Mitigating COVID-19 infection disease transmission in indoor environment using physical barriers

A critical review of research methodologies for COVID-19 transmission in indoor built environment

The Coronavirus Disease 2019 (COVID-19) has caused massive losses for the global economy. Scholars have used different methods to study the transmission mode and influencing factors of the virus to find effective methods to provide people with a healthy built environment. However, these studies arrived at different or even contradictory conclusions. This review presents the main research methodologies utilized in this field, summarizes the main investigation methods, and critically discusses their related conclusions. Data statistical analysis, sample collection, simulation models, and replication transmission scenarios are the main research methods. The summarized conclusion for prevention from all reviewed papers are: adequate ventilation and proper location of return air vents, proper use of personal protective equipment, as well as the reasonable and strict enforcement of policies are the main methods for reducing the transmission. Recommendations including standardized databases, causation clarification, rigorous experiment design, improved simulation accuracy and verification are provided.

The Health and Safety Experiences of Precariously Employed Bangladeshi Immigrant Workers in Toronto During the COVID-19 Pandemic

Racialized immigrants in Canada have been disproportionately impacted by the COVID-19 pandemic. Our qualitative, community-based study with South Asian Women and Immigrants' Services examined the impact of the second and third waves of the pandemic on the work and health of precariously employed Bangladeshi immigrant women and men in Toronto. Our study is based on interviews and focus group discussions with 45 workers, all conducted in Bangla, and 11 key informants. Interviews reveal work transitions, an increase in precarity, work in essential sectors, exposures at work, home and in transit, workplace prevention and management gaps, and an inability to take time off, with significant impacts on workers' physical and mental health. We discuss the implications of our findings for prevention, preparedness, and response by workplaces and governments to decrease the risk and reduce the impact of infectious diseases emergencies in the precarious work sector.

COVID-19 transmission and control in land public transport: A literature review

Land public transport is an important link within and between cities, and how to control the transmission of COVID-19 in land public transport is a critical issue in our daily lives. However, there are still many inconsistent opinions and views about the spread of SARS-CoV-2 in land public transport, which limits our ability to implement effective interventions. The purpose of this review is to overview the literature on transmission characteristics and routes of the epidemic in land public transport, as well as to investigate factors affecting its spread and provide feasible measures to mitigate the infection risk of passengers. We obtained 898 papers by searching the Web of Science, Pubmed, and WHO global COVID database by keywords, and finally selected 45 papers that can address the purpose of this review. Land public transport is a high outbreak area for COVID-19 due to characteristics like crowding, inadequate ventilation, long exposure time, and environmental closure. Different from surface touch transmission and drop spray transmission, aerosol inhalation transmission can occur not only in short distances but also in long distances. Insufficient ventilation is the most important factor influencing long-distance aerosol transmission. Other transmission factors (e.g., interpersonal distance, relative orientation, and ambient conditions) should be noticed as well, which have been summarized in this paper. To address various influencing factors, it is essential to suggest practical and efficient preventive measures. Among these, increased ventilation, particularly the fresh air (i.e., natural ventilation), has proven to effectively reduce indoor infection risk. Many preventive measures are also effective, such as enlarging social distance, avoiding face-to-face orientation, setting up physical partitions, disinfection, avoiding talking, and so on. As research on the epidemic has intensified, people have broken down many perceived barriers, but more comprehensive studies on monitoring systems and prevention measures in land public transport are still needed.

The multi-dimensional challenges of controlling respiratory virus transmission in indoor spaces: Insights from the linkage of a microscopic pedestrian simulation and SARS-CoV-2 transmission model

SARS-CoV-2 transmission in indoor spaces, where most infection events occur, depends on the types and duration of human interactions, among others. Understanding how these human behaviours interface with virus characteristics to drive pathogen transmission and dictate the outcomes of non-pharmaceutical interventions is important for the informed and safe use of indoor spaces. To better understand these complex interactions, we developed the Pedestrian Dynamics-Virus Spread model (PeDViS), an individual-based model that combines pedestrian behaviour models with virus spread models incorporating direct and indirect transmission routes. We explored the relationships between virus exposure and the duration, distance, respiratory behaviour, and environment in which interactions between infected and uninfected individuals took place and compared this to benchmark 'at risk' interactions (1.5 metres for 15 minutes). When considering aerosol transmission, individuals adhering to distancing measures may be at risk due to the buildup of airborne virus in the environment when infected individuals spend prolonged time indoors. In our restaurant case, guests seated at tables near infected individuals were at limited risk of infection but could, particularly in poorly ventilated places, experience risks that surpass that of benchmark interactions. Combining interventions that target different transmission routes can aid in accumulating impact, for instance by combining ventilation with face masks. The impact of such combined interventions depends on the relative importance of transmission routes, which is hard to disentangle and highly context dependent. This uncertainty should be considered when assessing transmission risks upon different types of human interactions in indoor spaces. We illustrated the multi-dimensionality of indoor SARS-CoV-2 transmission that emerges from the interplay of human behaviour and the spread of respiratory viruses. A modelling strategy that incorporates this in risk assessments can help inform policy makers and citizens on the safe use of indoor spaces with varying inter-human interactions.

Optimizing indoor air quality: CFD simulation and novel air cleaning methods for effective aerosol particle inhibition in public spaces

In contemporary building ventilation, displacement and mixing ventilation demand high air volumes for rapid virus elimination, resulting in elevated energy consumption. To minimize the spread of viruses and decrease energy consumption for ventilation, this study employed CFD to explore the efficacy of a downward uniform flow field in impeding the transmission of aerosol particles in a high-traffic public facility, like a supermarket. The findings indicate that the downward uniform flow field proves insufficient when individuals remain static for extended periods. A wind speed of 0.1 m/s or higher becomes essential to overpower the stationary thermal plume, which disrupts this flow field. In areas with human presence, however, this technique is found to be particularly efficient since mobile heat sources do not generate a fixed thermal plume. A 0.05 m/s downward uniform flow field can settle 90% of particles within just 22 s. This flow pattern contributes to the swift settling of aerosol particles and effectively diminishes their dispersion. Employing this flow pattern in public places with increased foot traffic, like supermarkets, can lower the risk of contracting novel coronavirus without augmenting energy consumption. In order to implement the flow field in a part of the domain, a new air purification device is proposed in this study. The device combined with shelves can optimize the flow field uniformity through the MLA (PSO-SVR) algorithm and alteration of the air distribution structure. The uniformity of the final flow field increased to 0.925. The combination of data-driven MLA with CFD showed good performance in predicting the flow field uniformity. These findings offer valuable insights and practical applications for the prevention and control of respiratory diseases, particularly in post-epidemic scenarios.

