2019 Novel Coronavirus (COVID-19) Pandemic: Built Environment Considerations To Reduce Transmission

Probiotic-Based Approaches for Sustainable Control of Infectious Risk in Mass Transport: Current Data and Future Perspectives

The built environments of high-traffic areas can play a significant role in the transmission of microorganisms and associated infections, sometimes favouring the selection of multidrug-resistant (MDR) organisms due to the excessive use of conventional disinfectants. Probiotic-based sanitation (PBS) was suggested as a novel alternative approach to control the infectious risk in crowded community environments due to its effectiveness in reducing fungal, bacterial, and viral pathogens in sanitary settings. PBS may thus trigger a paradigm shift from chemical to biological strategies in cleaning environments with high human occupancy, offering an ecological and economically sustainable alternative to conventional chemical disinfection. Providing robust data supporting the results reported so far, it has the potential to optimise bioburden control and infection prevention in mass transportation spaces. This review brings together existing research on PBS in mass transportation areas, pinpoints areas of lack of information, and explores its potential future uses, including the creation of probiotic-based materials for sustainable biocontrol in high-traffic areas.

An interdisciplinary perspective of the built-environment microbiome

The built environment provides an excellent setting for interdisciplinary research on the dynamics of microbial communities. The system is simplified compared to many natural settings, and to some extent the entire environment can be manipulated, from architectural design to materials use, air flow, human traffic, and capacity to disrupt microbial communities through cleaning. Here, we provide an overview of the ecology of the microbiome in the built environment. We address niche space and refugia, population, and community (metagenomic) dynamics, spatial ecology within a building, including the major microbial transmission mechanisms, as well as evolution. We also address landscape ecology, connecting microbiomes between physically separated buildings. At each stage, we pay particular attention to the actual and potential interface between disciplines, such as ecology, epidemiology, materials science, and human social behavior. We end by identifying some opportunities for future interdisciplinary research on the microbiome of the built environment.

Green Villages, the Pandemic, and the Future of California Urbanism

During the COVID-19 pandemic, the role of housing in controlling the spread of the virus was limited, as policies primarily focused on short-term measures such as lockdowns and social distancing. As the pandemic recedes, a shift has occurred towards restructuring the environment to confront future health crises better. This research thoroughly evaluates existing literature and housing complexes. It recommends that future projects prioritize several key features: ample exposure to natural environments, opportunities for growing food, encouragement of casual social interactions, inclusion of communal spaces, and provision of areas for exercise to help reduce the risks of contagion and alleviate the mental health impacts on residents. Based on research conducted during and after the pandemic, current recommendations for housing often provide generalized suggestions or propose ideal layouts through diagrams. This approach can be unrealistic from both spatial and economic perspectives and fails to inspire or stimulate creativity. This paper, by contrast, reviews and analyzes historical housing projects while critically examining three case studies that have the potential to inspire future designs. The goal is to provide officials, architects, and stakeholders with a series of practical possibilities and guidelines that contribute to the post-COVID home design process by making it more health-conscious and fostering the creation of new types of neighborhoods that can significantly impact the planning of cities in California.

Risk of infection due to airborne virus in classroom environments lacking mechanical ventilation

The COVID-19 pandemic highlighted the role of indoor environments on disease transmission. However, our understanding of how transmission occurred evolved as the pandemic progressed. Enclosed spaces where pathogen-laden aerosols accumulate were strongly linked to increased transmission events. Most classrooms, particulalry in the U.S., do not have any mechanical ventilation systems but do have many people congregating indoors for long periods of time. Here we employ a safe, non-pathogenic surrogate virus, the bacteriophage phi6, to interrogate aerosol transmission in classroom environments that do not have any natural or mechanical ventilation in order to provide baseline understanding of how effectively aerosols facilitate new infections. We measure exposure risk using a modified passive monitoring technique compliant with applicable standards, including ISO 14698-1:2003. We find that virus-laden aerosols establish new infections over all distances tested within minutes and that the time of exposure did not change transmission rate. We further find that relative humidity, but not temperature nor a UV-based disinfection device, significantly lowered transmission rates. Our data suggest that, even without mechanical ventilation, relative humidity remains an inexpensive and highly effective mitigation strategy while UV air treatment may not.

Street-level built environment on SARS-CoV-2 transmission: A study of Hong Kong

Understanding the association between SARS-CoV-2 Spatial Transmission Risk (SSTR) and Built Environments (BE) is crucial for implementing effective pandemic prevention measures. Massive efforts have been made to examine the macro-built environment at the regional level, which has neglected the living service areas at the residential scale. Therefore, this study aims to explore the association between Street-level Built Environments (SLBE) and SSTR in Hong Kong from the 1st to the early 5th waves of the pandemic to address this gap. A total of 3693 visited/resided buildings were collected and clustered by spatial autocorrelation, and then Google Street View (GSV) was employed to obtain SLBE features around the buildings. Eventually, the interpretable machine learning framework based on the random forest algorithm (RFA)-based SHapley Additive exPlanations (SHAP) model was proposed to reveal the hidden non-linear association between SSTR and SLBE. The results indicated that in the high-risk cluster area, street sidewalks, street sanitation facilities, and artificial structures were the primary risk factors positively associated with SSTR, in low-risk cluster areas with a significant positive association with traffic control facilities. Our study elucidates the role of SLBE in COVID-19 transmission, facilitates strategic resource allocation, and guides the optimization of outdoor behavior during pandemics for urban policymakers.

Analysis of a Large Severe Acute Respiratory Syndrome Coronavirus 2 (Alpha) Outbreak in a Catalan Prison Using Conventional and Genomic Epidemiology

Enforcing strict protocols that prevent transmission of airborne infections in prisons is challenging. We examine a large severe acute respiratory syndrome coronavirus 2 outbreak in a Catalan penitentiary center in February-April 2021, prior to vaccination deployment. The aim was to describe the evolution of the outbreak using classical and genomic epidemiology and the containment strategy applied. The outbreak was initially detected in 1 module but spread to 4, infecting 7 staff members and 140 incarcerated individuals, 6 of whom were hospitalized (4.4%). Genomic analysis confirmed a single origin (B.1.1.7). Contact tracing identified transmission vectors between modules and prevented further viral spread. In future similar scenarios, the control strategy described here may help limit transmission of airborne infections in correctional settings.

Antimicrobial Activity of Hydrogen Peroxide for Application in Food Safety and COVID-19 Mitigation: An Updated Review

Hydrogen peroxide (H2O2) is a well-known agent with a broad-spectrum antimicrobial activity against pathogenic bacteria, fungi, and viruses. It is a colorless liquid and commercially available in aqueous solution over a wide concentration range. It has been extensively used in the food industry by virtue of its strong oxidizing property and its ability to cause cellular oxidative damage in microbial cells. This review comprehensively documents recent research on the antimicrobial activity of H2O2 against organisms of concern for the food industry, as well as its effect against SARS-CoV-2 responsible for the COVID-19 pandemic. In addition, factors affecting the antimicrobial effectiveness of H2O2, different applications of H2O2 as a sanitizer or disinfectant in the food industry as well as safety concerns associated with H2O2 are discussed. Finally, recent efforts in enhancing the antimicrobial efficacy of H2O2 are also outlined.

