A New Way to Think About Air

We are, I hope, at the beginning stage of a revolution in the design of buildings and fresh air ventilation systems. Yes, spurred by covid-19 but, in my opinion, long overdue. This article from The Atlantic (my favorite magazine!) should be required reading of anyone involved in covid-19 policy or research, and anyone who wants a deeper understanding of practical measures you can do to reduce your risk of covid-19 and other air-borne illnesses.

I’ve been saving this article since September 7, 2021. That was before the Omicron surge, of course, but readers now may be able to appreciate even more, the wisdom presented here. To set the stage:

"The 19th and early 20th century saw a number of ambitious public-health efforts … The United States eliminated yellow fever and malaria, for example … One by one, the diseases that people accepted as inevitable facts in life—dysentery, typhoid, typhus, to name a few more—became unacceptable in the developing world. But after all this success, after all we’ve done to prevent the spread of disease through water and insects, we seem to have overlooked something. We overlooked air.

This turned out to have devastating consequences for the beginning of the coronavirus pandemic. The original dogma, you might remember, was that the novel coronavirus spread ... through droplets that quickly fell out of the air. We didn’t need ventilation or masks; we needed to wash our hands and disinfect everything we touched. But a year and half of evidence has made clear that the tiny virus-laden particles indeed linger in the air of poorly ventilated areas. It explains why outdoors is safer than in, why a single infected person can super-spread to dozens of others without directly speaking to or touching them. If we are to live with this coronavirus forever—as seems very likely—some scientists are now pushing to reimagine building ventilation and clean up indoor air. We don’t drink contaminated water. Why do we tolerate breathing contaminated air?"

The Atlantic, 9/7/2021 Article: Coronavirus Ventilation - A New Way to Think About Air

When Will It Be Safe To Go Back In The Water?

Of course, there is no one right answer. I’ll have a future blog post on “endemic” and what it means. For now, I was thinking of last summer, pre-Delta, when the case count in New Hampshire was as low as 20 a day. I was tentatively venturing out then, even risking a vacation to the beach. Now those look like the good old days.

As I hope you know by now, comparing case counts pre- and post-Omicron is not valid because the number of Omicron cases is way higher, per hospitalized person for example, than pre-Omicron. So I looked up the valid comparison measures of hospitalizations and deaths. See Covidactnow.org charts below:

Of these, to me, hospitalization is the best metric. (People stay multiple days in the hospital, so the 20/day count of hospital patients, compared to the 20/day cases, does NOT mean that 100% of cases end up in the hospital.) I’ll be looking for hospitalization rates down in the 20’s. That will be about 10% of the current numbers, so we have a ways to go.

The other excellent metric to follow comes from the well-known Georgia Tech site (covid19risk.biosci.gatech.edu), where they predict the probability of encountering one or more people currently with covid-19, based on the community spread numbers. So if I go into a small grocery store, let’s say assuming 100 people in the building, and the odds are less than 10% that there are one or more covid-positive people there, I would feel pretty good about that.

I don’t feel good at all about the current risk, which says that there is definitely some covid-19 virus in the air of that grocery store—see the graphic below. But we are moving in the right direction, as shown by the graphs above!

We’d like to hear your thoughts - we welcome those thoughts by email at safetulator@kohlerandlewis.com.

BinaxNOW on the Shelf at Walgreens in Keene!

Walgreens on West Street in Keene has over 100 BinaxNOW test kits sitting on their shelves as of today at noon, Thursday, 2/3/2022.

Reminder of our company policy for how to use antigen tests properly: if you have symptoms, wait until day 5 after having symptoms to do the antigen test (twice) for best accuracy - although it’s hard to wait that long and it’s better to get a PCR test as soon as possible.

If you have no symptoms and you want to use the test to see if you've got covid-19 or not, you need to do 2 tests, 24 hours apart, and they both have to be negative.

The best use of antigen tests is after you have had covid-19 - as per the February 2, 2022 post, wait at least five days after the onset of symptoms and do one test per day until you get two negative results.