Evaluation of intervention measures in reducing the driver's exposure to respiratory particles in a taxi with infected passengers

In the fifth wave of the COVID-19 epidemic in Hong Kong in early 2022, the large number of infected persons caused a shortage of ambulances and transportation vehicles operated by the government. To solve the problem, taxi drivers were recruited to transport infected persons to hospitals in their taxis. However, many of the drivers were infected after they began to participate in the plan. To tackle this issue, the present study numerically evaluated the effectiveness of several intervention measures in reducing the infection risk for taxi drivers. First, experiments were conducted inside a car to validate the large-eddy simulation (LES)-Lagrangian model for simulation of particle transport in a car. The validated model was then applied to calculate the particle dispersion and deposition in a Hong Kong taxi with intervention measures that included opening windows, installing partitions, and using a far-UVC lamp. The results show that opening the windows can significantly reduce the driver's total exposure by 97.4 %. Installing partitions and using a far-UVC lamp can further reduce the infection risk of driver by 55.9 % and 32.1 %, respectively. The results of this study can be used to support the implementation of effective intervention measures to protect taxi drivers from infection.

Generative design for COVID-19 and future pathogens using stochastic multi-agent simulation

We propose a generative design workflow that integrates a stochastic multi-agent simulation with the intent of helping building designers reduce the risk posed by COVID-19 and future pathogens. Our custom simulation randomly generates activities and movements of individual occupants, tracking the amount of virus transmitted through air and surfaces from contagious to susceptible agents. The stochastic nature of the simulation requires that many repetitions be performed to achieve statistically reliable results. Accordingly, a series of initial experiments identified parameter values that balanced the trade-off between computational cost and accuracy. Applying generative design to a case study based on an existing office space reduced the predicted transmission by around 10% to 20% compared with a baseline set of layouts. Additionally, a qualitative examination of the generated layouts revealed design patterns that may reduce transmission. Stochastic multi-agent simulation is a computationally expensive yet plausible way to generate safer building designs.

Towards the new generation of courtyard buildings as a healthy living concept for post-pandemic era

COVID-19 has laid a context for holistic research and practical approaches towards health issues in buildings. This study focuses on one particular residential building type, which is a combination of a modern apartment building with private double-oriented terraces, and a traditional courtyard building. This principle improves several aspects of healthy buildings and contributes to address indoor-outdoor interactions, daylighting, and the use of natural ventilation. The purpose of this study is to determine the factors underlying a particular type of semi-outdoor space within building forms and to explain their microclimatic behavior in buildings. One solid model and twelve porous apartment buildings with different numbers of porous sides, and terrace widths are evaluated using computational fluid dynamics. The k-ε turbulence model is adapted to simulate airflow in and around a four-story building. CFD simulations were validated against the wind-tunnel measurements. Investigations indicated that increasing the number of porous sides reduces the internal mean and maximum ages of air by -15.75 and -36.84%, which means improved ventilation performance. However, it leaves a negative trace on ventilation of the semi-outdoor spaces. Meanwhile, increasing the width of the terraces enhances the ventilation performance by reducing the mean age of air in units, courtyards, and terraces by -20%, -20%, and -9%, respectively.

Refined design of ventilation systems to mitigate infection risk in hospital wards: Perspective from ventilation openings setting

To prevent respiratory infections between patients and medical workers, the transmission risk of airborne pollutants in hospital wards must be mitigated. The ventilation modes, which are regarded as an important strategy to minimize the infection risk, are challenging to be systematically designed. Studies have considered the effect of ventilation openings (inlets/outlets) or infected source locations on the airflow distribution, pollutant removal, and infection risk mitigation. However, the relationship (such as relative distance) between ventilation openings and infected sources is critical because it affects the direct exhaust of exhaled pollutants, which has not been thoroughly studied. To explore pollutant removal and infection prevention in wards, different ventilation modes (with varying ventilation openings) and infected patient locations must be jointly considered. This study investigated displacement ventilation (DV), downward ventilation (DWV), and stratum ventilation (SV) with 4, 6, and 10 scenarios of ventilation openings, respectively. The optimal ventilation mode and relative distance between outlets and infected patients were analyzed based on the simulated pollutant concentration fields and the evaluated infection risk. The pollutant removal effect and infection risk mitigation of SV in the ward were largely improved by 75% and 59% compared with DV and DWV, respectively. The average infection risk was reduced below 7% when a non-dimensional relative distance (a ratio of the actual distance to the cubic root of the ward volume) was less than 0.25 between outlets and infected patient. This study can serve as a guide for the systematic ventilation system design in hospitals during the epidemic.

Risk perception of compound emergencies: A household survey on flood evacuation and sheltering behavior during the COVID-19 pandemic

Compound hazards are derived from independent disasters that occur simultaneously. Since the outbreak of COVID-19, the coupling of low-probability high-impact climate events has introduced a novel form of conflicting stressors that inhibits the operation of traditional logistics developed for single-hazard emergencies. The competing goals of hindering virus contagion and expediting massive evacuation have posed unique challenges for community safety. Yet, how a community perceives associated risks has been debated. This research utilized a web-based survey to explore the relationship between residents' perceptions of conflicting risks and emergency choices made during a historic compound event, the flooding in 2020 in Michigan, US that coincided with the pandemic. After the event, postal mail was randomly sent to 5,000 households living in the flooded area, collecting 556 responses. We developed two choice models for predicting survivors' evacuation options and sheltering length. The impact of sociodemographic factors on perceptions of COVID-19 risks was also examined. The results revealed greater levels of concern among females, democrats, and the economically inactive population. The relationship between evacuation choice and concern about virus exposure was dependent upon the number of seniors in the household. Concern about a lack of mask enforcement particularly discouraged evacuees from extended sheltering.

