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Alqarni Z, Rezgui Y, Petri I, Ghoroghi A. Viral infection transmission and indoor air quality: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171308. [PMID: 38432379 DOI: 10.1016/j.scitotenv.2024.171308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 02/03/2024] [Accepted: 02/25/2024] [Indexed: 03/05/2024]
Abstract
Respiratory disease transmission in indoor environments presents persistent challenges for health authorities, as exemplified by the recent COVID-19 pandemic. This underscores the urgent necessity to investigate the dynamics of viral infection transmission within indoor environments. This systematic review delves into the methodologies of respiratory infection transmission in indoor settings and explores how the quality of indoor air (IAQ) can be controlled to alleviate this risk while considering the imperative of sustainability. Among the 2722 articles reviewed, 178 were retained based on their focus on respiratory viral infection transmission and IAQ. Fifty eight articles delved into SARS-CoV-2 transmission, 21 papers evaluated IAQ in contexts of other pandemics, 53 papers assessed IAQ during the SARS-CoV-2 pandemic, and 46 papers examined control strategies to mitigate infectious transmission. Furthermore, of the 46 papers investigating control strategies, only nine considered energy consumption. These findings highlight clear gaps in current research, such as analyzing indoor air and surface samples for specific indoor environments, oversight of indoor and outdoor parameters (e.g., temperature, relative humidity (RH), and building orientation), neglect of occupancy schedules, and the absence of considerations for energy consumption while enhancing IAQ. This study distinctly identifies the indoor environmental conditions conducive to the thriving of each respiratory virus, offering IAQ trade-offs to mitigate the risk of dominant viruses at any given time. This study argues that future research should involve digital twins in conjunction with machine learning (ML) techniques. This approach aims to enhance IAQ by analyzing the transmission patterns of various respiratory viruses while considering energy consumption.
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Affiliation(s)
- Zahi Alqarni
- School of Engineering, Cardiff University, Cardiff CF24 3AA, UK; School of Computer Science, King Khalid University, Abha 62529, Saudi Arabia.
| | - Yacine Rezgui
- School of Engineering, Cardiff University, Cardiff CF24 3AA, UK
| | - Ioan Petri
- School of Engineering, Cardiff University, Cardiff CF24 3AA, UK
| | - Ali Ghoroghi
- School of Engineering, Cardiff University, Cardiff CF24 3AA, UK
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Das JK, Chee HY, Lakhani S, Khan MH, Islam M, Muhammad S, Bhutta ZA. COVID-19 Vaccines: How Efficient and Equitable Was the Initial Vaccination Process? Vaccines (Basel) 2022; 11:vaccines11010011. [PMID: 36679856 PMCID: PMC9862832 DOI: 10.3390/vaccines11010011] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 12/03/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
With nearly 11 billion doses of the COVID-19 vaccine being administered, stark differences in the vaccination rates persist. Vaccine distribution initiatives such as COVAX and African Vaccine Acquisition Trust (AVAT) were formed to ensure equitable vaccine delivery. This review evaluates the initial COVID-19 vaccination efforts and the impact of different vaccine distribution initiatives on equitable vaccination coverage in the early phase. We conducted a descriptive and trend analysis with sub-groups by various context parameters of data on COVID-19 vaccination from December 2020 till February 2022, from four public databases including UNICEF, WHO, COVID-19 Task Force and Our World in Data to examine COVID-19 vaccine distribution progress and the contributions of vaccine procurement initiatives. We found that High Income Countries (HICs) had much higher vaccination rate (78.4%) than Lower-Middle-Income Countries (LMICs) (55.5%) and Low-Income Countries (LICs) (10.9%). Large differentials (>80% to <10%) in the vaccination rates of eligible population of adults in LMICs and LICs existed. Differentials in the total vaccine doses delivered to each country ranged from 355.6% to 4.8% of the total population. In LICs, 53.3% of the total doses were obtained via COVAX, 30.9% by bilateral/multilateral agreements, 6.5% by donations and 3.8% by AVAT. In LMICs, 56.4% of total vaccines procured were via bilateral/multilateral agreements, 21.4% by COVAX, 4.2% by donations and 0.5% by AVAT. COVAX delivered 1 billion doses by January 2022 which constituted 53.2% and 21.4% of procured doses in LICs and LMICs. In LICs and LMICs, 6.5% and 4.2% of total doses were acquired through donations while 30.9% and 56.4% of doses were purchased. Despite global efforts, significant disparities were present in COVID-19 vaccination efforts amongst countries of different income groups. Future efforts should focus on addressing vaccine inequities explicitly and in improving global vaccine distribution.
