When the World Health Organization communicated in July 2020 that the virus responsible for the Covid-19 pandemic was spread through aerosolized transmission, not through droplets carried within a six foot radius as initially believed, the Centers for Disease Control hesitated to issue the same guidance. The costs and complications for dealing with these new findings were going to be much more challenging than social distancing, masking and closures, but ultimately necessary for the long term health and safety of the country.
Covid-19 and Indoor Air Quality
Fast forward 20 months and the government is ready to tackle the structural ramifications of the pandemic: “While there are various strategies for avoiding breathing [aerosolized virus particles] – from remote work to masking – we can and should talk more about how to make indoor environments safer by filtering or cleaning air,” explained Dr. Alondra Nelson, head of the White House Office of Science and Technology Policy, in a March 23 blog post.
“Research shows changing the air in a room multiple times an hour with filtered or clean outdoor air – using a window fan, by using higher MERV filters in a heating, ventilation, and air conditioning (HVAC) system, using portable air cleaning devices, and even just opening a window – can reduce the risk of Covid-19 transmission,” she added, further noting that “improving indoor air will [also] reduce the risk of getting the flu, a common cold, or other diseases spread by air, and lead to better overall health outcomes.”
“As more people put wellness at the forefront of their priorities, it will be increasingly important for property managers and developers to communicate their clean air efforts to prospective residents,” comments Chicago-based commercial interior designer Mary Cook. Owners and tenants “recognize the value of thoughtfully designed, well-ventilated spaces,” she shares, suggesting that “MERV ratings may become one way they share specifics about indoor air quality.” Will rental ads start publishing those numbers along with the unit’s square footage and number of parking spaces? It’s possible.
Initiative Guidelines and Funding Sources
Nelson’s blog tied into a White House-issued fact sheet promoting a new Clean Air in Buildings Challenge, an IAQ initiative related to its National Covid-19 Preparedness Plan. The Challenge includes a guide with four wellness design-based recommendations, using an Environmental Protection Agency best practices guide for building owners and managers:
- Create a clean indoor air action plan that assesses indoor air quality, plans for upgrades and improvements, and includes HVAC inspections and maintenance.
- Optimize fresh air ventilation by bringing in and circulating clean outdoor air indoors.
- Enhance air filtration and cleaning using the central HVAC system and in-room air cleaning devices.
- Engage the building community by communicating with building occupants to increase awareness, commitment, and participation.
The White House fact sheet says the $472 billion allocated in the American Rescue Plan and additional funds in the bipartisan infrastructure law can help cover costs for local governments, tribes and school districts to make the suggested upgrades.
Which buildings should be prioritized, beyond schools and workplaces? Americans may spend up to eight hours a day in these structures, but many more are spent at home. Which living spaces should get upgraded first? Clearly buildings that house vulnerable populations and that are in the greatest need of repairs and upgrades should be on the priority list. Here are some suggestions.
“According to data updated in 2019, 42% of public housing properties finished their last construction before 1975,” reported the Urban Institute, adding, “Over half of households in public housing were headed by a person who was 62 or older and/or was disabled, and 40 percent included children younger than 18.” These senior and disabled populations are often more at risk of catching and dying from Covid, according to the Mayo Clinic.
In addition to upgrading these properties, updated building codes should require new housing at every price point, including the most affordable, be designed to the highest residential IAQ standards.
There are 158 state veterans’ homes in all 50 states and Puerto Rico, according to the National Association of State Veterans Homes. They care for about 33,000 vets. “Veterans Homes were among the first facilities in the nation to face high rates of infection from COVID-19,” wrote The Council of State Governments in April 2021. Their patients were especially vulnerable, given their age and disabilities and poor oversight of these facilities. Repairs to meet quality standards were often neglected or inaccurately reported, according to the council.
Skilled Nursing Facilities
There are more than 15,000 nursing homes in the U.S. housing 1.3 million older Americans, according to 2016 CDC statistics. These facilities were hit hard in the early months of the pandemic. According to the Kaiser Family Foundation, more than 200,000 nursing home residents and staff died of Covid-19. Improving their ventilation systems will protect the seniors and workers who care for them, along with visitors.
In addition to upgrading veterans’ and nursing homes and strengthening building codes, incentives can be offered to developers building active adult and assisted living communities to offer added IAQ features to keep older adults healthier and safer longer.
This is a challenge with complicated jurisdictional and ownership structures, but as noted in lessons to be learned from the pandemic, Native Americans had much higher Covid-19 infections and fatalities than other communities. Ventilation upgrades, along with improved clean water access, can make a significant difference in combating this and future pandemics in the nation’s indigenous population.
Covid infection and fatality rates in state and federal prisons were significantly higher than the population at large during the first year of the pandemic, according to the Journal of the American Medical Association. This has implications for staff, visitors and prisoners.
Citing the conditions at California’s 168-year-old San Quentin prison, an article by the Association of American Medical Colleges reported: “They are essentially long corridors of cells stacked five levels high, looking out onto the same atrium. So, it’s really one large space with 750 people breathing and re-breathing the same air. It certainly doesn’t have any sort of modern ventilation that would negate that.”
Another AAMC contributor noted in the same article: “Group living where many people share airspace in a facility with poor ventilation is risky. There are ways to change that risk, but the U.S., by and large, has not done a great job of taking advantage of those opportunities.”
The Clean Air in Buildings Challenge can reverse that trend if the monies are allocated according to greatest need with responsible oversight. On a parallel track, governments at every level, from federal to local, can provide tax incentives for individual owners of single family residences to upgrade their ventilation systems, just as they’ve done with electric car and solar panel purchases. The IAQ investments can potentially pay for themselves with healthcare savings.
“The impact of The Clean Air in Buildings Challenge is a much-needed change for all types of housing,” observes Ridgewood, NJ-based interior designer Marina V. Umali. “As a WELL AP, I’m constantly hoping for all spaces to be required to have the best indoor air quality for the benefit of all types of occupants, no matter their income level or type of residence.”