A CFD-based framework to assess airborne infection risk in buildings

The COVID-19 pandemic has prompted huge efforts to further the scientific knowledge of indoor ventilation and its relationship to airborne infection risk. Exhaled infectious aerosols are spread and inhaled as a result of room airflow characteristics. Many calculation methods and assertions on risk assume 'well-mixed' flow conditions. However, ventilation in buildings is complex and often not showing well-mixed conditions. Ventilation guidance is typically based on the provision of generic minimum ventilation flow rates for a given space, irrespective of the effectiveness in the delivery of the supply air. Furthermore, the airflow might be heavily affected by the season, the HVAC ventilation, or the opening of windows, which would potentially generate draughts and non-uniform conditions. As a result, fresh air concentration would be variable depending upon a susceptible receptor's position in a room and, therefore, associated airborne infection risk. A computational fluid dynamics (CFD) and dynamic thermal modelling (DTM) framework is proposed to assess the influence of internal airflow characteristics on airborne infection risk. A simple metric is proposed, the hourly airborne infection rate (HAI) which can easily help designers to stress-test the ventilation within a building under several conditions. A case study is presented, and the results clearly demonstrate the importance of understanding detailed indoor airflow characteristics and associated concentration patterns in order to provide detailed design guidance, e.g. occupancy, supply air diffusers and furniture layouts, to reduce airborne infection risk.

Quantifying spatiotemporal variability in occupant exposure to an indoor airborne contaminant with an uncertain source location

Well-mixed zone models are often employed to compute indoor air quality and occupant exposures. While effective, a potential downside to assuming instantaneous, perfect mixing is underpredicting exposures to high intermittent concentrations within a room. When such cases are of concern, more spatially resolved models, like computational-fluid dynamics methods, are used for some or all of the zones. But, these models have higher computational costs and require more input information. A preferred compromise would be to continue with a multi-zone modeling approach for all rooms, but with a better assessment of the spatial variability within a room. To do so, we present a quantitative method for estimating a room's spatiotemporal variability, based on influential room parameters. Our proposed method disaggregates variability into the variability in a room's average concentration, and the spatial variability within the room relative to that average. This enables a detailed assessment of how variability in particular room parameters impacts the uncertain occupant exposures. To demonstrate the utility of this method, we simulate contaminant dispersion for a variety of possible source locations. We compute breathing-zone exposure during the releasing (source is active) and decaying (source is removed) periods. Using CFD methods, we found after a 30 minutes release the average standard deviation in the spatial distribution of exposure was approximately 28% of the source average exposure, whereas variability in the different average exposures was lower, only 10% of the total average. We also find that although uncertainty in the source location leads to variability in the average magnitude of transient exposure, it does not have a particularly large influence on the spatial distribution during the decaying period, or on the average contaminant removal rate. By systematically characterizing a room's average concentration, its variability, and the spatial variability within the room important insights can be gained as to how much uncertainty is introduced into occupant exposure predictions by assuming a uniform in-room contaminant concentration. We discuss how the results of these characterizations can improve our understanding of the uncertainty in occupant exposures relative to well-mixed models.

Research on the cross-contamination in the confined conference room with the radiant floor heating system integrated with the down-supply ventilation

The performance of a confined conference room under radiant heat floor combined with down-supply ventilation (RFDS) is investigated. The purpose of the study is to reveal the mechanism of indoor contaminants transmission from infected person and to protect the occupants. The exhaled contaminant dispersion was simulated using a CFD model and experimentally validated in an office with the down-supply ventilation (DS). The effects of radiant floor (RF) combined with down-supply ventilation on airflow and contaminant distribution in the room was evaluated with regard to different RF temperatures and inlet velocities. The influence of downdraft from the envelope on the airflow pattern of the room is also discussed. It is proved that the exposure risk of pollutants can be reduced by strengthening the insulation of the envelope. The simulation results showed that the proposed RFDS system could significantly reduce the level of exposure to contaminants in the breathing zone (BZ) of occupants. In this research case, the RFDS reduced the average exposure rates by more than 50% relative to the case with the only down-supply warm air heating. Furthermore, With improved envelope insulation, the probability of infection can be reduced by more than 80% only by avoiding a simultaneous inlet velocity of 0.3 m/s at RF temperatures no less than 27 °C. The results suggested an improved fresh air heating mode for passive ultra-low energy consumption buildings with good thermal insulation and air tightness.

Review of an intelligent indoor environment monitoring and management system for COVID-19 risk mitigation

The coronavirus disease (COVID-19) outbreak has turned the world upside down bringing about a massive impact on society due to enforced measures such as the curtailment of personal travel and limitations on economic activities. The global pandemic resulted in numerous people spending their time at home, working, and learning from home hence exposing them to air contaminants of outdoor and indoor origins. COVID-19 is caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), which spreads by airborne transmission. The viruses found indoors are linked to the building's ventilation system quality. The ventilation flow in an indoor environment controls the movement and advection of any aerosols, pollutants, and Carbon Dioxide (CO2) created by indoor sources/occupants; the quantity of CO2 can be measured by sensors. Indoor CO2 monitoring is a technique used to track a person's COVID-19 risk, but high or low CO2 levels do not necessarily mean that the COVID-19 virus is present in the air. CO2 monitors, in short, can help inform an individual whether they are breathing in clean air. In terms of COVID-19 risk mitigation strategies, intelligent indoor monitoring systems use various sensors that are available in the marketplace. This work presents a review of scientific articles that influence intelligent monitoring development and indoor environmental quality management system. The paper underlines that the non-dispersive infrared (NDIR) sensor and ESP8266 microcontroller support the development of low-cost indoor air monitoring at learning facilities.

Finding the proper position of supply and return registers of air condition system in a conference hall in term of COVID-19 virus spread

The outbreak of the COVID-19 has affected all aspects of people's lives around the world. As air transmits the viruses, air-conditioning systems in buildings, surrounded environments, and public transport have a significant role in restricting the transmission of airborne pathogens. In this paper, a computational fluid dynamic (CFD) model is deployed to simulate the dispersion of the COVID-19 virus due to the coughing of a patient in a conference hall, and the effect of displacement of supply and return registers of the air conditioning system is investigated. A validated Eulerian-Lagrangian CFD model is used to simulate the airflow in the conference hall. The particles created by coughing are droplets of the patient's saliva that contain the virus. Three cases with different positions of supply and return registers have been compared. The simulation results show that case1 has the best performance; since after 80 s in case 1 that the inlet registers are in the longitudinal wall, the whole particles are removed from space. However, in other cases, some particles are still in space.