Evaluating the resilience of residential buildings during a pandemic with a sustainable construction approach

The COVID-19 pandemic has been a catastrophic event that has affected all aspects of human life worldwide. Due to the high genetic mutations of the virus, there has been a prolonged search for definitive therapeutic discovery, leading to extended periods of home quarantine. As a result, homes have become multipurpose spaces for work, education, sports, and other daily activities. Given the importance of residential buildings as the first line of defense against possible future pandemics, a model has been proposed to assess their readiness to handle pandemics using a sustainable development approach. This study investigates the most crucial criteria for evaluating residential buildings and applies them in a Multi-Criteria Decision Making (MCDM) process. The final evaluation model is presented using the SWARA and COCOSO methods, along with a set of criteria selected and weighted by experts. The study shows that the criteria related to health and safety are more critical than other sectors. Buildings that meet the standards of this group better are likely to have a higher score.

Built Environment and SARS-CoV-2 Transmission in Long-Term Care Facilities: Cross-Sectional Survey and Data Linkage

OBJECTIVES

To describe the built environment in long-term care facilities (LTCF) and its association with introduction and transmission of SARS-CoV-2 infection.

DESIGN

Cross-sectional survey with linkage to routine surveillance data.

SETTING AND PARTICIPANTS

LTCFs in England caring for adults ≥65 years old, participating in the VIVALDI study (ISRCTN14447421) were eligible. Data were included from residents and staff.

METHODS

Cross-sectional survey of the LTCF built environment with linkage to routinely collected asymptomatic and symptomatic SARS-CoV-2 testing and vaccination data between September 1, 2020, and March 31, 2022. We used individual and LTCF level Poisson and Negative Binomial regression models to identify risk factors for 4 outcomes: incidence rate of resident infections and outbreaks, outbreak size, and duration. We considered interactions with variant transmissibility (pre vs post Omicron dominance).

RESULTS

A total of 134 of 151 (88.7%) LTCFs participated in the survey, contributing data for 13,010 residents and 17,766 staff. After adjustment and stratification, outbreak incidence (measuring infection introduction) was only associated with SARS-CoV-2 incidence in the community [incidence rate ratio (IRR) for high vs low incidence, 2.84; 95% CI, 1.85-4.36]. Characteristics of the built environment were associated with transmission outcomes and differed by variant transmissibility. For resident infection incidence, factors included number of storeys (0.64; 0.43-0.97) and bedrooms (1.04; 1.02-1.06), and purpose-built vs converted buildings (1.99; 1.08-3.69). Air quality was associated with outbreak size (dry vs just right 1.46; 1.00-2.13). Funding model (0.99; 0.99-1.00), crowding (0.98; 0.96-0.99), and bedroom temperature (1.15; 1.01-1.32) were associated with outbreak duration.

CONCLUSIONS AND IMPLICATIONS

We describe previously undocumented diversity in LTCF built environments. LTCFs have limited opportunities to prevent SARS-CoV-2 introduction, which was only driven by community incidence. However, adjusting the built environment, for example by isolating infected residents or improving airflow, may reduce transmission, although data quality was limited by subjectivity. Identifying LTCF built environment modifications that prevent infection transmission should be a research priority.

Perspectives on Assessing the Flexibility of Hospitals for Crisis Mode Operations: Lessons From the COVID-19 Pandemic in the Netherlands

BACKGROUND

The COVID-19 pandemic placed healthcare design at the heart of the crisis. Hospitals faced challenges such as rapidly increasing their intensive care unit capacity, enabling physical distancing measures, quickly converting to telehealth and telework practices, and above all, keeping patients and staff safe. Improving flexibility in hospital facility design and adaptability of hospital operations to function in "crisis mode" can be seen as ways of future-proofing for pandemics. In a design brief, flexibility is typically mentioned as an important target. Meanwhile, robustness of technical infrastructure is called for, and standardization at unit level with single-occupancy inpatient accommodation may be considered a way to enhance flexibility and adaptability in dealing with a surge in infectious patients.

AIM

To future-proof facility design with pandemic preparedness and resilience in mind, this study evaluated what kinds of interventions were taken in Dutch hospital facilities and what perspectives need to be considered when hospitals operate in crisis mode.

METHODS

We have collected data from facility and estate professionals from 30 Dutch hospitals. Using a practice-based approach, in-depth interviewing helped uncover and compare successful operational strategies and design elements that provided the flexibility needed in the early stages of the recent crisis.

RESULTS

As we looked at existing facilities and alterations made to allow hospitals to operate during the COVID-19 pandemic, we discovered that staff availability and adaptability were deemed crucial.

CONCLUSION

We add the perspective of staff as an essential factor to be considered when future-proofing hospital facility desigr crisis mode operation.

Identifying spatial heterogeneity of COVID-19 transmission clusters and their built-environment features at the neighbourhood scale

The identification of high-risk areas for infectious disease transmission and its built-environment features are crucial for targeted surveillance and early prevention efforts. While previous research has explored the association between infectious disease incidence and urban built environment, the investigation of spatial heterogeneity of built-environment features in high-risk areas has been insufficient. This paper aims to address this gap by analysing the spatial heterogeneity of COVID-19 clusters in Shanghai at the neighbourhood scale and examining associated built-environment features. Using a spatiotemporal clustering algorithm, the study analysed 1395 reported cases in Shanghai from March 6 to March 17, 2022. Both global Poisson regression (GPR) and geographically weighted Poisson regression (GWPR) models were applied to examine the association between built-environment variables and the size of COVID-19 clusters. Our findings suggest that larger COVID-19 clusters emerging in the suburbs compared with the downtown and multiple built-environment features are significantly associated with this pattern. Specifically, neighbourhoods with a higher proportion of commercial, public service and industrial land, higher centrality of metro stations, and proximity to hospitals are positively associated with larger COVID-19 clusters, while neighbourhoods with higher land use mix and green/open spaces density are associated with smaller COVID-19 clusters. Moreover, we identified that metro stations with high centrality present the highest risk in the downtown, while commercial and public service places exhibit the highest risk in the suburbs. By highlighting the overlooked spatial heterogeneity of built-environment features for high-risk areas, this study aims to provide valuable guidance for public health departments in implementing place-based interventions to effectively prevent the spread of potential epidemics.

Airborne influenza virus shedding by patients in health care units: Removal mechanisms affecting virus transmission

In this study, we characterize the distribution of airborne viruses (influenza A/B) in hospital rooms of patients with confirmed infections. Concurrently, we monitored fine particulate matter (PM2.5 & PM10) and several physical parameters including the room air exchange rate, temperature, and relative humidity to identify corresponding correlations with virus transport and removal determinants. The results continue to raise concerns about indoor air quality (IAQ) in healthcare facilities and the potential exposure of patients, staff and visitors to aerosolized viruses as well as elevated indoor PM levels caused by outdoor sources and/or re-suspension of settled particles by indoor activities. The influenza A virus was detected in 42% of 33 monitored rooms, with viruses detectible up to 1.5 m away from the infected patient. Active coughing was a statistically significant variable that contributed to a higher positive rate of virus detection in the collected air samples. Viral load across patient rooms ranged between 222 and 5,760 copies/m3, with a mean of 820 copies/m3. Measured PM2.5 and PM10 levels exceeded IAQ daily exposure guidelines in most monitored rooms. Statistical and numerical analyses showed that dispersion was the dominant viral removal pathway followed by settling. Changes in the relative humidity and the room's temperature were had a significant impact on the viral load removal. In closure, we highlight the need for an integrated approach to control determinants of IAQ in patients' rooms.

