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https://www.bmj.com/content/370/bmj.m3206) (https://www.nytimes.com/2020/07/30/health/diamond-princess-coronavirus-aerosol.html)


Something in the air


Dr Rhys Thomas, Chief Scientific Officer at infection mitigation specialist PP-L and a frontline NHS doctor, says the lack of encouragement to reduce airborne transmission of COVID-19 is a major oversight.


With the roadmap laid out for the government to lead us out of lockdown, the end of the pandemic seems as though it could be in sight. However, there is a worry that COVID-19 can still spread quickly and easily through air vents, mitigating the effects of lockdowns and vaccinations.


By failing to follow the lead of other nations that are now recognising the importance of ventilation in relation to the airborne nature of the virus, the UK’s approach hasn’t been as comprehensive or as forceful as it could be, with quietly introduced, piecemeal changes to regulations being too little, too late.


At the moment, some governments don’t want to come out and admit that COVID-19 is an airborne hazard and that their failure to recognise it as such has led to higher infection and mortality rates and suffered even greater impacts from new variants.


Research shows that 80% of the spread of the virus is through airborne transmission indoors – the inhalation of infected droplets that are moving around in the room’s air currents or ventilation systems – which a two-metre distance or the opening of a window is unlikely to combat.


The airborne nature of COVID-19 is what has caught governments off guard, and meant we are still playing catch-up while new variants are starting to appear, which was also always to be expected. In terms of preparedness, the UK was geared up for an influenza-like pandemic rather than an airborne one, such as the challenge posed by a SARS coronavirus.


As with all airborne illnesses, the greatest risk of transmission is indoors and in confined spaces such as public transport, office buildings, factories, and even potentially the new quarantine hotels which are being introduced to prevent the spread of the virus. The government’s ‘Hands, Face, Space’ messaging covers the opening of windows to help with airflow, but the reality is much more complex.


The risk of infection indoors is vastly higher than outside, and current advice simply isn’t enough. There’s a perception – even in hospitals – that fresh air is clean air. I’ve been shocked to see hospitals that I’ve visited assuming that simply opening a window is enough.


That is simply not the case – the air needs to be disinfected by ultraviolet light for it to be clean enough to prevent the spread of coronaviruses.


56 | INFECTION CONTROL


I saw this in practice in the first SARS pandemic in 2003, where UV was used and proved incredibly effective in South East Asian hospitals, and once again against the latest SARS Coronavirus that causes COVID-19.


The spread of the virus around the Diamond Princess cruise ship, which hit global headlines in early 2020 when more than 700 passengers and crew tested positive for COVID-19, has become a case-in-point for the theory behind airborne transmission.


Researchers from Harvard and the Illinois Institute of Technology developed a computer model of the cruise ship outbreak, which found that the virus spread most readily in microscopic droplets light enough to linger in the air. The research added to the pressure already being placed on the World Health Organization to recognise the airborne dangers of the virus, including an open letter which was signed by more than 200 experts.


The key point here is that there has been some level of recognition from various government departments that the virus is airborne, and they have mitigated accordingly.


Part F of the Building Regulations on ventilation has been updated and is curently out to consultation, and the Health and Safety Executive’s COVID-Secure Guidance for the Workplace on Ventilation has also been quietly updated in recent weeks to recommend the use of ultraviolet air filtration systems, which are proven to kill airborne contaminants.


These UK regulations are now, at last, starting to get more aligned to other global institutions’ recommendations such as the renowned Centers for Disease Control and Prevention (CDC), who support the importance of ventilation and UV devices to significantly reduce infection risk. This is a positive step, but the key communication issue is that if the government don’t fully endorse and be more vocal about the airborne threat of COVID-19, and regulatory changes being made, then neither will the wider public.


This is a huge issue, because the government is already twitter.com/TomoCleaning


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