Back In The Covid Life Again
It’s been 3-1/2 years since the Covid-19 pandemic began. We have all the experience and tools we need to manage the virus and prevent outbreaks and surges, and to prevent large numbers of cases, hospitalizations, deaths, and life-altering “long covid”.
As we once again gather together in schools and other buildings, the amount of virus in our communities is on the rise. In the U.S., the only reliable current monitoring comes from sampling for the amount of the virus in sewage at the treatment plants. These numbers are now at an historically medium level, not counting the huge Omicron surge of the winter of 2022-2023. At the current level, in the past when we were counting carefully, there were 300-600 deaths a day attributable to covid-19. That means 100,000+ a year!
Although barely reported, current covid-19 outbreaks are temporarily shutting down or affecting operations in multiple schools and other buildings throughout the U.S., including an emergency call center in Kentucky.
And yet, many people don’t seem to know that they have missed doing the most effective measures for control of covid-19, and instead seem to be resigned to their fate of continuing frequent cases. A spokesperson at the call center said “We had in place precautions … hand washing, the masks, and we had hand sanitizing stations …”
This might sound OK until you realize that hand washing and sanitizing come from the early and wrong advice about how the virus spreads [see Mar. 21, 2022 blog post], and that masks reduce the risk by only about 25% [see item #1 in the March 10, 2022 blog post]. Here’s how we can do better. (Check the referenced previous issues of this blog for all the details.)
Top Five Best Practices to Minimize Covid-19 Spread
1. Great fresh air ventilation in buildings. This is like having everyone wear a really really good mask without the hassles, and has been shown to cut the number of cases of covid-19 and other airborne infectious diseases by 80%! [See Dec. 16, 2022 blog post and Oct. 14, 2022 blog post and Dec. 6, 2021 blog post.]
2. Monitor carbon dioxide (CO2) to make sure you are achieving #1. In Vermont, for example, the state issued to every public school an advanced CO2 meter that also measures small particle air pollution as from wildfires. Keep the CO2 reading below 800 ppm, as the state recommends. [COVID-19 Mechanical Engineering Recommendations] The rooms need to be monitored when they have normal occupancy. Some buildings have automatic electronic systems that do this, or you can take around your hand-held meter. Some buildings have large, permanent meters installed to show people that the building fresh air is “in the green zone”—this is an excellent practice. [See #3 in the Apr. 29, 2022 blog post.]
3. Be sure your building’s mechanical ventilation systems are set right and working well. There’s a ton of information on this topic here in our blog and website. And here’s a new, simple checklist for the start of the school year.
4. Establish a culture that it’s OK to stay away when you’re sick, and have the best facilities and practices when someone gets sick during the day. In 2020, Vermont encouraged all schools to set up Isolation Rooms where sick people can avoid infecting anyone else because the air from the room is exhausted, not recirculated. If your school does not have this, you can set it up in any room with a window and a window fan to exhaust the air. [See Feb. 9, 2023 blog post.]
5. Use covid-19 antigen tests—now less than $5 each. [See Dec. 16, 2022 blog post.] These tests give results in 10-20 minutes, use a short nose swab (not those terrible long ones from the early days of the pandemic!), and tell you definitively whether or not someone is contagious to spread the virus today [see Aug. 5, 2022 blog post]. They are not sensitive enough to detect a low level of the disease, below the level where you are contagious. So someone with symptoms and a negative test should still be sent home for the day and asked to stay home as long as there are symptoms, and to re-test daily.
The antigen tests also can be used by people who want to be sure they are not contagious when they gather with other people—family gatherings, teacher meetings, singing rehearsals, nursing home staff, etc. I have not seen any studies on this, but my feeling is that the dollar cost of these tests turns out to be less than the cost of absent teachers and students, medical expenses, and the anxiety associated with covid-19 outbreaks or continuing cases and risk.
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