The Impact of Greenspace, Walking, and Cycling on the Health of Urban Residents during the COVID-19 Pandemic: A Study of London

Vulnerability to COVID-19 has been linked to public health issues like obesity and physical fitness, which consecutively can be linked to access to urban greenspace. However, the value of greenspaces remains contentious in the literature and unclear in practice. In view of very high COVID-19 mortality rates, we use data from London boroughs to explore the impact of green infrastructure in terms of the size, accessibility, and support of physical activity and healthy lifestyles (e.g., walking and cycling). Results show no significant relationship between the availability of greenspace and the probability of being obese or dying from COVID-19. Cycling once, thrice, or five times weekly was found to improve healthy weight, as does cycling once a month. However, the probability of dying from COVID-19 during lockdowns is correlated to the frequency of walking or cycling as a result of decreased social distancing, while the frequency of walking and cycling is determined by availability and access to greenspace.

Risk factors for COVID-19 outbreaks in livestock slaughtering and processing facilities in Republic of Korea

BACKGROUND

The goal of this study was to help prevent and control the spread of coronavirus disease 2019 (COVID-19) by identifying transmission routes and risk factors in livestock slaughtering and processing facilities (SPFs) and establishing an optimal intervention strategy for outbreaks.

METHODS

This case series study was a demographic analysis of patients with confirmed COVID-19 associated with 5 SPFs in Korea between January and June 2021. Additionally, in a retrospective cohort study, the association between COVID-19 infection and risk factors was analyzed for SPFs at which outbreaks occurred.

RESULTS

The COVID-19 attack rates were 11.2%, 24.5%, and 6.8% at 3 poultry SPFs (PSPFs) and 15.5% and 25.2% at 2 mammal SPFs (MSPFs). Regarding spatial risk factors, the COVID-19 risk levels were 12.1-, 5.2-, and 5.0-fold higher in the refrigeration/ freezing, by-product processing, and carcass cutting areas, respectively, than in the office area. The risk of COVID-19 infection was 2.1 times higher among employees of subcontractors than among employees of contractors. The COVID-19 risk levels were 5.3- and 3.0-fold higher in foreign workers than in native Korean workers in the PSPFs and MSPFs, respectively.

CONCLUSION

As the COVID-19 pandemic continues, a detailed policy for infectious disease prevention and control intervention is needed, without interrupting economic activities. Thus, we propose an ideal intervention plan to prevent COVID-19 through disinfection and preemptive testing and to block its transmission through effective contact management during outbreaks at SPFs.

Feeling WELL: COVID-19 and the Adoption of Wellness Themes in Interior Design Curricula

Interior design (ID) pedagogy should include theories and applications, which advance human health and wellness in the built environment. Design for wellness and well-being is referenced in 5 of the 13 Council for Interior Design Accreditation (CIDA) knowledge application standards. This focus on wellness was amplified during the coronavirus disease 2019 (COVID-19) pandemic experience, which elevated our collective understanding of contagions, disease transmission, sanitation practices, vaccination efficacy, and immunity, as well as the devastating turmoil-social, economic, and psychological-of the pandemic's tragic spread. Thus, the purpose of this study was to examine ID educators' attitudes, intentions, and behaviors related to teaching wellness and to determine if the pandemic impacted wellness pedagogy. For this mixed methods study, we employed an online survey (n = 86) followed by participant interviews (n = 11). Data from the questionnaire and interviews suggested that peer attitudes toward wellness were a significant factor that influenced teaching behavior. Teaching intentions were predicted by prior teaching, attitudes, and perceived behavioral control (ability to teach wellness). Although experience with the pandemic was not a predictor of teaching behavior, it did surface as a strong motivator for future teaching adjustments. Findings also showed wide-ranging understandings and definitions of wellness-related themes. Implications for design programs seeking to equip faculty with the tools needed to integrate wellness more deeply into ID curricula are discussed.

Spatial variations of the third and fourth COVID-19 waves in Hong Kong: A comparative study using built environment and socio-demographic characteristics

Since the first confirmed case was reported in January 2020, Hong Kong has experienced multiple waves of COVID-19 outbreaks. Recent literature has explored the spatial patterns of disease incidence and their relationships with the built environment and demographic characteristics. Nonetheless, few studies aim at the comparative patterns of different epidemic waves occurring in the same spatial context. This study analyses spatial patterns of the third and fourth COVID-19 epidemic waves and then evaluates the spatial relationship between case incidence and built environment and socio-demographic characteristics. By collecting local-related cases, this study incorporates a two-fold analytical strategy: (1) Using rank-size distribution and log-odd ratio to depict the spatial pattern of COVID-19 incidence rates; (2) through global and local regression models, investigating incidence's associations with the urban built environment and socio-demographic characteristics. The results reveal that the two different epidemic waves have far distinct spatial tendencies to their infection risk factors, reflecting location-specific associations with the built environments and socio-demographics. Collectively, we discover that the third and fourth COVID-19 waves are likely associated with residential context and urban activities, respectively. Practical implications are discussed that would be of interest to policymakers and health professionals.

COVID-19 pandemic and minority health disparities in New York City: A spatial and temporal perspective

New York City (NYC) was the epicenter of COVID-19 pandemic for a long time, and the government introduced a city-wide lockdown policy to mitigate the spread of virus. Minority communities, however, suffered disproportionally high percentage of infection and mortality rates, a disturbing phenomenon that deserves scrutiny. Adopting a spatial and temporal perspective, this study aims to investigate health disparities in this pandemic by focusing on mobility in the city. Considering both public transit and the lockdown policy essential factors that impact infection and mortality, this study introduced a measure indicating mobility-restricted transit as the spatial factor. Additional factors include ethnic minorities based on their nativity and three categories of social vulnerability: socioeconomic status, household composition, and housing type. This study selects eight phases, each of which consists of 2 weeks to derive infection and mortality rates to investigate the impacts of those factors. As infection and mortality data are published based on ZIP code, this study further estimates the infection and mortality rates at a finer level of census tract through spatial apportionment. Results reveal the significant impact of mobility-restricted transit on both infection and mortality and show certain clusters of neighborhoods being highly impacted. In addition, this study identifies neighborhoods where native-born and foreign-born of each ethnic minority (Blacks, Hispanics, and Asians) have high risk of infection and mortality. Through a spatial and temporal perspectives, this study identifies the complexity of patterns in minority health disparities in COVID-19 pandemic, which can inform policy makers for localized support to vulnerable neighborhoods to alleviate minority health disparities.