Agent-Based Simulation for Infectious Disease Modelling over a Period of Multiple Days, with Application to an Airport Scenario

With the COVID-19 pandemic, the role of infectious disease spreading in public places has been brought into focus more than ever. Places that are of particular interest regarding the spread of infectious diseases are international airport terminals, not only for the protection of staff and ground crew members but also to help minimize the risk of the spread of infectious entities such as COVID-19 around the globe. Computational modelling and simulation can help in understanding and predicting the spreading of infectious diseases in any such scenario. In this paper, we propose a model, which combines a simulation of high geometric detail regarding virus spreading with an account of the temporal progress of infection dynamics. We, thus, introduce an agent-based social force model for tracking the spread of infectious diseases by modelling aerosol traces and concentration of virus load in the air. We complement this agent-based model to have consistency over a period of several days. We then apply this model to investigate simulations in a realistic airport setting with multiple virus variants of varying contagiousness. According to our experiments, a virus variant has to be at least twelve times more contagious than the respective control to result in a level of infection of more than 30%. Combinations of agent-based models with temporal components can be valuable tools in an attempt to assess the risk of infection attributable to a particular virus and its variants.

Impact of ionizers on prevention of airborne infection in classroom

Infectious diseases (e.g., coronavirus disease 2019) dramatically impact human life, economy and social development. Exploring the low-cost and energy-saving approaches is essential in removing infectious virus particles from indoors, such as in classrooms. The application of air purification devices, such as negative ion generators (ionizers), gains popularity because of the favorable removal capacity for particles and the low operation cost. However, small and portable ionizers have potential disadvantages in the removal efficiency owing to the limited horizontal diffusion of negative ions. This study aims to investigate the layout strategy (number and location) of ionizers based on the energy-efficient natural ventilation in the classroom to improve removal efficiency (negative ions to particles) and decrease infection risk. Three infected students were considered in the classroom. The simulations of negative ion and particle concentrations were performed and validated by the experiment. Results showed that as the number of ionizers was 4 and 5, the removal performance was largely improved by combining ionizer with natural ventilation. Compared with the scenario without an ionizer, the scenario with 5 ionizers largely increased the average removal efficiency from around 20% to 85% and decreased the average infection risk by 23%. The setup with 5 ionizers placed upstream of the classroom was determined as the optimal layout strategy, particularly when the location and number of the infected students were unknown. This work can provide a guideline for applying ionizers to public buildings when natural ventilation is used.

ELECTRONIC SUPPLEMENTARY MATERIAL ESM

the Appendix is available in the online version of this article at 10.1007/s12273-022-0959-z.

Combining Phi6 as a surrogate virus and computational large-eddy simulations to study airborne transmission of SARS-CoV-2 in a restaurant

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.

COVID-19 and Unmet Medical Needs for People With Chronic Diseases: A Cross-Sectional Study

Gaps between medical needs and health services accessibility are defined as unmet medical needs (UMN). Previous studies assessing UMNs during the coronavirus disease 2019 (COVID-19) pandemic did not account for factors such as the type of medical insurance or chronic disease. Therefore, this study investigated various factors, including medical insurance and chronic diseases, affecting self-reported UMN during the pandemic in Daejeon Metropolitan City, South Korea. This cross-sectional study was conducted using Daejeon Metropolitan City Health Surveys data from 2020. The weighted prevalence of UMN was estimated among participants (n = 1494) aged ≥18 years, while chi-squared and logistic models were used to assess the association between UMN and participant characteristics. The prevalence of UMN was 6.4% (n = 97). Female sex and low education levels were significantly associated with reporting UMN. Medical aid beneficiaries were less likely to report UMN than adults with National Health Programs coverage. Participants with chronic diseases, such as hypertension and arthritis, and those with depression, were more likely to report UMN than adults without these conditions. The findings highlight the need for targeted efforts to decrease UMN in the COVID-19 pandemic, especially for women and individuals with low education levels. The results also indicate that high-risk disease groups should be targeted with additional enabling services to support the management of chronic conditions.

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 numerical approach for preventing the dispersion of infectious disease in a meeting room

Airborne transmission of respiratory aerosols carrying infectious viruses has generated many concerns about cross-contamination risks, particularly in indoor environments. ANSYS Fluent software has been used to investigate the dispersion of the viral particles generated during a coughing event and their transport dynamics inside a safe social-distance meeting room. Computational fluid dynamics based on coupled Eulerian-Lagrangian techniques are used to explore the characteristics of the airflow field in the domain. The main objective of this study is to investigate the effects of the window opening frequency, exhaust layouts, and the location of the air conditioner systems on the dispersion of the particles. The results show that reducing the output capacity by raising the concentration of suspended particles and increasing their traveled distance caused a growth in the individuals' exposure to contaminants. Moreover, decreasing the distance between the ventilation systems installed location and the ceiling can drop the fraction of the suspended particles by over 35%, and the number of individuals who are subjected to becoming infected by viral particles drops from 6 to 2. As well, the results demonstrated when the direction of input airflow and generated particles were the same, the fraction of suspended particles of 4.125%, whereas if the inputs were shifted to the opposite direction of particle injection, the fraction of particles in fluid increased by 5.000%.

A review of facilities management interventions to mitigate respiratory infections in existing buildings

The Covid-19 pandemic reveals that the hazard of the respiratory virus was a secondary consideration in the design, development, construction, and management of public and commercial buildings. Retrofitting such buildings poses a significant challenge for building owners and facilities managers. This article reviews current research and practices in building operations interventions for indoor respiratory infection control from the perspective of facilities managers to assess the effectiveness of available solutions. This review systematically selects and synthesises eighty-six articles identified through the PRISMA process plus supplementary articles identified as part of the review process, that deal with facilities' operations and maintenance (O&M) interventions. The paper reviewed the context, interventions, mechanisms, and outcomes discussed in these articles, concluding that interventions for respiratory virus transmission in existing buildings fall into three categories under the Facilities Management (FM) discipline: Hard services (HVAC and drainage system controls) to prevent aerosol transmissions, Soft Services (cleaning and disinfection) to prevent fomite transmissions, and space management (space planning and occupancy controls) to eliminate droplet transmissions. Additionally, the research emphasised the need for FM intervention studies that examine occupant behaviours with integrated intervention results and guide FM intervention decision-making. This review expands the knowledge of FM for infection control and highlights future research opportunities.

