Poorly ventilated schools are a super-spreader event waiting to happen. It may be as simple as opening windows


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Geoff Hanmer, University of Technology Sydney and Bruce Milthorpe, University of Technology SydneyInfections of the Deltra strain are increasing across Australia. A significant number of recent outbreaks have been in schools.

In the earlier waves of the COVID outbreak, in 2020, evidence showed children were getting COVID at much lower rates than adults, and the advice from experts was to keep schools open. But a series of papers later showed children were at similar risk of infection to adults.

This is even worse with Delta. According to the US Centers for Disease Control, the Delta variant is about twice as infectious as the earlier strains. And preliminary data suggest children and adolescents are at greater risk of becoming infected with this variant, and transmitting it.




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The World Health Organization has recognised SARS-CoV-2, the virus that causes COVID-19, is airborne. The evidence for aerosol transmission is now enough for the Australian Infection Control Expert Group (ICEG), which advises the federal government, to have recently amended its earlier advice that COVID-19 was only spread by contact and droplets:

ICEG has also recognised broader circumstances in which there may be potential for aerosol transmission […] ICEG […] notes the risk may be higher under certain conditions, such as poorly ventilated indoor crowded environments.

“Poorly ventilated indoor crowded environments” accurately describes conditions at many schools. Even in lockdown, schools are still open for children of essential workers and classrooms in use can have relatively high occupancy.

In or out of lockdown, poorly ventilated schools are a super-spreader event waiting to happen.

How are schools ventilated?

Most schools are naturally ventilated. This means windows must be open to deliver fresh air which will dilute and disperse airborne pathogens.

It is not a coincidence the current Australian outbreaks are happening in winter, when naturally ventilated buildings, including most schools, are more likely to have their windows shut to keep the heat in.

Some schools, particularly those with open learning spaces, have buildings too deep for natural ventilation and are mechanically ventilated. This may involve air conditioning, but not all air conditioning includes ventilation. For instance, a split system air conditioner typically recirculates air inside a space whereas ventilation introduces fresh air into the building.




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Mechanically ventilated buildings are supposed to have around 10 litres per second (l/s) of fresh air per person. But the temptation to throttle back fresh air to save energy and money is ever present. And even with 10 l/s per person coming in, there may be places with poor ventilation. This includes stairwells, lifts, corridors and assembly spaces.

As aerosols may persist in the air for hours, schools with poor ventilation become a high risk for transmission and kids can take it back to their families.

We have been measuring ventilation in schools and other buildings in Sydney, Canberra, Brisbane and Adelaide using a carbon dioxide (CO2) meter. This is because C02, which is exhaled by humans, is a good proxy for the level of ventilation in a space.

Outside air is about 400-415 ppm (parts per million) of CO2 and well-ventilated indoor environments are typically below 800 ppm with best practice around 600 ppm.

CO₂ monitor in school showing 417ppm
This measurement of a classroom in an older-built school shows safe CO2 levels.
Author provided

Our informal measurements show many newer mechanically ventilated buildings are not well ventilated. Perhaps counter-intuitively, older style naturally ventilated school buildings with leaky wooden windows on both sides of the room and high ceilings often appear to perform well.

Just looking at a building is not a reliable guide to how well ventilated it is.

What schools need to do

We can do several things to ensure schools are well ventilated. The first is to ensure the school has access to a CO2 meter and takes action where CO2 is above 800 ppm.

If the building has windows and doors, open them. This may require kids and teachers putting on an extra layer of clothing, turning up the heating, providing supplementary heaters and making revised security arrangements.

Anything required to keep people safe and thermally comfortable in a well ventilated space is likely to be much cheaper than dealing with an outbreak.

Serviceable standalone NDIR sensor-type CO2 meters can be bought online for less than A$100. More sophisticated networkable devices are available for under A$500.




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If the space is mechanically ventilated, a school will need to get a mechanical engineer to work out how the system can be improved. In the meantime, staff could try opening doors, using fans to mix air in large volume spaces or move activities outside.

Where improvements in ventilation are not immediately possible, portable air purifiers can reduce the amount of virus in the air. An air purifier will need at least a HEPA (high-efficiency particulate absorbing) filter to be effective and has to be matched to the size of the room. A typical classroom may need two devices to work and a large open plan space may need several.

In future, we will need to change building regulations to deliver safe, clean air in schools. For now, we just need to do the best we can. It may be as simple as opening the windows.The Conversation

Geoff Hanmer, Honorary Professional Fellow, University of Technology Sydney and Bruce Milthorpe, Emeritus Professor, Faculty of Science, University of Technology Sydney

This article is republished from The Conversation under a Creative Commons license. Read the original article.

How a perfect storm of events is turning Myanmar into a ‘super-spreader’ COVID state


Adam Simpson, University of South Australia and Nicholas Farrelly, University of TasmaniaMyanmar is facing a catastrophic health crisis that could have ramifications not just for the country’s long-suffering people, but across the region as well.