Epstein-Barr virus and cytomegalovirus coinfection in Egyptian COVID-19 patients

Background

Reactivation of herpesviruses such as Epstein-Barr virus (EBV) and cytomegalovirus (CMV) in COVID-19 patients reported in many studies in different countries during the pandemic. We aimed to measure prevalence of this coinfection in Egyptian COVID-19 patients with elevated liver enzymes and its relation to the severity and the outcome of COVID-19 infection in those patients.

Methods

A cross-sectional study was carried out on 110 COVID-19 patients with elevated liver enzymes regardless the severity of COVID-19 disease. All patients were subjected to medical history, clinical examination, laboratory investigations, high-resolution computed tomography chest (HRCT chest). Epstein-Barr virus (EBV) and Human cytomegalovirus (HCMV) were determined by VCA IgM and CMV IgM respectively by enzyme-linked immunosorbent assay (ELISA).

Results

Of the included 110 patients with COVID-19 illness, 5 (4.5%) were Epstein-Barr virus seropositive and 5 (4.5%) were human cytomegalovirus seropositive. Regarding the symptoms, the incidence of fever in the EBV and CMV seropositive group was apparently higher than that in the EBV and CMV seronegative group. In lab tests, the platelets and albumin of EBV and CMV seropositive group decreased more significantly than EBV and HCMV seronegative group, and serum ferritin, D-dimer, and C-reactive protein show higher values in seropositive group than in seronegative group but not statistically significant. Seropositive group had received higher doses of steroids than seronegative group. The median of hospital stay in seropositive group was (15 days) nearly double that of seronegative group with statistically significant difference between both groups.

Conclusion

Coinfection of EBV and CMV in COVID-19 Egyptian has no effect on the disease severity or the clinical outcome of the disease. But those patients had higher hospital stay duration.

Next-Generation Vaccines Against COVID-19 Variants: Beyond the Spike Protein

Vaccines are among the most effective medical countermeasures against infectious diseases. The current Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has spurred the scientific strategies to fight against the disease. Since 2020, a great number of vaccines based on different platforms have been in development in response to the pandemic, among which mRNA, adenoviral vector, and subunit vaccines have been clinically approved for use in humans. These first-generation COVID-19 vaccines largely target the viral spike (S) protein and aim for eliciting potent neutralizing antibodies. With the emergence of SARS-CoV-2 variants, especially the highly transmissible Omicron strains, the S-based vaccine strategies have been faced constant challenges due to strong immune escape by the variants. The coronavirus nucleocapsid (N) is one of the viral proteins that induces strong T-cell immunity and is more conserved across different SARS-CoV-2 variants. Inclusion of N in the development of COVID-19 vaccines has been reported. Here, we briefly reviewed and discussed COVID-19 disease, current S-based vaccine strategies, and focused on the immunobiology of N protein in SARS-CoV-2 host immunity, as well as the next-generation vaccine strategies involving N protein, to combat current and emerging SARS-CoV-2 variants.

Identification of Common Dysregulated Genes in COVID-19 and Hypersensitivity Pneumonitis: A Systems Biology and Machine Learning Approach

A comprehensive knowledge on systems biology of severe acute respiratory syndrome coronavirus 2 is crucial for differential diagnosis of COVID-19. Interestingly, the radiological and pathological features of COVID-19 mimic that of hypersensitivity pneumonitis (HP), another pulmonary fibrotic phenotype. This motivated us to explore the overlapping pathophysiology of COVID-19 and HP, if any, and using a systems biology approach. Two datasets were obtained from the Gene Expression Omnibus database (GSE147507 and GSE150910) and common differentially expressed genes (DEGs) for both diseases identified. Fourteen common DEGs, significantly altered in both diseases, were found to be implicated in complement activation and growth factor activity. A total of five microRNAs (hsa-miR-1-3p, hsa-miR-20a-5p, hsa-miR-107, hsa-miR-16-5p, and hsa-miR-34b-5p) and five transcription factors (KLF6, ZBTB7A, ELF1, NFIL3, and ZBT33) exhibited highest interaction with these common genes. Next, C3, CFB, MMP-9, and IL1A were identified as common hub genes for both COVID-19 and HP. Finally, these top-ranked genes (hub genes) were evaluated using random forest classifier to discriminate between the disease and control group (coronavirus disease 2019 [COVID-19] vs. controls, and HP vs. controls). This supervised machine learning approach demonstrated 100% and 87.6% accuracy in differentiating COVID-19 from controls, and HP from controls, respectively. These findings provide new molecular leads that inform COVID-19 and HP diagnostics and therapeutics research and innovation.

Mechanisms, Techniques and Devices of Airborne Virus Detection: A Review

Airborne viruses, such as COVID-19, cause pandemics all over the world. Virus-containing particles produced by infected individuals are suspended in the air for extended periods, actually resulting in viral aerosols and the spread of infectious diseases. Aerosol collection and detection devices are essential for limiting the spread of airborne virus diseases. This review provides an overview of the primary mechanisms and enhancement techniques for collecting and detecting airborne viruses. Indoor virus detection strategies for scenarios with varying ventilations are also summarized based on the excellent performance of existing advanced comprehensive devices. This review provides guidance for the development of future aerosol detection devices and aids in the control of airborne transmission diseases, such as COVID-19, influenza and other airborne transmission viruses.

A ventilation early warning system (VEWS) for diaphanous workspaces considering COVID-19 and future pandemics scenarios

The COVID-19 pandemic has generated new needs due to the associated health risks and, more specifically, its rapid infection rate. Prevention measures to avoid contagions in indoor spaces, especially in office and public buildings (e.g., hospitals, public administration, educational centres, etc.), have led to the need for adequate ventilation to dilute the possible concentration of the virus. This article presents our contribution to this new challenge, namely the Ventilation Early Warning System (VEWS) which has aims to adapt the operation of the current Heating, Ventilating and Air Conditioning (HVAC) systems to the ventilation needs of diaphanous workspaces, based on a Smart Campus Digital Twin (SCDT) framework approach, while maintaining sustainability. Different technologies such as the Internet of Things (IoT), Building Information Modelling (BIM) and Artificial Intelligence (AI) algorithms are combined to collect and integrate monitoring data (historical records, real-time information, and location-related patterns) to carry out forecasting simulations in this digital twin. The generated outputs serve to assist facility managers in their building governance, considering the appropriate application of health measures to reduce the risk of coronavirus contagion in combination with sustainability criteria. The article also provides the results of the implementation of the VEWS in a university workspace as a case study. Its application has made it possible to detect and warn of inadequate ventilation situations for the daily flow of people in the different controlled zones.