Sustainable solutions for indoor pollution abatement during COVID phase: A critical study on current technologies & challenges

The appearance of the contagious virus COVID-19, several revelations and environmental health experts punctually predicted the possibly disastrous public health complications of coexisting catching and airborne contamination-arbitrated disease. But much attention has been given on the outdoor-mediated interactions. Almost 3.8 million premature deaths occur every year globally due to the illness from indoor air pollution. Considering the human staying longer span indoors due to restricted human activities or work from home, the indoor air quality (IAQ) might show prominent role for individual health life. Currently, the Environmental Protection Agency (EPA) ensures no regulation of indoor airborne pollution. Herein, the paper underlines the common bases of indoor air pollution, poor IAQ, and impacts of the aerosolized airborne particles on the human health. In order to address these challenges and collective contagion events in indoor environment, several emerging control techniques and preventive sustainable solutions are suggested. By this, more innovations need to be investigated in future to measure the impact of indoor air pollution on individual health.

Challenges and coping strategies of online learning for college students in the context of COVID-19: A survey of Chinese universities

The COVID-19 epidemic has disrupted the normal teaching and learning in universities, which poses significant challenges to higher education. The traditional face-to-face learning mode has been switched to online (distance) learning, causing various influences on students' academic performance, physical and psychological well-being. As higher education plays a central role in technology innovation and society development, it is of great importance to investigate and improve online learning in the context of COVID-19. This study distributed online questionnaires to undergraduate and postgraduate students from 30 provinces or municipalities in China (covering 88% of the whole country). Results indicate that online learning mode is more likely to reduce the academic performance of lower-grade students (e.g., freshman and sophomore). The learning environment could be one of essential factors affecting the academic performance during online education. Studying at home or dormitory is more evidently correlated with academic performance decline. Regarding the physical and mental health during online learning, most students had experienced eye strain (84%) and cervical stiff (79%), while anxiety is the most prominent mental issue (66% of occurrence). Several coping strategies are suggested to improve the online learning in post-pandemic era, which is essential for higher education and promoting a civilized and sustainable society.

The Built Environment Assessment of Residential Areas in Wuhan during the Coronavirus Disease (COVID-19) Outbreak

The COVID-19 epidemic has emerged as one of the biggest challenges, and the world is focused on preventing and controlling COVID-19. Although there is still insufficient understanding of how environmental conditions may impact the COVID-19 pandemic, airborne transmission is regarded as an important environmental factor that influences the spread of COVID-19. The natural ventilation potential (NVP) is critical for airborne infection control in the micro-built environment, where infectious and susceptible people share air spaces. Taking Wuhan as the research area, we evaluated the NVP in residential areas to combat COVID-19 during the outbreak. We determined four fundamental residential area layouts (point layout, parallel layout, center-around layout, and mixed layout) based on the semantic similarity model for point of interest (POI) picking. Our analyses indicated that the center-around and point layout had a higher NVP, while the mixed and parallel layouts had a lower NVP in winter and spring. Further analysis showed that the proportion of the worst NVP has been rising, while the proportion of the poor NVP remains very high in Wuhan. This study suggested the need to efficiently improve the residential area layout in Wuhan for better urban ventilation to combat COVID-19 without losing other benefits.

Ventilation strategies and design impacts on indoor airborne transmission: A review

The COVID-19 outbreak has brought the indoor airborne transmission issue to the forefront. Although ventilation systems provide clean air and dilute indoor contaminated air, there is strong evidence that airborne transmission is the main route for contamination spread. This review paper aims to critically investigate ventilation impacts on particle spread and identify efficient ventilation strategies in controlling aerosol distribution in clinical and non-clinical environments. This article also examines influential ventilation design features (i.e., exhaust location) affecting ventilation performance in preventing aerosols spread. This paper shortlisted published documents for a review based on identification (keywords), pre-processing, screening, and eligibility of these articles. The literature review emphasizes the importance of ventilation systems' design and demonstrates all strategies (i.e., mechanical ventilation) could efficiently remove particles if appropriately designed. The study highlights the need for occupant-based ventilation systems, such as personalized ventilation instead of central systems, to reduce cross-infections. The literature underlines critical impacts of design features like ventilation rates and the number and location of exhausts and suggests designing systems considering airborne transmission. This review underpins that a higher ventilation rate should not be regarded as a sole indicator for designing ventilation systems because it cannot guarantee reducing risks. Using filtration and decontamination devices based on building functionalities and particle sizes can also increase ventilation performance. This paper suggests future research on optimizing ventilation systems, particularly in high infection risk spaces such as multi-storey hotel quarantine facilities. This review contributes to adjusting ventilation facilities to control indoor aerosol transmission.

Tempo-spatial infection risk assessment of airborne virus via CO2 concentration field monitoring in built environment

The aerosol transmission was academically recognized as a possible transmission route of Coronavirus disease 2019 (COVID-19). We established an approach to assess the indoor tempo-spatial airborne-disease infection risks through aerosol transmission via real-time CO2 field measurement and occupancy monitoring. Compared to former studies, the proposed method can evaluate real-time airborne disease infection risks through aerosol transmission routes. The approach was utilized in a university office. The accumulated infection risk was calculated for three occupants with practical working schedules (from occupancy recording) and one hypothesis occupant with a typical working schedule. COVID-19 was used as an example. Results demonstrated that the individual infection risks diversified with different dwell times and working places in the office. For the three occupants with a practical working schedule, their 3-day accumulated infection risks were respectively 0.050%, 0.035%, 0.027% and 0.041% due to 11.6, 9.0 and 13.8 h exposure with an initial infector percentage of 1%. The results demonstrate that location and dwell time are both important factors influencing the infection risk of certain occupant in built environment, whereas existing literature seldom took these two points into consideration simultaneously. On the contrary, our proposed approach treated the infection risks as place-by-place, time-by-time and person-by-person diversified in the built environment. The risk assessment results can provide early warning for building occupants and contribute to the transmission control of air-borne disease.

