Nationwide assessment of energy costs and policies to limit airborne infection risks in U.S. schools

Practices such as improved ventilation and air filtration are being considered by schools to reduce the transmission of Severe Acute Respiratory Syndrome Coronavirus 2 that causes the pandemic of coronavirus disease 2019 (COVID-19). Improved ventilation may significantly increase the energy cost of heating, ventilation, and air conditioning (HVAC), exacerbating financial challenges schools face amidst the worst pandemic in decades. This study evaluated HVAC energy costs for reducing COVID-19 airborne infection risks in 111,485 public and private schools in the U.S. to support decision-making. The average annual HVAC energy cost to maintain the infection risk below 1% for the schools in the U.S. is estimated at $20.1 per square meter or $308.4 per capita with improved ventilation and air filtration, where the private schools have higher costs than the public schools on average. The cost could be reduced by adopting partial online learning. It is also found that additional cost to control infection risk with increased ventilation and air filtration is significantly lower for PK-5 schools than that for middle and high schools in all states, indicating the possibility of remaining in-person instruction for PK-5 schools with necessary governmental assistance. Analyses of school HVAC energy cost to reduce airborne infection risk under different intervention scenarios provide important operational guidelines, financial implications, and policy insights for schools, community stakeholders, and policymakers to keep schools safe during the ongoing pandemic and improve preparedness for epidemics projected in the future.

Coronavirus disease 2019 vaccines: landscape of global studies and potential risks.

ABSTRACT: With the outbreak of the coronavirus disease 2019 (COVID-19) pandemic, the importance of vaccines in epidemic prevention and public health has become even more obvious than ever. However, the emergence of multiple severe acute respiratory syndrome coronavirus 2 variants worldwide has raised concerns about the effectiveness of current COVID-19 vaccines. Here, we review the characteristics of COVID-19 vaccine candidates in five platforms and the latest clinical trial results of them. In addition, we further discuss future directions for the research and development of the next generation of COVID-19 vaccines. We also summarize the serious adverse events reported recently after the large-scale vaccination with the current COVID-19 vaccines, including the thromboembolism caused by the AstraZeneca and Johnson & Johnson vaccines.

Understanding building-occupant-microbiome interactions toward healthy built environments: A review.

Built environments, occupants, and microbiomes constitute a system of ecosystems with extensive interactions that impact one another. Understanding the interactions between these systems is essential to develop strategies for effective management of the built environment and its inhabitants to enhance public health and well-being. Numerous studies have been conducted to characterize the microbiomes of the built environment. This review summarizes current progress in understanding the interactions between attributes of built environments and occupant behaviors that shape the structure and dynamics of indoor microbial communities. In addition, this review also discusses the challenges and future research needs in the field of microbiomes of the built environment that necessitate research beyond the basic characterization of microbiomes in order to gain an understanding of the causal mechanisms between the built environment, occupants, and microbiomes, which will provide a knowledge base for the development of transformative intervention strategies toward healthy built environments. The pressing need to control the transmission of SARS-CoV-2 in indoor environments highlights the urgency and significance of understanding the complex interactions between the built environment, occupants, and microbiomes, which is the focus of this review.

Integrated environment-occupant-pathogen information modeling to assess and communicate room-level outbreak risks of infectious diseases.

Microbial pathogen transmission within built environments is a main public health concern. The pandemic of coronavirus disease 2019 (COVID-19) adds to the urgency of developing effective means to reduce pathogen transmission in mass-gathering public buildings such as schools, hospitals, and airports. To inform occupants and guide facility managers to prevent and respond to infectious disease outbreaks, this study proposed a framework to assess room-level outbreak risks in buildings by modeling built environment characteristics, occupancy information, and pathogen transmission. Building information modeling (BIM) is exploited to automatically retrieve building parameters and possible occupant interactions that are relevant to pathogen transmission. The extracted information is fed into an environment pathogen transmission model to derive the basic reproduction numbers for different pathogens, which serve as proxies of outbreak potentials in rooms. A web-based system is developed to provide timely information regarding outbreak risks to occupants and facility managers. The efficacy of the proposed method was demonstrated by a case study, in which building characteristics, occupancy schedules, pathogen parameters, as well as hygiene and cleaning practices are considered for outbreak risk assessment. This study contributes to the body of knowledge by computationally integrating building, occupant, and pathogen information modeling for infectious disease outbreak assessment, and communicating actionable information for built environment management.