Personal protective equipment (PPE) disposal during COVID-19: An emerging source of microplastic and microfiber pollution in the environment

Waste generated by healthcare facilities during the COVID-19 pandemic has become a new source of pollution, particularly with the widespread use of single-use personal protective equipment (PPE). Releasing microplastics (MPs) and microfibers (MFs) from discarded PPE becomes an emerging threat to environmental sustainability. MPs/MFs have recently been reported in a variety of aquatic and terrestrial ecosystems, including water, deep-sea sediments, air, and soil. As COVID-19 spreads, the use of plastic-made PPE in healthcare facilities has increased significantly worldwide, resulting in massive amounts of plastic waste entering the terrestrial and marine environments. High loads of MPs/MFs emitted into the environment due to excessive PPE consumption are easily consumed by aquatic organisms, disrupting the food chain, and potentially causing chronic health problems in humans. Thus, proper management of PPE waste is critical for ensuring a post-COVID sustainable environment, which has recently attracted the attention of the scientific community. The current study aims to review the global consumption and sustainable management of discarded PPE in the context of COVID-19. The severe impacts of PPE-emitted MPs/MFs on human health and other environmental segments are briefly addressed. Despite extensive research progress in the area, many questions about MP/MF contamination in the context of COVID-19 remain unanswered. Therefore, in response to the post-COVID environmental remediation concerns, future research directions and recommendations are highlighted considering the current MP/MF research progress from COVID-related PPE waste.

Extending the Protection Ability and Life Cycle of Medical Masks through the Washing Process

The reuse of decontaminated disposable medical face masks can contribute to reducing the environmental burden of discarded masks. This research is focused on the effect of household and laboratory washing at 50 °C on the quality and functionality of the nonwoven structure of polypropylene medical masks by varying the washing procedure, bath composition, disinfectant agent, and number of washing cycles as a basis for reusability. The barrier properties of the medical mask were analyzed before and after the first and fifth washing cycle indirectly by measuring the contact angle of the liquid droplets with the front and back surface of the mask, further by measuring air permeability and determining antimicrobial resistance. Additional analysis included FTIR, pH of the material surface and aqueous extract, as well as the determination of residual substances-surfactants-in the aqueous extract of washed versus unwashed medical masks, while their aesthetic aspect was examined by measuring their spectral characteristics. The results showed that household washing had a stronger impact on the change of some functional properties, primarily air permeability, than laboratory washing. The addition of the disinfectant agent, didecyldimethylammonium chloride, contributes to the protective ability and supports the idea that washing of medical masks under controlled conditions can preserve barrier properties and enable reusability.

Pollution free UV-C radiation to mitigate COVID-19 transmission

The high rate of transmission of the COVID-19 virus has brought various types of disinfection techniques, for instance, hydrogen peroxide vaporization, microwave generating steam, UV radiation, and dry heating, etc. to prevent the further transmission of the virus. The chemical-based techniques are predominantly used for sanitization of hands, buildings, hospitals, etc. However, these chemicals may affect the health of humans and the environment in unexplored aspects. Furthermore, the UV lamp-based radiation sanitization technique had been applied but has not gained larger acceptability owing to its limitation to penetrate different materials. Therefore, the optical properties of materials are especially important for the utilization of UV light on such disinfection applications. The germicidal or microorganism inactivation application of UV-C has only been in-use in a closed chamber, due to its harmful effect on human skin and the eye. However, it is essential to optimize UV for its use in an open environment for a larger benefit to mitigate the virus spread. In view of this, far UV-C (222 nm) based technology has emerged as a potential option for the sanitization in open areas and degradation of microorganisms present in aerosol during the working conditions. Hence, in the present review article, efforts have been made to evaluate the technical aspects of UV (under the different spectrum and wavelength ranges) and the control of COVID 19 virus spread in the atmosphere including the possibilities of the human body sanitization in working condition.

Assessment of Regional Health Resource Carrying Capacity and Security in Public Health Emergencies Based on the COVID-19 Outbreak

The Omicron variant of COVID-19, which emerged at the end of 2021, has caused a new wave of infections around the world and is causing a new wave of the crisis due to the extreme variability of the pathogen. In response to public health emergencies such as SARS and COVID-19, the first task is to identify the vulnerabilities of regional health systems and perform a comprehensive assessment of the region's resilience. In this paper, we take the carrying capacity of medical resources as the focus; evaluate the medical, human, and financial resources of various regions; and construct an epidemic safety index based on the actual situation or future trend of the epidemic outbreak to evaluate and predict the risk level of each region in response to the epidemic. The study firstly evaluates the epidemic safety index for each province and city in China and 150 countries around the world, using the first wave of the COVID-19 epidemic in 2020 and the Omicron variant virus in 2022 as the background, respectively, and justifies the index through the actual performance in terms of epidemic prevention and control, based on which the epidemic safety index for 150 countries in the next year is predicted. The conclusions show that Europe, the Americas, and parts of Asia will face a significant risk of epidemic shocks in the coming period and that countries need to formulate policies in response to the actual situation of the epidemic.

Evaluating Efficacy of a COVID-19 Alternative Care Site Preparedness Assessment Tool for Catastrophic Healthcare Surge Capacity during Pandemic Response

During the COVID-19 pandemic, implementing catastrophic healthcare surge capacity required a network of facility infrastructure beyond the immediate hospital to triage the rapidly growing numbers of infected individuals and treat emerging disease cases. Providing regional continuity-of-care requires an assessment of buildings for alternative care sites (ACS) to extend healthcare operations into non-healthcare settings. The American Institute of Architects (AIA) appointed a COVID-19 ACS Task Force involving architects, engineers, public health, and healthcare professionals to conduct a charrette (i.e., intensive workshop) to establish guidance during the alert phase of the pandemic. The task force developed an ACS Preparedness Assessment Tool (PAT) for healthcare teams to assist with their rapid evaluation of building sites for establishing healthcare operations in non-healthcare settings. The tool was quickly updated (V2.0) and then translated into multiple languages. Subsequently, the authors of this manuscript reviewed the efficacy of the PAT V2.0 in the context of reported case studies from healthcare teams who developed a COVID-19 ACS in community settings. In summary, policy makers should re-examine the role of the built environment during emergency pandemic response and its impact on patients and health professionals. An updated ACS PAT tool should be established as part of the public health preparedness for implementing catastrophic healthcare surge capacity.

Reducing Vaccinia virus transmission indoors within 60 seconds: Applying SAFEAIR-X aerosol with Iodine-V as a disinfectant

Iodine-V ((C26H39N4O15)x * (I2)y) demonstrates an in vitro virucidal activity by deactivating SARS-CoV-2 viral titers. It combines elemental iodine (I2) and fulvic acid (C14H12O8), forming a clathrate compound. The antiviral properties of Iodine-V reduce viral load in the air to inhibit viral transmission indoors. This antiviral property was applied to form a disinfectant solution called SAFEAIR-X Aerosol. The current study evaluates the antiviral efficacy of Iodine-V in aerosol form in a prototype called SAFEAIR-X Aerosol. The experiment measured the antiviral efficacy of SAFEAIR-X following exposure to the Vaccinia virus (VACV) samples as a confirmed surrogate for SARS-CoV-2. The SAFEAIR-X showed 96% effectiveness, with 2 seconds of spraying duration and 60 seconds of contact time releasing less than 0.0001 ppm of iodine into the air, and a log reduction value of 1.50 at 60 seconds in 2 out of 3 tests was observed. Therefore, this study demonstrates SAFEAIR-X aerosol as a potential indoor surface and air disinfectant.