Numerical Evaluation of a Novel Vertical Drop Airflow System to Mitigate Droplet Transmission in Trains

Owing to the outbreak of COVID-19, researchers are exploring methods to prevent contact and non-contact infections that occur via multiple transmission routes. However, studies on preventing infections caused by droplet transmission in public transportation are insufficient. To prevent the spread of infectious diseases, a new ventilation system in railway vehicles must be developed. In this study, a novel vertical drop airflow (VDA) system is proposed to mitigate the effect of droplet transmission in a high-speed train cabin. The droplet transmission route and droplet fate are investigated using three-dimensional fluid dynamics simulations, performed employing the Eulerian–Lagrangian model. Additionally, a porous model is adopted to simulate the effect of close-fitting masks. The results indicate that 120 s after coughing, the decrease in the droplet number in the VDA system is 72.1% of that observed in the conventional system. Moreover, the VDA system effectively suppresses droplet transmission because the maximum droplet travel distances of the VDA systems are 49.9% to 67.0% of those of the conventional systems. Furthermore, the effect of reducing droplet transmission by wearing a close-fitting mask is confirmed in all systems. Thus, the decrease in both droplet number and droplet transmission area in train cabins validate that the proposed VDA system has an effective airflow design to prevent droplet infection.

A practical approach for preventing dispersion of infection disease in naturally ventilated room

During the ongoing COVID-19 pandemic period, the airborne transmission of viruses has raised widespread concern as daily activities are resumed in public buildings. It is essential to develop mitigation strategies of infection disease transmission (e.g., increase of ventilation rate) in different scenarios to reduce the infection risk. For classrooms in schools, natural ventilation is generally used to provide outdoor air into rooms. However, the supply air volume depends strongly on the local conditions, e.g., window opening size and outdoor wind speed. In this study, the optimal design of classroom window openings is investigated, based on which low-cost window-integrated fans are then employed to enhance the efficiency of natural ventilation and infection disease control. Taking infected students as pollutant sources, numerical simulations are carried out to predict the pollutant concentration under various scenarios of pollutant sources and window opening modes (with/without fans), and to calculate the infection risk. It is found that by redesigning window openings, the airflow distribution performance index (ADPI) can be increased by 17% with corresponding infection likelihood decreased by 27%. The window-integrated fan has a significant effect on improving ventilation performance and prevention of infection disease transmission, leading to an ADPI of 99% and minimum infection probability of 11% for students sitting near the windows. This work can help to develop low-cost and effective mitigating measures of infection disease in classrooms by using hybrid ventilation systems.

Exposure Risk to Medical Staff in a Nasopharyngeal Swab Sampling Cabin under Four Different Ventilation Strategies

Medical staff working in a nasopharyngeal swab sampling cabin are exposed to a higher exposure risk of COVID-19. In this study, computational fluid dynamics (CFD) are used to evaluate the exposure risk to medical staff in a nasopharyngeal swab sampling cabin of Chinese customs under four different ventilation strategies, i.e., multiple supply fans ventilation (MSFV), multiple exhaust fans ventilation (MEFV), single exhaust fan and outer windows closed ventilation (SEFV), and single exhaust fan and outer windows opened ventilation (SEFV-W). The impact of physical partitions on exposure risk is also discussed. The results show that MSFV performed best in reducing exposure risk. No significant difference was found between MEFV and SEFV. SEFV-W performed better than SEFV with a ventilation rate of 10–50 L/(s∙Person), while it performed worse with a ventilation rate of 50–90 L/(s∙Person). The exposure risk to medical staff did not decrease linearly with the increase in the ventilation flow rate under the four ventilation strategies. For MSFV, the installation of partitions is conducive to the reduction in the exposure risk. This study is expected to provide some guidance for ventilation designs in sampling cabins.

Airflow deflectors of external windowsto induce ventilation: Towards COVID-19 prevention and control

Since the Corona Virus Disease 2019 (COVID-19) outbreak, the normalization of the epidemic has posed great challenge to epidemic prevention and control in indoor environment. Ventilation systems are commonly used to prevent and control indoor transmission of disease. However, most naturally ventilated rooms are not efficient to prevent the spread of virus, i.e., classrooms. The goal of this work is to effectively adopt forced interference strategies (e.g., airflow deflector) applied to external windows to strengthen airflow diffusion performance (ADP) of natural ventilation. So far, no systematic study has been done to investigate the effectiveness of such airflow deflectors on its influence on natural ventilation and effectiveness of preventing the disease transmission in indoor environment. In this work, a case study was conducted based on cross-ventilated classrooms. Different settings of airflow deflectors (i.e., size and installation angle) were applied to the external windows. Air Diffusion Performance Index (ADPI) was utilized to evaluated airflow diffusion performance under different settings of the airflow deflectors. Then, the Wells-Riley model was applied to evaluate infection risk. According to the results, the infection risk can be reduced by 19.29% when infection source is located at the center of classroom and 17.47% when source is located near the side walls. This work would provide guidance for the design of classrooms ventilated with induced natural wind for epidemic prevention and control.

A Review on Applications of CFD Modeling in COVID-19 Pandemic

COVID-19 pandemic has started a big challenge to the world health and economy during recent years. Many efforts were made to use the computation fluid dynamic (CFD) approach in this pandemic. CFD was used to understanding the airborne dispersion and transmission of this virus in different situations and buildings. The effect of the different conditions of the ventilation was studied by the CFD modeling to discuss preventing the COVID-19 transmission. Social distancing and using the facial masks were also modeled by the CFD approach to study the effect on reducing dispersion of the microdroplets containing the virus. Most of these recent applications of the CFD were reviewed for COVID-19 in this article. Special applications of the CFD modeling such as COVID-19 microfluidic biosensors, and COVID-19 inactivation using UV radiation were also reviewed in this research. The main findings of each research were also summarized in a table to answer critical questions about the effectiveness levels of applying the COVID-19 health protocols. CFD applications for modeling of COVID-19 dispersion in an airplane cabin, an elevator, a small classroom, a supermarket, an operating room of a hospital, a restaurant, a hospital waiting room, and a children's recovery room in a hospital were discussed briefly in different scenarios. CFD modeling for studying the effect of social distancing with different spaces, using and not using facial masks, difference of sneezing and coughing, different inlet/outlet ventilation layouts, combining air-conditioning and sanitizing machine, and using general or local air-conditioning systems were reviewed.

CFD modeling of airborne pathogen transmission of COVID-19 in confined spaces under different ventilation strategies

Airborne transmission is an important route of spread of viral diseases (e.g., COVID-19) inside the confined spaces. In this respect, computational fluid dynamics (CFD) emerged as a reliable and fast tool to understand the complex flow patterns in such spaces. Most of the recent studies, nonetheless, focused on the spatial distribution of airborne pathogens to identify the infection probability without considering the exposure time. This research proposes a framework to evaluate the infection probability related to both spatial and temporal parameters. A validated Eulerian-Lagrangian CFD model of exhaled droplets is first developed and then evaluated with an office case study impacted by different ventilation strategies (i.e., cross- (CV), single- (SV), mechanical- (MV) and no-ventilation (NV)). CFD results were analyzed in a bespoke code to calculate the tempo-spatial distribution of accumulated airborne pathogens. Furthermore, two indices of local and general infection risks were used to evaluate the infection probability of the ventilation scenarios. The results suggest that SV has the highest infection probability while SV and NO result in higher dispersions of airborne pathogens inside the room. Eventually, the time history of indices reveals that the efficiency of CV and MV can be poor in certain regions of the room.