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Affiliation(s)
- Jai K. Das
- Institute of Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi 74000, Pakistan
| | - Hsien Yao Chee
- Global Health Research Center and Division of Natural and Applied Sciences, Duke Kunshan University, Kunshan 215316, China
- Center of Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Sohail Lakhani
- Institute of Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Maryam Hameed Khan
- Institute of Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
| | - Muhammad Islam
- Center of Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
| | - Sajid Muhammad
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi 74000, Pakistan
| | - Zulfiqar A. Bhutta
- Institute of Global Health and Development, Aga Khan University, Karachi 74800, Pakistan
- Center of Excellence in Women and Child Health, Aga Khan University, Karachi 74000, Pakistan
- Center of Global Child Health, The Hospital for Sick Children, Toronto, ON M5G 1X8, Canada
- Correspondence: ; Tel.: (+1)-416-813-7654-x-328532
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Oksanen L, Auvinen M, Kuula J, Malmgren R, Romantschuk M, Hyvärinen A, Laitinen S, Maunula L, Sanmark E, Geneid A, Sofieva S, Salokas J, Veskiväli H, Sironen T, Grönholm T, Hellsten A, Atanasova N. Combining Phi6 as a surrogate virus and computational large-eddy simulations to study airborne transmission of SARS-CoV-2 in a restaurant. INDOOR AIR 2022; 32:e13165. [PMID: 36437671 PMCID: PMC10100099 DOI: 10.1111/ina.13165] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 09/30/2022] [Accepted: 10/08/2022] [Indexed: 05/18/2023]
Abstract
COVID-19 has highlighted the need for indoor risk-reduction strategies. Our aim is to provide information about the virus dispersion and attempts to reduce the infection risk. Indoor transmission was studied simulating a dining situation in a restaurant. Aerosolized Phi6 viruses were detected with several methods. The aerosol dispersion was modeled by using the Large-Eddy Simulation (LES) technique. Three risk-reduction strategies were studied: (1) augmenting ventilation with air purifiers, (2) spatial partitioning with dividers, and (3) combination of 1 and 2. In all simulations infectious viruses were detected throughout the space proving the existence long-distance aerosol transmission indoors. Experimental cumulative virus numbers and LES dispersion results were qualitatively similar. The LES results were further utilized to derive the evolution of infection probability. Air purifiers augmenting the effective ventilation rate by 65% reduced the spatially averaged infection probability by 30%-32%. This relative reduction manifests with approximately 15 min lag as aerosol dispersion only gradually reaches the purifier units. Both viral findings and LES results confirm that spatial partitioning has a negligible effect on the mean infection-probability indoors, but may affect the local levels adversely. Exploitation of high-resolution LES jointly with microbiological measurements enables an informative interpretation of the experimental results and facilitates a more complete risk assessment.
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Affiliation(s)
- Lotta Oksanen
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | | | - Joel Kuula
- Finnish Meteorological InstituteHelsinkiFinland
| | - Rasmus Malmgren
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Martin Romantschuk
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiLahtiFinland
| | | | | | - Leena Maunula
- Faculty of Veterinary Medicine, Food Hygiene and Environmental HealthUniversity of HelsinkiHelsinkiFinland
| | - Enni Sanmark
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Ahmed Geneid
- Department of Otorhinolaryngology and Phoniatrics – Head and Neck SurgeryHelsinki University HospitalHelsinkiFinland
- Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
| | - Svetlana Sofieva
- Finnish Meteorological InstituteHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Julija Salokas
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Helin Veskiväli
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
| | - Tarja Sironen
- Department of Virology, Faculty of MedicineUniversity of HelsinkiHelsinkiFinland
- Department of Veterinary Biosciences, Faculty of Veterinary MedicineUniversity of HelsinkiHelsinkiFinland
| | | | | | - Nina Atanasova
- Finnish Meteorological InstituteHelsinkiFinland
- Faculty of Biological and Environmental SciencesUniversity of HelsinkiHelsinkiFinland
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Kuhfeldt K, Turcinovic J, Sullivan M, Landaverde L, Doucette-Stamm L, Hamer DH, Platt JT, Klapperich C, Landsberg HE, Connor JH. Examination of SARS-CoV-2 In-Class Transmission at a Large Urban University With Public Health Mandates Using Epidemiological and Genomic Methodology. JAMA Netw Open 2022; 5:e2225430. [PMID: 35930286 PMCID: PMC9356317 DOI: 10.1001/jamanetworkopen.2022.25430] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/20/2023] Open
Abstract