SARS-CoV-2 airborne transmission: a review of risk factors and possible preventative measures using air purifiers

The rapid spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and the resulting worldwide death toll have prompted worries regarding its transmission mechanisms. Direct, indirect, and droplet modes are the basic mechanisms of transmission. SARS-CoV-2 spreads by respiratory droplets (size range >10 μm size ranges), aerosols (5 μm), airborne, and particulate matter. The rapid transmission of SARS-CoV-2 is due to the involvement of tiny indoor air particulate matter (PM_2.5), which functions as a vector. SARS-CoV-2 is more contagious in the indoor environment where particulate matter floats for a longer period and greater distances. Extended residence time in the environment raises the risk of SARS-CoV-2 entering the lower respiratory tract, which may cause serious infection and possibly death. To decrease viral transmission in the indoor environment, it is essential to catch and kill the SARS-CoV-2 virus and maintain virus-free air, which will significantly reduce viral exposure concerns. Therefore, effective air filters with anti-viral, anti-bacterial, and anti-air-pollutant characteristics are gaining popularity recently. It is essential to develop cost-effective materials based on nanoparticles and metal-organic frameworks in order to lower the risk of airborne transmission in developing countries. A diverse range of materials play an important role in the manufacturing of effective air filters. We have summarized in this review article the basic concepts of the transmission routes of SARS-CoV-2 virus and precautionary measures using air purifiers with efficient materials-based air filters for the indoor environment. The performance of air-filter materials, challenges and alternative approaches, and future perspectives are also presented. We believe that air purifiers fabricated with highly efficient materials can control various air pollutants and prevent upcoming pandemics.

The social ecology of COVID-19 prevalence and risk in Montreal, QC, Canada

This descriptive study examined the social ecology of COVID-19 risk exposure across Montreal (Quebec, Canada) by comparing fifteen neighborhoods with contrasting COVID-19 prevalence. Census 2016 data were combined with an online survey (n = 502) of residents living in the targeted neighborhoods. Chi-square and t-test were used to analyze the differences in sample proportions and means. As of October 1, 2020, compared to the least affected Montreal neighborhoods, the most Impacted neighborhoods had a 2.6 times higher COVID-19 prevalence (2370.9 active cases per 100,000 residents) and a 2.5 times higher death rate (260.6 deaths per 100,000 people). High prevalence neighborhoods were lower income, more highly racialized, denser, and had a larger share of public transit users than least affected neighborhoods. Compared with respondents from the least affected neighborhoods, survey respondents in high prevalence neighborhoods were more likely to report a lower income, hold at-risk occupations, live in apartment buildings, use public transit, and perceive themselves at risk of becoming infected with COVID-19 and less capable of avoiding COVID-19 transmission, but less likely to comply with stay-at-home recommendations. No significant differences between neighborhoods were found in terms of compliance with recommended COVID-19 hygiene preventive measures (mask wearing and hand washing). RESULTS: suggest that at-risk occupations and a lower capacity to avoid COVID-19 exposure, but not differences in compliance with public sanitary directives, were key factors associated with higher neighborhood prevalence of COVID-19.

Relationships between building attributes and COVID-19 infection in London

In the UK, all domestic COVID-19 restrictions have been removed since they were introduced in March 2020. After illustrating the spatial-temporal variations in COVID-19 infection rates across London, this study then particularly aimed to examine the relationships of COVID-19 infection rates with building attributes, including building density, type, age, and use, since previous studies have shown that the built environment plays an important role in public health. Multisource data from national health services and the London Geomni map were processed with GIS techniques and statistically analysed. From March 2020 to April 2022, the infection rate of COVID-19 in London was 3,159.28 cases per 10,000 people. The spatial distribution across London was uneven, with a range from 1,837.88 to 4,391.79 per 10,000 people. During this period, it was revealed that building attributes played a significant role in COVID-19 infection. It was noted that higher building density areas had lower COVID-19 infection rates in London. Moreover, a higher percentage of historic or flat buildings tended to lead to a decrease in infection rates. In terms of building use, the rate of COVID-19 infection tended to be lower in public buildings and higher in residential buildings. Variations in the infection rate were more sensitive to building type; in particular, the percentage of residents living in flats contributed the most to variations in COVID-19 infection rates, with a value of 2.3%. This study is expected to provide support for policy and practice towards pandemic-resilient architectural design.

Lessons learnt for enhancing hospital resilience to pandemics: A qualitative analysis from Italy

The COVID-19 pandemic has outlined the need to strengthen the resilience of healthcare systems. It has cost millions of human lives and has had indirect health impacts too. Hospital buildings have undergone extensive modifications and adaptations to ensure infection control and prevention measures, and, as it is happened following past epidemics, the COVID-19 experience might change the design of hospital buildings in the future. This paper aims to capitalise on the knowledge developed by the stakeholders directly involved with the hospital response during the pandemic to generate new evidence that will enhance resilience of hospital buildings to pandemics. The research adopted qualitative research methods, namely literature review and interviews with Italian experts including doctors and facility managers to collect data which were analysed through a thematic analysis. The findings include the identification of new needs for hospital buildings and the related actions to be taken or already performed at hospital building and service level which are viable for long term implementation and are aimed at improving hospital resilience to pandemics. The results specify how to improve resilience by means of structural modifications (e.g. placing filter zones among different wards, ensuring the presence of airborne infection isolation rooms at least in the emergency departments), technological changes (e.g. oversizing capacity such as medical gases, information technology improvement for delivering healthcare services remotely), and operational measures (e.g. assessing the risk of infection before admission, dividing acute-care from low-care assets). The needs discussed in this paper substantiate the urge to renovate the Italian healthcare infrastructures and they can be considered useful elements of knowledge for enhancing hospital resilience to pandemics in the extended and in the post-COVID-19 era.

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.

Social Factors Contributing to Healthcare Service Requirements during the First COVID-19 Lockdown among Older Adults

This study examined social characteristics and their relations to healthcare service demand among older adults during the first COVID-19 lockdown in 2020. The sample was based on a cohort of 103,955 adults over the age of 65. A general index of needs was composed based on healthcare service use data and was predicted in a multi-nominal logistic regression. The frequency of the total needs significantly (p < 0.000) declined while supportive community services (4.9%, 2.0%), living in a community framework (27.0%, 15.2%), and living in a private residence (29.7%, 20.1%) were significantly associated (p < 0.000) with less frequent needs compared to the complementary groups. Supportive communities turned out to be an extremely important service for older adults. Policy makers should consider expanding supportive community services for older adults, as it was shown to have a positive correlation with lower healthcare service use, which might be an indicator of better overall health.