Prediction and control of aerosol transmission of SARS-CoV-2 in ventilated context: from source to receptor

Global spread of COVID-19 has seriously threatened human life and health. The aerosol transmission route of SARS-CoV-2 is observed often associated with infection clusters under poorly ventilated environment. In the context of COVID-19 pandemic, significant transformation and optimization of traditional ventilation systems are needed. This paper is aimed to offer better understanding and insights into effective ventilation design to maximize its ability in airborne risk control, for particularly the COVID-19. Comprehensive reviews of each phase of aerosol transmission of SARS-CoV-2 from source to receptor are conducted, so as to provide a theoretical basis for risk prediction and control. Infection risk models and their key parameters for risk assessment of SARS-CoV-2 are analyzed. Special focus is given on the efficacy of different ventilation strategies in mitigating airborne transmission. Ventilation interventions are found mainly impacting on the dispersion and inhalation phases of aerosol transmission. The airflow patterns become a key factor in controlling the aerosol diffusion and distribution. Novel and personalized ventilation design, effective integration with other environmental control techniques and resilient HVAC system design to adapt both common and epidemic conditions are still remaining challenging, which need to be solved with the aid of multidisciplinary research and intelligent technologies.

Evaluation of airborne particle exposure for riding elevators

Social distancing is a key factor for health during the COVID-19 pandemic. In many indoor spaces, such as elevators, it is difficult to maintain social distancing. This investigation used computational-fluid-dynamics (CFD) to study airborne particle exposure in riding an elevator in a typical building with 35 floors. The elevator traveled from the ground floor to the 35th floor with two stops on floor 10 and floor 20, comprising 114 s. The CFD simulated the dispersion of the aerosolized particles exhaled by an index person while breathing in both lobby and elevator areas. The study calculated the accumulated dose of susceptible riders riding in elevators with the index person under different conditions including different ventilation rates, air supply methods, and elevator cab geometries. This investigation also studied a case with a single cough from the index person as the person entered the elevator. The results show that, due to the short duration of the average elevator ride, the number of particles inhaled by a susceptible rider was low. For the reference case with a 72 ACH (air changes per hour) ventilation rate, the highest accumulated particle dose by a susceptible passenger close to the index person was only 1.59. The cough would cause other riders to inhale approximately 8 orders of magnitude higher particle mass than from continuous breathing by the index person for the whole duration of the ride.

Comparison of COVID-19 infection risks through aerosol transmission in supermarkets and small shops

Aerosol transmission is academically recognized as possible transmission route of Coronavirus disease 2019 (COVID-19). We established an approach to assess the airborne-disease infection risks through aerosol transmission based on the dose-response model and aerosol transport model. The accuracy of evaluation was guaranteed with on-site surveyed ventilation rate and occupant behavior. With the proposed approach, COVID-19 infection risks in 5 typical supermarkets and 21 small shops were evaluated. With one original infected early-shift staff, the average aerosols concentrations at steady-state are 1.06 × 10-3 RNA copies/m3 in the supermarkets and 4.73 × 10-2 RNA copies/m3 in the small shops. With the assumption of 5% original infected staff in the retail buildings, the infection probability of one customer is 1.40 × 10-6 for visiting one small shop and 6.22 × 10-6 for visiting one supermarket. The averaged infection risk in the supermarkets is higher than the small shops (p-value<0.001). On the other hand, the infection risks are higher for the staff working with the infected staff compared with the customers. The proposed approach can be applied to other occupied buildings and assist the pandemic control policy making for sustainable cities and society.

Exploring the potentials of personalized ventilation in mitigating airborne infection risk for two closely ranged occupants with different risk assessment models

In the context of COVID-19, new requirements are occurring in ventilation systems to mitigate airborne transmission risk in indoor environment. Personalized ventilation (PV) which directly delivers clean air to the occupant's breathing zone is considered as a promising solution. To explore the potentials of PV in preventing the spread of infectious aerosols between closely ranged occupants, experiments were conducted with two breathing thermal manikins with three different relative orientations. Nebulized aerosols were used to mimic exhaled droplets transmitted between the occupants. Four risk assessment models were applied to evaluate the exposure or infection risk affected by PV with different operation modes. Results show that PV was effective in reducing the user's infection risk compared with mixing ventilation alone. Relative orientations and operation modes of PV significantly affected its performance in airborne risk control. The infection risk of SARS-CoV-2 was reduced by 65% with PV of 9 L/s after an exposure duration of 2 h back-to-back as assessed by the dose-response model, indicating effective protection effect of PV against airborne transmission. While the side-by-side orientation was found to be the most critical condition for PV in airborne risk control as it would accelerate diffusion of infectious droplets in lateral diffusion to occupants by side. Optimal designs of PV for closely ranged occupants were hereby discussed. The four risk assessment models were compared and validated by experiments with PV, implying basically consistent rules of the predicted risk with PV among the four models. The relevance and applicability of these models were discussed to provide a basis for risk assessment with non-uniformly distributed pathogens indoor.

Effective ventilation and air disinfection system for reducing coronavirus disease 2019 (COVID-19) infection risk in office buildings

During the COVID-19 pandemic, an increasing amount of evidence has suggested that the virus can be transmitted through the air inside buildings. The ventilation system used to create the indoor environment would facilitate the transmission of the airborne infectious diseases. However, the existing ventilation systems in most buildings cannot supply sufficient clean outdoor air for diluting the virus concentration. To reduce the airborne infection risk and minimize energy consumption, especially in existing buildings with well-mixed ventilation systems, this investigation used an ultraviolet-C (UV-C) air disinfection device (Rheem's third generation products, RM3) with 99.9% disinfection efficiency to clean air carrying the COVID-19 virus (severe acute respiratory syndrome coronavirus 2, SARS-CoV-2) which could help promote environmental sustainability and create healthy cities. This investigation assessed the impact of the RM3 UV-C units on the infection risk, the number of RM3 UV-C units required, and the strategy for decreasing the infection risk, with the use of computational-fluid-dynamics (CFD) numerical simulations. An actual office building with a combination of individual offices and workstations was selected as an example for the research. According to the numerical results, the best strategy would be to use a combination of 100% outside air and UV-C in heating, ventilation and air-conditioning (HVAC) ducts with air disinfected by the RM3 UV-C units. The infection risk in the office building could thus be reduced to a negligible level. These findings could provide theoretical basis and engineering application basis for COVID-19 epidemic prevention and control.

