Effectiveness of personalized ventilation in reducing airborne infection risk for long-term care facilities

Throughout history, the human population has experienced major outbreaks of infectious diseases. In December 2019 the previously unknown SARS-CoV-2 virus emerged, which had a huge impact globally. Residents of long- term care facilities (LTCFs) showed to be highly susceptible to infection due to their frailty. Respiratory infectious diseases, such as COVID-19, can spread among others via the airborne transmission route. This is caused by sharing the same indoor environment. To reduce the risk of infection via the airborne route, it is important to consider ventilation and other building services system measures, including personalized ventilation (PV). PV has the potential of being a suitable solution for LTCFs, as it could still allow interaction between residents and visitors in the common rooms, which is regarded very important from a mental health perspective. To identify the potential of PV in the context of infection risk, a laboratory experiment was conducted to investigate its effectiveness on the infection risk reduction. The research was performed in a controlled climate chamber. In the experiment a person was mimicked and positioned close to a PV system that provided filtered recirculated air. A particle source maintained a constant particle concentration in the room. The performance of the PV system was measured through the particle concentration near the breathing zone as compared to the room concentration. Several design parameters were investigated. Translating the outcomes to a fictive (equivalent) ventilation rate, the Wells-Riley equation was applied to determine the infection risk. The outcomes indicated that, in this laboratory setting, the PV system can reduce the risk of an infection up to 50%. The performance is affected by the distance of the supply head to the breathing zone, the angle of the supply head, airflows in the room and the location of the particle source. To further optimize the system and allow its application in LTCFs, several aspects still need further attention, such as mobility/placing the person, the breathing pattern of the user and factors influencing the comfort and use. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Practical Indicators for Risk of Airborne Transmission in Shared Indoor Environments and Their Application to COVID-19 Outbreaks.

Some infectious diseases, including COVID-19, can undergo airborne transmission. This may happen at close proximity, but as time indoors increases, infections can occur in shared room air despite distancing. We propose two indicators of infection risk for this situation, that is, relative risk parameter (Hr) and risk parameter (H). They combine the key factors that control airborne disease transmission indoors: virus-containing aerosol generation rate, breathing flow rate, masking and its quality, ventilation and aerosol-removal rates, number of occupants, and duration of exposure. COVID-19 outbreaks show a clear trend that is consistent with airborne infection and enable recommendations to minimize transmission risk. Transmission in typical prepandemic indoor spaces is highly sensitive to mitigation efforts. Previous outbreaks of measles, influenza, and tuberculosis were also assessed. Measles outbreaks occur at much lower risk parameter values than COVID-19, while tuberculosis outbreaks are observed at higher risk parameter values. Because both diseases are accepted as airborne, the fact that COVID-19 is less contagious than measles does not rule out airborne transmission. It is important that future outbreak reports include information on masking, ventilation and aerosol-removal rates, number of occupants, and duration of exposure, to investigate airborne transmission.

Viral transmission in COVID-19: the role of the aerosol

Since there is no adequate treatment for COVID-19, prevention of the transmission of SARS-CoV2 is the best way to cope with the pandemic. National guidelines for non-pharmaceutical interventions focus mainly on the interference with viral transmission via droplets and surface by hygiene measures, limitation of human contact, and social distancing. There is growing evidence that a third route of transmission by aerosols - exhaled tiny particles with viable infectious virus that remain airborne for hours - may be relevant. This route may even be the predominant way of viral transmission in the case of so-called superspreading events. It implies the need for adequate ventilation at indoor spaces without recirculation of virus containing aerosols. Here, the use of face-masks might be of added value too. These measures appear to be especially pivotal during episodes of colder weather, when people spend significantly more time indoors.