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 Quantitative Risk Estimation Platform for Indoor Aerosol Transmission of COVID-19

Aerosol transmission has played a significant role in the transmission of COVID-19 disease worldwide. We developed a COVID-19 aerosol transmission risk estimation model to better understand how key parameters associated with indoor spaces and infector emissions affect inhaled deposited dose of aerosol particles that convey the SARS-CoV-2 virus. The model calculates the concentration of size-resolved, virus-laden aerosol particles in well-mixed indoor air challenged by emissions from an index case(s). The model uses a mechanistic approach, accounting for particle emission dynamics, particle deposition to indoor surfaces, ventilation rate, and single-zone filtration. The novelty of this model relates to the concept of "inhaled & deposited dose" in the respiratory system of receptors linked to a dose-response curve for human coronavirus HCoV-229E. We estimated the volume of inhaled & deposited dose of particles in the 0.5-4 μm range expressed in picoliters (pL) in a well-documented COVID-19 outbreak in restaurant X in Guangzhou China. We anchored the attack rate with the dose-response curve of HCoV-229E which provides a preliminary estimate of the average SARS-CoV-2 dose per person, expressed in plaque forming units (PFUs). For a reasonable emission scenario, we estimate approximately three PFU per pL deposited, yielding roughly 10 PFUs deposited in the respiratory system of those infected in restaurant X. To explore the model's utility, we tested it with four COVID-19 outbreaks. The risk estimates from the model fit reasonably well with the reported number of confirmed cases given available metadata from the outbreaks and uncertainties associated with model assumptions.

Implications of the COVID-19 pandemic for urban informal housing and planning interventions: Evidence from Singapore

The outbreak of the COVID-19 pandemic revealed the crucial role of social distancing and hygiene practices in reducing virus transmission and thus revealed the high risk of infection in urban informal housing. Through an empirical study of Singapore's infectious situation and antiepidemic measures, this paper shows that the number of infected migrant workers living in dormitories was three hundred times greater than the number of infected local urban residents, not only because of the migrants' 'vulnerable' position but also because their living conditions fostered widespread transmission of the virus. The dwelling conditions of migrant dormitories, such as overcrowded living spaces, widely shared sanitation facilities, and poor hygiene practices, present great challenges to standard prevention strategies and control measures. Adverse health impacts resulting from the lockdown of dormitories during the COVID-19 pandemic suggest the importance of planning intervention in the dwelling conditions of informal housing, and indicate a need for the governments' active reforms of building codes and health care systems to promote the health of disadvantaged groups and then create more inclusive and healthy cities for all the society.

Health and environment from adaptation to adaptivity: a situated relational account

The definitions and conceptualizations of health, and the management of healthcare have been challenged by the current global scenarios (e.g., new diseases, new geographical distribution of diseases, effects of climate change on health, etc.) and by the ongoing scholarship in humanities and science. In this paper we question the mainstream definition of health adopted by the WHO-'a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity' (WHO in Preamble to the constitution of the World Health Organization as adopted by the international health conference, The World Health Organization, 1948)-and its role in providing tools to understand what health is in the contemporary context. More specifically, we argue that this context requires to take into account the role of the environment both in medical theory and in the healthcare practice. To do so, we analyse WHO documents dated 1984 and 1986 which define health as 'coping with the environment'. We develop the idea of 'coping with the environment', by focusing on two cardinal concepts: adaptation in public health and adaptivity in philosophy of biology. We argue that the notions of adaptation and adaptivity can be of major benefit for the characterization of health, and have practical implications. We explore some of these implications by discussing two recent case studies of adaptivity in public health, which can be valuable to further develop adaptive strategies in the current pandemic scenario: community-centred care and microbiologically healthier buildings.

Optimized mechanism for fast removal of infectious pathogen-laden aerosols in the negative-pressure unit

It has been frequently emphasized that highly contagious respiratory disease pathogens (such as SARS-CoV-2) are transmitted to the other hosts in the form of micro-sized aerosols (< 5 μm) in the air without physical contacts. Hospital environments such as negative-pressure unit are considered being consistently exposed to pathogens, so it is essential to quickly discharge them through the effective ventilation system. To achieve that, in the present study, we propose the optimized ventilation mechanism and design for the fastest removal of pathogen-laden aerosol using numerical simulations. We quantitatively evaluated the aerosol removal performance of various ventilation configurations (combinations of air exhaust and supply ducts), and found that the key mechanism is to form the coherent (preferentially upward) airflow structure to surround the respiratory flow containing the aerosol cluster. We believe that the present findings will play a critical role in developing the high-efficiency negative-pressure facility irrespective of its size and environments.

Improving the Effectiveness of Anti-COVID Measures in Buildings: Learning from Users’ Perception

The COVID-19 spread abruptly changed the fruition of indoor environments, where necessary adaptive measures have since been implemented. Buildings open to the public were suddenly equipped with physical devices aiming to encourage users’ appropriate behaviors, such as hand sanitizing, social distancing, and temperature monitoring. Through a twofold architectural-psychological perspective, the paper presents a research aiming to understand how users perceive these devices in the Italian context and to identify the design features that could improve their effectiveness in enhancing individuals’ awareness. With an interdisciplinary approach, four methods were adopted: observational field surveys, background and normative framework analysis, survey research through an online questionnaire, and case studies survey research. The results confirm the overall effectiveness of the implemented anti-COVID strategies, their suitability in encouraging individuals’ appropriate behaviors, and the importance of regulating the users’ flow indoors. The research allowed defining the devices (hand-sanitizing devices and temperature-measurement instruments) and wayfinding systems more suited to be included in the prevention strategy and identified their more appropriate design features in relation to the users’ feedback. Operational suggestions are presented as well. The adopted experimental approach can be useful in supporting decision making in managing of the built environment in both the current and future contexts.

Childcare Issues and the Pandemic: Working Women’s Experiences in the Face of COVID-19

Purpose: The COVID-19 pandemic has drastically impacted everyday life. Not only has it assailed the world’s populations with millions of deaths and cases, but COVID-19 has also ravaged global economies and affected the lives of women and their children. The purpose of this study was to detail women’s experiences during the COVID-19 pandemic and the solutions they came up with to deal with the problems they encountered. Method: Data collection occurred in the midwestern United States, in the State of Indiana, from August 2020 to August 2021. Sixty-six women participated in the study. The study used open-ended survey questions. The data results were combined, analyzed, and constructed into themes based on their similarity in their subject matter. The researchers identified four main themes. Findings and Conclusion: Results indicated that, for some of the mothers, it was a struggle to be at home with their children at all times. Unique experiences faced by some expectant mothers who were already mothers, and thus had the experience of prenatal care pre-COVID-19, had to grapple with the fact that they were not allowed to come to their prenatal appointments with anyone. Participants complained about cooking all the time, with some needing to use the internet to look for new recipes. Poor eating habits by some children during the pandemic led to some parents needing to come up with a schedule for family members regarding breakfast, lunch, dinner, and snacks to curtail the COVID-19-related acquired poor eating habits. A shared experience from the study revolved around childcare policies and schedules. The results suggested that enacting a paid childcare leave, developing flexible working hours, and changing how employers conduct work reviews are critical to alleviating some of the burdens working women face during school closures during the pandemic. Finally, participants suggested identifying better ways to provide and prioritize childcare to lessen gender inequalities within the workforce.