IMPORTANCE SARS-CoV-2, the causative agent of COVID-19, has displayed person-to-person transmission in a variety of indoor situations. This potential for robust transmission has posed significant challenges and concerns for day-to-day activities of colleges and universities where indoor learning is a focus for students, faculty, and staff. OBJECTIVE To assess whether in-class instruction without any physical distancing, but with other public health mitigation strategies, is a risk for driving SARS-CoV-2 transmission. DESIGN, SETTING, AND PARTICIPANTS This cohort study examined the evidence for SARS-CoV-2 transmission on a large urban US university campus using contact tracing, class attendance, and whole genome sequencing during the 2021 fall semester. Eligible participants were on-campus and off-campus individuals involved in campus activities. Data were analyzed between September and December 2021. EXPOSURES Participation in class and work activities on a campus with mandated vaccination and indoor masking but that was otherwise fully open without physical distancing during a time of ongoing transmission of SARS-CoV-2, both at the university and in the surrounding counties. MAIN OUTCOMES AND MEASURES Likelihood of in-class infection was assessed by measuring the genetic distance between all potential in-class transmission pairings using polymerase chain reaction testing. RESULTS More than 600 000 polymerase chain reaction tests were conducted throughout the semester, with 896 tests (0.1%) showing detectable SARS-CoV-2; there were over 850 cases of SARS-CoV-2 infection identified through weekly surveillance testing of all students and faculty on campus during the fall 2021 semester. The rolling mean average of positive tests ranged between 4 and 27 daily cases. Of more than 140 000 in-person class events and a total student population of 33 000 between graduate and undergraduate students, only 9 instances of potential in-class transmission were identified, accounting for 0.0045% of all classroom meetings. CONCLUSIONS AND RELEVANCE In this cohort study, the data suggested that under robust transmission abatement strategies, in-class instruction was not an appreciable source of disease transmission.
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Affiliation(s)
- Kayla Kuhfeldt
- Student Health Services, Boston University, Boston, Massachusetts
| | - Jacquelyn Turcinovic
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts
- Program in Bioinformatics, Boston University, Boston, Massachusetts
| | - Madison Sullivan
- Student Health Services, Boston University, Boston, Massachusetts
| | - Lena Landaverde
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, Massachusetts
- Boston University Clinical Testing Laboratory, Research Department, Boston University, Boston, Massachusetts
| | - Lynn Doucette-Stamm
- Boston University Clinical Testing Laboratory, Research Department, Boston University, Boston, Massachusetts
| | - Davidson H. Hamer
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts
- Department of Global Health, Boston University School of Public Health, Boston, Massachusetts
- Section of Infectious Disease, Department of Medicine, Boston University School of Medicine; Boston, Massachusetts
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, Massachusetts
| | - Judy T. Platt
- Student Health Services, Boston University, Boston, Massachusetts
| | - Catherine Klapperich
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, Massachusetts
| | | | - John H. Connor
- Department of Microbiology, Boston University School of Medicine, Boston, Massachusetts
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, Massachusetts
- Program in Bioinformatics, Boston University, Boston, Massachusetts
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, Massachusetts
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Afful AE, Osei Assibey Antwi ADD, Ayarkwa J, Acquah GKK. Impact of improved indoor environment on recovery from COVID-19 infections: a review of literature. FACILITIES 2022. [DOI: 10.1108/f-02-2022-0021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
This study aims to explore the impact of the indoor environment on recovery from COVID-19 infections. Extant literature on the impact of the four key themes of the indoor environment (indoor air quality, indoor thermal quality, daylighting and visual comfort, and acoustic comfort) on COVID-19 infection and recovery rates were reviewed.
Design/methodology/approach
Data collection for this study was based on extant literature within the Scopus database and scoped to a time frame of 2020–2021 because the topical issue of indoor environmental quality (IEQ) and its impact on COVID-19 arose in the wake of the pandemic. In total, 224 documents were systematically desk reviewed from various journals.
Findings
The study identified that air pollutants such as PM2.5 and PM10 as well as air-conditioned places, low ambient temperatures, poor ventilation and no views of the outdoor environment were deteriorating factors for COVID-19 patients. On the other hand, proper ventilation, the use of air cleaners, views of the outdoor environment and allowance for ample daylighting were improvement factors for COVID-19 patients. The inter-relationship of the various concepts was presented in an ontology chart.
Practical implications
As COVID-19 still exists and keeps evolving, this study provides suggestions to industry professionals, especially health-care Facility Managers, to create a post-pandemic environment focusing on the IEQ and finding long-term and reliable solutions for the well-being of occupants. Adaptability is crucial. New, creative technology solutions are being introduced daily, but it is up to the facility managers and health-care professionals to analyse and specify the most cost- and outcome-effective technologies for their facility.
Originality/value
The study brought to light the pivotal role of the indoor environment on the health and well-being of occupants, particularly in the contraction, spread, prevention and control of infectious diseases such as COVID-19.