The country is experiencing a major spike in COVID cases — what one Doctors Without Borders official referred to as “uncontrolled community spread” — fuelled by the military junta’s gross mismanagement of the crisis and a collapsing health sector.

The military regime’s official COVID statistics are running at around 6,000 cases and 300 deaths per day, but no one believes these are accurate. This is, after all, the junta that staged a military coup in February and then tried to argue it was constitutionally valid.

With only 2.8% of Myanmar’s 54 million people fully vaccinated, there are now concerns the country could become a “COVID superspreader state”. And this could lead to the emergence of new variants, says the UN’s special rapporteur for human rights in Myanmar.

This is very, very dangerous for all kinds of reasons […] This is a region that is susceptible to even greater suffering as a result of Myanmar becoming a super-spreader state.

Doctors being imprisoned

The UN says a “perfect storm” of factors is fuelling the deepening health crisis.

Medical staff have been on strike as part of the civil disobedience movement against the coup. Oxygen and other medical equipment are increasingly expensive and in short supply. Even getting an oxygen concentrator into Myanmar is not straightforward, though Singapore said this week it will rush 200 machines into the country.




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Most troublingly, at least 157 medics, including the former head of Myanmar’s COVID-19 vaccination program, have been arrested and charged with high treason. In Yangon, military personnel have pretended to be COVID patients in need of emergency treatment, then arrested the doctors who came to help.

Reliable figures on the infection rate are impossible to obtain, but civil society groups that assist with cremations and funeral services in Yangon say they are seeing up to 1,000 uncounted COVID deaths a day in that city alone. The national total may be several thousand per day.

One reason it’s impossible to get an accurate count of COVID cases is the extremely low rate of testing. There are only around 15,000 COVID tests being conducted per day in a country of 54 million people. The tests are, however, returning a positive rate of around 37%, or 370 positives for every 1,000 tests.

It’s also believed nearly 50 prisoners at the crowded, notorious Insein Prison are now infected with COVID but are being denied treatment by the military.

These prisoners include top leaders from Aung San Suu Kyi’s National League for Democracy, doctors connected with the civil disobedience movement, and foreigners like Australian academic Sean Turnell, an adviser to Suu Kyi who was arrested by the junta after the coup and is being held on bogus charges.

Another adviser and lawyer to Suu Kyi, Nyan Win, died last week after being infected with COVID at Insein.

Protesters marching against the junta in the capital, Yangon, in mid-July.
AP

Myanmar’s poor are disproportionatly suffering

Such a catastrophic health situation is exacerbating Myanmar’s inequalities. Poorer people are less able to socially distance and less likely to get tested and receive meaningful treatment. They suffer invisibly, often in silence.

In a report published this week, the World Bank estimated Myanmar’s economy would contract by 18% this year due to the effects of the pandemic and the coup. The share of people living in poverty is also likely to more than double by the beginning of 2022, compared to 2019.




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The ethnic minority regions of the country may well be disproportionately suffering, too. Since the coup, conflicts have intensified across the country between the military and the ethnic armed organisations and pro-democracy advocates that have joined them, causing immense social dislocation.

The UN refugee agency estimates 200,000 people were internally displaced from February to June, bringing the total of displaced people in the country to 680,000. These marginalised groups are even less likely to have access to medical treatment.

These figures are also not taking into account the refugees outside the country, such as the million Rohingya languishing in the cramped refugee camps in Bangladesh. The Bangladesh government has said it will begin vaccinating the Rohingya next month.

International aid desperately needed

When Cyclone Nargis killed 140,000 people in Myanmar in 2008, the country’s previous military regime received wide-ranging offers of assistance from ASEAN, the regional bloc, and the wider international community.

But since the coup, Western aid to Myanmar has been redirected through non-government groups, causing hold-ups. The UN says the junta has also yet to account for US$350 million in COVID aid the International Monetary Fund sent to Myanmar just days before the coup in February.

The country hasn’t received vaccine doses since May, though China pledged to send 6 million doses by August, with the first batch arriving last week. China may end up being the most proactive donor, since it is worried about a COVID outbreak along its shared border with Myanmar.

Optimists say this may be a time for reconciliation and for everyone in Myanmar to unite against the common enemy of COVID. Yet it is hard to imagine that happening right now, when the military’s own mishandling of the pandemic has generated so much outrage from the population.




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What can be done? Perhaps Australia, which we are told is “awash” in AstraZeneca vaccines, could make rapid moves to send desperately needed supplies to Myanmar via its non-government partners. It would be a bold and impressive diplomatic move.

There is then the need for the international community to confront the Myanmar generals for their appalling mishandling of the country since the coup. By seizing control from elected leaders, they have impoverished their own people, sparked new conflicts and exacerbated the damage done by a global pandemic.

The heartbreaking reality is the people of Myanmar have been left without the prospect of significant relief at the worst possible time.The Conversation

Adam Simpson, Senior Lecturer, University of South Australia and Nicholas Farrelly, Professor and Head of Social Sciences, University of Tasmania

This article is republished from The Conversation under a Creative Commons license. Read the original article.