A Review on Risk Management of Coronavirus Disease 19 (COVID-19) Infection in Dental Practice: Focus on Prosthodontics and All-Ceramic Materials

Background: A novel β-coronavirus infection (COVID-19) was first detected in Wuhan city, spreading rapidly to other countries and leading to a pandemic. Dental professionals and patients are exposed to a high risk of COVID-19 infection, particularly in the prosthodontic practice, because of the bio-aerosol produced during teeth preparation with dental handpieces and the strict contact with oral fluids during impression making. This paper aimed to provide an overview to limit the risk of transmission of COVID-19 infections during prosthetic procedures in dental offices. Methods: An electronic search was conducted on the electronic databases of PubMed/Medline, Google Scholar, Embase, Scopus, Dynamed, and Open Grey with the following queries: (COVID-19) AND/OR (SARS-CoV-2) AND/OR (Coronavirus) AND/OR (contaminated surface) AND/OR (cross-infection) AND/OR (Prosthodontics) AND/OR (dental ceramic) AND/OR (glass-ceramic). A manual search was performed as well. Results: From the 1023 collected records, 32 papers were included. Conclusions: Dental offices are at high risk of spreading SARS-CoV-2 infection due to the close contact with patients and continuous exposure to saliva during dental procedures. Therefore, pre-check triages via telephone, decontamination, the disinfection of impressions, the sterilization of scanner tips, and the use of specific personal protective equipment, dental high-speed handpieces with dedicated anti-retraction valves, and effective mouthwashes are strongly recommended.

Influence of indoor airflow on particle spread of a single breath and cough in enclosures: Does opening a window really 'help'?

The spread of respiratory diseases via aerosol particles in indoor settings is of significant concern. The SARS-CoV-2 virus has been found to spread widely in confined enclosures like hotels, hospitals, cruise ships, prisons, and churches. Particles exhaled from a person indoors can remain suspended long enough for increasing the opportunity for particles to spread spatially. Careful consideration of the ventilation system is essential to minimise the spread of particles containing infectious pathogens. Previous studies have shown that indoor airflow induced by opened windows would minimise the spread of particles. However, how outdoor airflow through an open window influences the indoor airflow has not been considered. The aim of this study is to provide a clear understanding of the indoor particle spread across multiple rooms, in a situation similar to what is found in quarantine hotels and cruise ships, using a combination of HVAC (Heating, Ventilation and Air-Conditioning) ventilation and an opening window. Using a previously validated mathematical model, we used 3D CFD (computational fluid dynamics) simulations to investigate to what extent different indoor airflow scenarios contribute to the transport of a single injection of particles ( 1 . 3 μ m ) in a basic 3D multi-room indoor environment. Although this study is limited to short times, we demonstrate that in certain conditions approximately 80% of the particles move from one room to the corridor and over 60% move to the nearby room within 5 to 15 s. Our results provide additional information to help identifying relevant recommendations to limit particles from spreading in enclosures.

Measurement of contagion spatial spread probability in public places: A case study on COVID-19

The scale and scope of the COVID-19 epidemic have highlighted the need for timely control of viral transmission. This paper proposed a new spatial probability model of epidemic infection using an improved Wasserstein distance algorithm and Monte Carlo simulation. This method identifies the public places in which COVID-19 spreads and grows easily. The Wasserstein Distance algorithm is used to calculate the distribution similarity between COVID-19 cases and the public places. Further, we used hypothesis tests and Monte Carlo simulation to estimate the spatial spread probability of COVID-19 in different public places. We used Snow's data to test the stability and accuracy of this measurement. This verification proved that our method is reliable and robust. We applied our method to the detailed geographic data of COVID-19 cases and public places in Wuhan. We found that, rather than financial service institutions and markets, public buildings such as restaurants and hospitals in Wuhan are 95 percent more likely to be the public places of COVID-19 spread.

Amassing the Covid-19 driven PPE wastes in the dwelling environment of Chittagong Metropolis and associated implications

This study investigates the Covid-19 driven indiscriminate disposal of PPE wastes (mostly face mask and medical wastes) in Chittagong metropolitan area (CMA), Bangladesh. Based on the field monitoring, the mean PPE density (PPE/m2± SD) was calculated to be 0.0226 ± 0.0145, 0.0164 ± 0.0122, and 0.0110 ± 0.00863 for July, August, and September 2021, respectively (during the peak time of Covid-19 in Bangladesh). Moreover, gross information on PPE waste generation in the city was calculated using several parameters such as population density, face mask acceptance rate by urban population, total Covid-19 confirmed cases, quarantined and isolated patients, corresponding medical waste generation rate (kg/bed/day), etc. Moreover, the waste generated due to face mask and other PPEs in the CMA during the whole Covid-19 period (April 4, 2020 to September 5, 2021) were calculated to be 64183.03 and 128695.75 tons, respectively. It has been observed that the negligence of general people, lack of awareness about environmental pollution, and poor municipal waste management practices are the root causes for the contamination of the dwelling environment by PPE wastes. As a result, new challenges have emerged in solid waste management, which necessitates the development of an appropriate waste management strategy. The ultimate policies and strategies may help to achieve the SDG goals 3, 6, 11, 12, 13, and 15, and increase public perception on the use and subsequent disposal of PPEs, especially face masks.

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.

Geographies of infections: built environment and COVID-19 pandemic in metropolitan Melbourne

This paper uses spatial statistical techniques to reflect on geographies of COVID-19 infections in metropolitan Melbourne. We argue that the evolution of the COVID-19 pandemic, which has become widespread since early 2020 in Melbourne, typically proceeds through multiple built environment attributes - diversity, destination accessibility, distance to transit, design, and density. The spread of the contagion is institutionalised within local communities and postcodes, and reshapes movement practices, discourses, and structures of administrative politics. We demonstrate how a focus on spatial patterns of the built environment can inform scholarship on the spread of infections associated with COVID-19 pandemic and geographies of infections more broadly, by highlighting the consistency of built environment influences on COVID-19 infections across three waves of outbreaks. A focus on the built environment influence seeks to enact visions of the future as new variants emerge, illustrating the importance of understanding geographies of infections as global cities adapt to 'COVID-normal' living. We argue that understanding geographies of infections within cities could be a springboard for pursuing sustainable urban development via inclusive compact, mixed-use development and safe public transport.

Rethinking Outdoor Courtyard Spaces on University Campuses to Enhance Health and Wellbeing: The Anti-Virus Built Environment

Responding to the events surrounding the COVID-19 pandemic, this study explores how to improve health and wellbeing and reduce infections in outdoor open spaces on university campuses to maximize their potential as a response to future crises. The study identifies the relationship between human behavior (social) and the various physical and environmental elements of these spaces. A case study and mixed-methods approach were undertaken, comprising four modes of inspection: user analysis layer using questionnaires and observations to survey students’ needs and behavior; context analysis layer using space syntax and CFD to examine the space’s physical and environmental conditions; design solutions reflecting an understanding of virus transmission; and a performance analysis layer to test the performance of ‘anti-virus’ courtyards. The findings demonstrated that students are willing to use the open spaces that they used before the pandemic, at the same frequency. This indicates a need to redesign the current spaces to prevent the spread of viruses. The study highlights the social, physical, and environmental implications to be considered in designs for outdoor anti-virus spaces. It provides a comprehensive process for transforming outdoor spaces on university campuses into anti-virus spaces that meet users’ needs. These findings have implications for the designing and retrofitting of open spaces to reduce infection.