Optimization of air supply parameters for stratum ventilation based on proper orthogonal decomposition

Under the current COVID-19 epidemic conditions, stratum ventilation can provide treated fresh air directly into the human breathing zone, improving the air quality for inhalation. However, in the design of air supply parameters for stratum ventilation, the traditional trial-and-error and experimental methods are inefficient and time consuming, and they cannot be used to identify the optimal air supply parameters from a large number of parameters. Therefore, in this paper, the inverse design method based on proper orthogonal decomposition (POD) was applied to the design of ventilation parameters for a room with stratum ventilation. Predicted mean vote (PMV), predicted percentage dissatisfied (PPD) and droplet nuclei concentration in the human breathing zone were selected as design objectives to optimize air supply parameters. The transmission of COVID-19 was controlled by reducing the concentration of droplet nuclei in the respiratory area. The results show that, compared with the trial-and-error method, the inverse design method based on POD is more than 90% faster. POD method can greatly expand the sample size. Considering the dispersion of exhaled droplet nuclei in the room, the appropriate stratum ventilation parameters can reduce the concentration of fine droplet nuclei by more than 20% compared with the traditional design parameters.

Passenger exposure to respiratory aerosols in a train cabin: Effects of window, injection source, output flow location

Nowadays the use of public transportation (PT) has been identified as high risk as due to the transfer of particles carrying the coronavirus from an infected passenger to others. This study puts forward a new computational framework for predicting the spread of droplets produced while the infected passenger talking inside the cabin of a train during various scenarios, including the changes in the outflows' location and the infected passenger's position. CFD was used to conduct the study, using the Euler-Lagrange approach to capture the transmission of particles, and Reynolds-averaged Navier-Stokes equations (RANS) to compute the airflow field. The results revealed that opening the window reduces the duration of particles inside the domain. So that when the window is open, the particle's shelf time can decrease to 25 percent comparing with closed mode. It was found that the passenger sitting next to the infected passenger encountered the highest infection risk. The conclusions made in this work show that the most desirable situation is obtained when the infected passenger is sitting next to the exits, whether the window is closed or open. The results of this paper offer comprehensive insights into how to keep indoor environments safe against infection aerosols.

On the Critical Role of Human Feces and Public Toilets in the Transmission of COVID-19: Evidence from China

The surprising spread speed of the COVID-19 pandemic creates an urgent need for investigating the transmission chain or transmission pattern of COVID-19 beyond the traditional respiratory channels. This study therefore examines whether human feces and public toilets play a critical role in the transmission of COVID-19. First, it develops a theoretical model that simulates the transmission chain of COVID-19 through public restrooms. Second, it uses stabilized epidemic data from China to empirically examine this theory, conducting an empirical estimation using a two-stage least squares (2SLS) model with appropriate instrumental variables (IVs). This study confirms that the wastewater directly promotes the transmission of COVID-19 within a city. However, the role of garbage in this transmission chain is more indirect in the sense that garbage has a complex relationship with public toilets, and it promotes the transmission of COVID-19 within a city through interaction with public toilets and, hence, human feces. These findings have very strong policy implications in the sense that if we can somehow use the ratio of public toilets as a policy instrument, then we can find a way to minimize the total number of infections in a region. As shown in this study, pushing the ratio of public toilets (against open defecation) to the local population in a city to its optimal level would help to reduce the total infection in a region.

Optimal control of high-rise building mechanical ventilation system for achieving low risk of COVID-19 transmission and ventilative cooling

As suggested by many guidelines, a high ventilation rate is required to dilute the indoor virus particles and reduce the airborne transmission risk, i.e., dilution ventilation (DV). However, high ventilation rates may result in high energy costs. Ventilative cooling (VC), which requires high ventilation rates like DV, is an option to reduce the cooling energy consumption. By combining DV and VC, this paper investigated the operation of the mechanical ventilation system in high-rise buildings during the COVID-19 pandemic, aiming to minimizing the cooling related energy consumption and reducing COVID-19 transmission. First, a modified Wells-Riley model was proposed to calculate DV rates. The ventilation rate required to achieve VC was also introduced. Then, a new ventilation control strategy was proposed for achieving DV and VC. Finally, a case study was conducted on a real high-rise building, where the required DV rate and the impact of the settings of the mechanical ventilation on the energy savings were evaluated. The results indicate that the required ventilation rates vary from 36 m3/s to 3306 m3/s depending on the protective measures. When the occupants follow the protective measures, the proper settings of the mechanical ventilation system can reduce energy consumption by around 40%.

Occupational Health and Safety Measures in Healthcare Settings during COVID-19: Strategies for Protecting Staff, Patients and Visitors

The COVID-19 (SARS-CoV-2) pandemic has profoundly impacted almost every aspect of healthcare systems worldwide, placing the health and safety of frontline healthcare workers at risk, and it still continues to remain an important public health challenge. Several hospitals have put in place strategies to manage space, staff, and supplies in order to continue to deliver optimum care to patients while at the same time protecting the health and safety of staff and patients. However, the emergence of the second and third waves of the virus with the influx of new cases continue to add an additional level of complexity to the already challenging situation of containing the spread and lowering the rate of transmission, thus pushing healthcare systems to the limit. In this narrative review paper, we describe various strategies including administrative controls, environmental controls, and use of personal protective equipment, implemented by occupational health and safety departments for the protection of healthcare workers, patients, and visitors from SARS-CoV-2 virus infection. The protection and safeguard of the health and safety of healthcare workers and patients through the implementation of effective infection control measures, adequate management of possible outbreaks and minimization of the risk of nosocomial transmission is an important and effective strategy of SARS-CoV-2 pandemic management in any healthcare facility. High quality patient care hinges on ensuring that the care providers are well protected and supported so they can provide the best quality of care to their patients.