prioritize allowable activities and guide implementation of phased lockdowns or re-opening. Using a public bus in Singapore as a case study, we evaluate the relative risk of infection across scenarios such as different activities and passenger positions and demonstrate the effectiveness of our risk assessment methodology as a simple and easily interpretable framework. For example, this study revealed that the bus's air-conditioning greatly influences dispersion and increases the risk of certain seats and that talking can result in similar relative risk to coughing for passengers around an infected person. Both numerical and experimental approaches show similar relative risk levels with a Spearman's correlation coefficient of 0.74 despite differing observables, demonstrating applicability of this risk assessment methodology to other scenarios.

Numerical and experimental analyses for the improvement of surface instant decontamination technology through biocidal agent dispersion: Potential of application during pandemic

The transmission of SARS-CoV-2 through contact with contaminated surfaces or objects is an important form of transmissibility. Thus, in this study, we evaluated the performance of a disinfection chamber designed for instantaneous dispersion of the biocidal agent solution, in order to characterize a new device that can be used to protect individuals by reducing the transmissibility of the disease through contaminated surfaces. We proposed the necessary adjustments in the configuration to improve the dispersion on surfaces and the effectiveness of the developed equipment. Computational Fluid Dynamics (CFD) simulations of the present technology with a chamber having six nebulizer nozzles were performed and validated through qualitative and quantitative comparisons, and experimental tests were conducted using the method Water-Sensitive Paper (WSP), with an exposure to the biocidal agent for 10 and 30 s. After evaluation, a new passage procedure for the chamber with six nozzles and a new configuration of the disinfection chamber were proposed. In the chamber with six nozzles, a deficiency was identified in its central region, where the suspended droplet concentration was close to zero. However, with the new passage procedure, there was a significant increase in wettability of the surface. With the proposition of the chamber with 12 nozzles, the suspended droplet concentration in different regions increased, with an average increase of 266%. The experimental results of the new configuration proved that there was an increase in wettability at all times of exposure, and it was more significant for an exposure of 30 s. Additionally, even in different passage procedures, there were no significant differences in the results for an exposure of 10 s, thereby showing the effectiveness of the new configuration or improved spraying and wettability by the biocidal agent, as well as in minimizing the impact caused by human factor in the performance of the disinfection technology.

Insights into the evaporation characteristics of saliva droplets and aerosols: Levitation experiments and numerical modeling

Understanding the transmission phenomena of SARS-CoV-2 by virus-laden droplets and aerosols is of paramount importance for controlling the current COVID-19 pandemic. Detailed information about the lifetime and kinematics of airborne droplets of different size is relevant in order to evaluate hygiene measures like wearing masks but also social distancing and ventilation concepts for indoor environments. However, the evaporation process of expiratory droplets and aerosols is not fully understood. Consequently, the main objective of this study is to present evaporation characteristics of saliva droplets. An acoustic levitator is utilized in conjunction with microscopic imaging for recording the temporal evolution of the evaporation of saliva droplets under well-defined ambient conditions. Following the evaporation of the water content, a saliva droplet reaches a final size, which remains stable in the timescale of hours. By investigating numerous droplets of different size, it was found that the final droplet diameter correlates well to 20 % of the initial diameter. This correlation is independent of the ambient conditions for a temperature range from 20  °C to 29  °C and a relative humidity from 6 % to up to 65 %. The experimentally obtained evaporation characteristics are implemented into a numerical model, which is based on one-dimensional droplet kinematics and a rapid mixing evaporation model. By taking into account the evaporation-falling curve as presented by Wells, the significance of the experimental results for predicting the lifetime of saliva droplets and aerosols is demonstrated. The numerical predictions may be used to determine the impact of the droplet size and the ambient conditions on the transmission risks of infectious diseases like COVID-19.