Covid-19 Testing--You're Doing It Wrong

An upcoming blog post will tell you what our policies are that we think we’re doing right, but first, here are ways that you (and millions of people) may be doing it wrong:

  • Wrong: requiring a negative PCR test after having had the disease, before being allowed to (return to work) (play tennis) (compete in the Olympics) etc. ==> “A PCR test might say you're positive for coronavirus for three or four weeks after you've recovered because it's still picking up past infection and the small fragments (of the virus) are still being amplified...” (PCR vs. Antigen Tests - Covid-19 Wellness - CNN.com 1/19/2022) And sometimes even longer than that!

  • Wrong: at the first blush of symptoms, taking an antigen test. Not enough time for the virus to get to detectable levels, so you will get a negative result whether you are infected, and infectious, or not. (Special Reports - Medpagetoday.com 1/20/2022)

  • Wrong: requiring or using any covid-19 test with a negative result with the testing time as much as 48 or 72 hours in advance before you are allowed into the event or onto the cruise ship, etc. “If the requirement is a PCR within like 72 hours of travel or similar, a lot can happen in those three days.” (PCR vs. Antigen Tests - Covid-19 Wellness - CNN.com 1/19/2022)

  • Wrong: returning to work today because some number of days have elapsed, even though you just tested positive with an antigen test. “As long as you continue to test positive on a rapid at-home test, you should still consider yourself potentially contagious, Kissler said. … It is safest to continue to isolate until you no longer test positive, the experts stressed.” (Still Testing Positive Covid-19 - Today.com 1/18/2022)

  • Wrong: returning to work after having covid-19 because you have a negative antigen test result on, say, day 3. “The first test should not be taken before the fifth day after symptoms have started (or the day a [positive] test was taken if symptoms were not present).” (Special Reports - Medpagetoday.com 1/20/2022) And wow, consider this: “… almost a third of people with COVID-19 were still contagious five days after symptom onset or a positive test.” (How Long Is Contagious Infectious Period With Omicron, Delta - Businessinsider.com 1/22/2022) And after ten days, 5% were still infectious!

We don't have live comments or feedback set up yet for blog posts, but you're always welcome to email us at safetulator@kohlerandlewis.com and tell us if you'd like us to post your comment.

Three Is The Magical Number

Looks like three months of enhanced immunity may be about all we can count on from a booster shot. That is, in this UK study of the Pfizer vaccine, “By three months, the booster reduces the risk of a symptomatic infection only by about 50%.” To which I say: remember, everything is additive. So add in a good mask, and good fresh air ventilation, and some air purification, then your risk will be much less.

NPR.org - Covid Booster Omicron Efficacy - January 19, 2022

And according to the NFL (which I trust due to their extensive monitoring), it’s about the same three month period of relative immunity after having had the Omicron version of covid-19. That is, they exempt players from frequent testing for 90 days after their infection.

2022 - Interesting Times Continue!

Wow, lots of new covid-19 developments lately! Here is a review of a few of the topics over the last month and a preview of what’s coming up in the blog:

Some of the topics in the last month …

  • A very detailed study found that 61% of covid-19 cases came from a single type of indoor activity (Dec. 15).

  • We updated our comprehensive company policy on covid-19 safety (Dec. 17, and again on Jan. 10) and it’s already a little out of date—the latest information shows that antigen tests are not accurate until five or six days have passed since the onset of symptoms. So if you have symptoms, just get a PCR test as soon as possible!

  • Everything you ever wanted to know about masks—well at least what our practices are—including four short videos (Jan. 4).

  • The news, now echoed from many sources, that antigen tests are useless to test for the onset of covid-19 if you have no symptoms (Jan. 7). OK, just as the government is giving away hundreds of millions of antigen tests and I bet most people will use them incorrectly.

  • Yes, we all want the pandemic to be over, but it’s sobering to see the CDCs chart of community spread rates across the country (Jan. 10).

  • Air purifiers are perhaps the most underused, effective measure to reduce covid-19 risk—they function like an additional really good mask for everyone in the room, without the hassle. We reprinted our comprehensive advice.

  • Scary news from The Atlantic magazine (always excellent!) on the desperate shape of many of our hospitals (Jan. 12).

  • Finally, a true story of the importance of using multiple methods for risk reduction, and a new video on the use of the fresh air meters we sell (Jan. 20).

And in the days ahead …

  • Quite a collection of important new national stories, including an update on Omicron symptoms, and a review of fresh air ventilation advice from the CDC and WHO.

  • A story and recommendations from us on another important part of indoor air quality in the winter: humidity levels.