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Kuhfeldt K, Turcinovic J, Sullivan M, Landaverde L, Doucette-Stamm L, Hamer DH, Platt J, Klapperich C, Landsberg HE, Connor JH. Minimal SARS-CoV-2 classroom transmission at a large urban university experiencing repeated into campus introduction. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2022:2022.03.16.22271983. [PMID: 35313596 PMCID: PMC8936094 DOI: 10.1101/2022.03.16.22271983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
SARS-CoV-2, the causative agent of COVID-19, has displayed person to person transmission in a variety of indoor situations. This potential for robust transmission has posed significant challenges to day-to-day activities of colleges and universities where indoor learning is a focus. Concerns about transmission in the classroom setting have been of concern for students, faculty and staff. With the simultaneous implementation of both non-pharmaceutical and pharmaceutical control measures meant to curb the spread of the disease, defining whether in-class instruction without any physical distancing is a risk for driving transmission is important. We examined the evidence for SARS-CoV-2 transmission on a large urban university campus that mandated vaccination and masking but was otherwise fully open without physical distancing during a time of ongoing transmission of SARS-CoV-2 both at the university and in the surrounding counties. Using weekly surveillance testing of all on-campus individuals and rapid contact tracing of individuals testing positive for the virus we found little evidence of in-class transmission. Of more than 140,000 in-person class events, only nine instances of potential in-class transmission were identified. When each of these events were further interrogated by whole-genome sequencing of all positive cases significant genetic distance was identified between all potential in-class transmission pairings, providing evidence that all individuals were infected outside of the classroom. These data suggest that under robust transmission abatement strategies, in-class instruction is not an appreciable source of disease transmission.
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Affiliation(s)
- Kayla Kuhfeldt
- Student Health Services, Boston University, Boston, MA USA
| | - Jacquelyn Turcinovic
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Program in Bioinformatics, Boston University, Boston, MA, USA
| | | | - Lena Landaverde
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, MA, USA
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, MA
| | - Lynn Doucette-Stamm
- BU Clinical Testing Laboratory, Research Department, Boston University, Boston, MA
| | - Davidson H Hamer
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Department of Global Health, Boston University School of Public Health, Boston, MA
- Section of Infectious Disease, Department of Medicine, Boston University School of Medicine; Boston, MA
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, MA
| | - Judy Platt
- Department of Global Health, Boston University School of Public Health, Boston, MA
| | - Catherine Klapperich
- Department of Biomedical Engineering and Precision Diagnostics Center, Boston University, Boston, MA, USA
| | | | - John H Connor
- Department of Microbiology, Boston University School of Medicine, Boston, MA, USA
- National Emerging Infectious Diseases Laboratories, Boston University, Boston, MA, USA
- Program in Bioinformatics, Boston University, Boston, MA, USA
- Center for Emerging Infectious Disease Research and Policy, Boston University, Boston, MA
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Arpino F, Grossi G, Cortellessa G, Mikszewski A, Morawska L, Buonanno G, Stabile L. Risk of SARS-CoV-2 in a car cabin assessed through 3D CFD simulations. INDOOR AIR 2022; 32:e13012. [PMID: 35347787 PMCID: PMC9111293 DOI: 10.1111/ina.13012] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/09/2022] [Accepted: 02/18/2022] [Indexed: 05/26/2023]
Abstract
In this study, the risk of infection from SARS-CoV-2 Delta variant of passengers sharing a car cabin with an infected subject for a 30-min journey is estimated through an integrated approach combining a recently developed predictive emission-to-risk approach and a validated CFD numerical model numerically solved using the open-source OpenFOAM software. Different scenarios were investigated to evaluate the effect of the infected subject position within the car cabin, the airflow rate of the HVAC system, the HVAC ventilation mode, and the expiratory activity (breathing vs. speaking). The numerical simulations here performed reveal that the risk of infection is strongly influenced by several key parameters: As an example, under the same ventilation mode and emitting scenario, the risk of infection ranges from zero to roughly 50% as a function of the HVAC flow rate. The results obtained also demonstrate that (i) simplified zero-dimensional approaches limit proper evaluation of the risk in such confined spaces, conversely, (ii) CFD approaches are needed to investigate the complex fluid dynamics in similar indoor environments, and, thus, (iii) the risk of infection in indoor environments characterized by fixed seats can be in principle controlled by properly designing the flow patterns of the environment.
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Affiliation(s)
- Fausto Arpino
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoFRItaly
| | - Giorgio Grossi
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoFRItaly
| | - Gino Cortellessa
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoFRItaly
| | - Alex Mikszewski
- International Laboratory for Air Quality and HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Lidia Morawska
- International Laboratory for Air Quality and HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Giorgio Buonanno
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoFRItaly
- International Laboratory for Air Quality and HealthQueensland University of TechnologyBrisbaneQueenslandAustralia
| | - Luca Stabile
- Department of Civil and Mechanical EngineeringUniversity of Cassino and Southern LazioCassinoFRItaly
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