Are Historical Buildings More Adaptive to Minimize the Risks of Airborne Transmission of Viruses and Public Health? A Study of the Hazzazi House in Jeddah (Saudi Arabia)

The coronavirus (COVID-19) pandemic has brought immense challenges to the natural and built environment to develop an antivirus-enabled model for reducing potential risks of spreading the virus at varied scales such as buildings, neighborhoods, and cities. Spatial configurations of structures may hinder or assist the spread of viruses in the built environment. In this study, we have hypothesized that suitable air ventilation in historic buildings may enhance the built environment to combat the spreading of infectious viruses. To provide such quantitative shreds of evidence, we have generated and estimated an integrated model to summarize obtained information by considering natural ventilation, wind speed, inflow and outflow, wind direction, and forecasting the associated risks of airborne disease transmission in a historical building (i.e., the Hazzazi House in particular). Intrinsically, the results have demonstrated that the effectiveness of natural ventilation has directly influenced reducing the risks of transmitting airborne infectious viruses for the selected heritage building in Jeddah (Saudi Arabia). The adopted methods in this research may be useful to understand the potentials of conserving old heritage buildings. Consequently, the results demonstrate that natural air ventilation systems are critical to combat the spread of infectious diseases in the pandemic.

The design of safe classrooms of educational buildings for facing contagions and transmission of diseases: A novel approach combining audits, calibrated energy models, building performance (BPS) and computational fluid dynamic (CFD) simulations

The proposed investigation is aimed at providing useful suggestions and guidelines for the renovation of educational buildings, in order to do University classrooms safe and sustainable indoor places, with respect to the 2020 SARS-CoV-2 global pandemic. Classrooms and common spaces have to be thought again, for a new "in-presence" life, after the recent worldwide emergency following the spring 2020 pandemic diffusion of COVID-19. In this paper, starting from a real case study, and thus the architectural and technological refurbishment of an Italian University building (Campobasso, South Italy, cold climate), with the aims of improving the classrooms' quality and safety, a comprehensive approach for the retrofit design is proposed. By taking into account the necessary come back to classrooms starting, hopefully, from the next months (Autumn 2020), experimental studies (monitoring and investigations of the current energy performances) are followed by the coupling of different numerical methods of investigations, and thus building performance simulations, under transient conditions of heat transfer, and computational fluid dynamics studies, to evidence criticalities and potentialities to designers involved in the re-thinking of indoor spaces hosting multiple persons, with quite high occupancy patterns. Both energy impacts, in terms of monthly and annual increase of energy demands due to higher mechanical ventilation, and indoor distribution of microclimatic parameters (i.e., temperature, airspeed, age of air) are here investigated, by proposing new scenarios and evidencing the usefulness of HVAC systems, equipment (e.g., sensible heat recovery, without flows' contamination) and suitability of some strategies for the air distribution systems (ceiling squared and linear slot diffusers) compared to traditional ones.

Occupational Safety and Health Training for Undergraduates Nursing Students: A Spanish Pilot

Most of blood borne and airborne pathogens are highly contagious, harmful and have prevalence among healthcare workers. In this group, healthcare students, especially nursing undergraduates, have even higher risk to be exposed and suffered a contagious accident. One of the main pillars to prevent exposure to such pathogens and decrease accidents seems to be through education. A prospective observational educational research focused on quantifying the students' knowledge, and prevention culture was carried out. The educational approach based on the development of a technological tool, its integration in the students' education, and posterior assessment. The Chi-square, ANOVA, Kruskal-Wallis, Man-Whitney U, and Spearman correlations were used to determine the effect of such educational methodology. The results, previous to the integration of the educational approach, showed differences between the elementary and proficient knowledge and correct procedure in each academic year (p < 0.05), being the best year the third academic year. The mean of elementary knowledge among second year students after the inclusion of the educational methodology improved for 2017/2018 with a mean of 7.5 (1.11) and in 2018/2019 with 7.87 (1.34). This study argued that the educational approach proposed could improve the prevention culture and knowledge among students and future healthcare professionals.

Liquid-curtain-based strategy to restrain plume during flushing

How to prevent the flushing-induced plume without changing people's daily habits? Enlightened by thoughts of redesigning the restroom, this article provides a redesigned toilet using liquid-curtain-based strategy and verifies its advantages from the computational fluid dynamics. Two favorable effects are spotted: (1) the liquid curtain can suppress the upward virus particles (only 1% viruses can be lifted out of the toilet) and (2) the flow distribution caused by the liquid curtain can deliver virus particles into the sewage efficiently.