Prolonged prothrombin time at admission predicts poor clinical outcome in COVID-19 patients.

BACKGROUND: The prognostic value of coagulation disorder in coronavirus disease 2019 (COVID-19) patients should be demonstrated. AIM: To investigate the abnormalities of coagulation parameters in the patients with COVID-19 and their prognostic values. METHODS: Consecutive patients admitted in the isolation ward of Renmin Hospital of Wuhan University from January 31 to February 5, 2020 with confirmed COVID-19 were included. The primary outcomes were death and survival as of March 11. Demographics, vital signs, comorbidities and laboratory tests were collected and compared between those who died and survivors. Logistic regression analysis for prognostic factors was performed. Kaplan-Meier analysis was used to compare the estimated survival rate between patients with prolonged prothrombin time and normal prothrombin time. RESULTS: The total number of patients with confirmed COVID-19 who were enrolled was 213. The median age was 62 years, and 95 patients (44.6%) were men. Fifty-one patients were critical (23.9%), 79 patients were severe (37.1%) and 83 patients were moderate (39%). As of March 11, 2020, 99 patients were discharged (46.5%), 79 patients (37.1%) stayed in the hospital and 35 patients (16.2%) died. Median time to death was 6 (4-8) d, while median hospital stay was 32 (22-36) d in survivors (P < 0.001). More men (P = 0.002) and elderly patients (P < 0.001) were found in the group of those who died. The respiration rate at admission was higher in the group of those who died (P < 0.001). The incidences of hypertension (P = 0.028), cerebrovascular disease (P < 0.001), chronic kidney disease (P = 0.02) and chronic obstructive pulmonary disease (P < 0.001) were higher in the group of those who died. Platelet count was decreased in the group of those who died (P = 0.002) whereas prothrombin time (P < 0.001), activated partial thromboplastin time (P = 0.033), concentration of D-dimer (P < 0.001) and fibrin degradation products (P < 0.001) were increased in the group of those who died. Prothrombin time [odds ratio (OR): 2.19, P = 0.004], respiration rate (OR: 1.223, P < 0.001), age (OR: 1.074, P < 0.001) and fibrin degradation products concentration (OR: 1.02, P = 0.014) were predictors of death. The survival rate was significantly lower in patients with prolonged prothrombin time compare to those with normal prothrombin time (P < 0.001). CONCLUSION: Prothrombin time, concentration of fibrin degradation products, respiration rate and age were predictive factors for clinical outcomes of COVID-19 patients.

Segmenting areas of potential contamination for adaptive robotic disinfection in built environments.

Mass-gathering built environments such as hospitals, schools, and airports can become hot spots for pathogen transmission and exposure. Disinfection is critical for reducing infection risks and preventing outbreaks of infectious diseases. However, cleaning and disinfection are labor-intensive, time-consuming, and health-undermining, particularly during the pandemic of the coronavirus disease in 2019. To address the challenge, a novel framework is proposed in this study to enable robotic disinfection in built environments to reduce pathogen transmission and exposure. First, a simultaneous localization and mapping technique is exploited for robot navigation in built environments. Second, a deep-learning method is developed to segment and map areas of potential contamination in three dimensions based on the object affordance concept. Third, with short-wavelength ultraviolet light, the trajectories of robotic disinfection are generated to adapt to the geometries of areas of potential contamination to ensure complete and safe disinfection. Both simulations and physical experiments were conducted to validate the proposed methods, which demonstrated the feasibility of intelligent robotic disinfection and highlighted the applicability in mass-gathering built environments.