Practical experiences on the prevention and treatment strategies to fight against COVID-19 in hospital

Airborne infection risk assessment of COVID-19 in an inpatient department through on-site occupant behavior surveys

Airborne transmission is a possible infection route of the coronavirus disease 2019 (COVID-19). This investigation focuses on the airborne infection risk of COVID-19 in a nursing unit in an inpatient building in Shenzhen, China. On-site measurements and questionnaire surveys were conducted to obtain the air change rates and occupant trajectories, respectively. The aerosol transport and dose–response models were applied to evaluate the infection risk. The average outdoor air change rate measured in the wards was 1.1 h⁻¹, which is below the minimum limit of 2.0 h⁻¹ required by ASHRAE 170–2021. Considering the surveyed occupant behavior during one week, the patients and their attendants spent an average of 19.4 h/d and 15.1 h/d, respectively, in the wards, whereas the nurses primarily worked in the nurse station (3.0 h/d) and wards (2.4 h/d). The doctors primarily worked in their offices (2.6 h/d) and wards (1.1 h/d). Assuming one undetected COVID-19 infector emitting severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in the nursing unit, we calculated the accumulated viral dose and infection probabilities of the occupants. After one week, the cumulative infection risks of the patients and attendants were almost equal (0.002), and were higher than those of the nurses (0.0013) and doctors (0.0004). Proper protection measures, such as reducing the number of attendants, increasing the air change rate, and wearing masks, were found to reduce the infection risk. It should be noted that the reported results are based on several assumptions, such as the speculated virological properties of SARS-CoV-2 and the particular trajectories of occupants. Moreover, only second generations of transmission were taken into consideration, whereas in reality, the week-long exposure may cause third generation of transmission or worse.

Study on ventilation rates and assessment of infection risks of COVID-19 in an outpatient building

A modified Wells-Riley model combining the airborne route and close contact route was proposed to predict the infection risks of coronavirus disease 2019 (COVID-19) in main functional spaces of an outpatient building in Shenzhen, China. The personnel densities and ventilation rates in the 20 waiting rooms, outpatient hall and hospital street were on-site measured. The average fresh air volume per person and occupant area per person in the 20 waiting rooms were 77.6 m³/h and 6.47 m²/per, satisfied with the Chinese standard. The average waiting time of the occupants was 0.69 h. Thus, assuming the proportion of infected people in the outpatient building was 2%, the daily average infection probabilities of COVID-19 in the 20 waiting rooms were 0.19–1.88% with a reasonable setting of the quanta produced by an infector (q = 45 quanta/h) and the effective exposure dose of pathogen per unit close contact time (β = 0.05 h⁻¹). The design of the semi-closed hospital street with a height of 24 m improved its natural ventilation with a fresh air volume per person of 70–185 m³/h and further dilute the viral aerosol and decreased the infection risk to a negligible level (i.e., below 0.04% with an infector proportion of 2%). The assessment method provides real-time prediction of indoor infection risk and good assist in spread control of COVID-19.