Clean air is key to defeating COVID-19

Opinion

Hey there, time traveller!
This article was published 07/12/2022 (1032 days ago), so information in it may no longer be current.

Before the name John Snow was attached to a fictional Game of Thrones character, there was a real John Snow who became known as the father of modern epidemiology.

In 1854, a cholera outbreak struck England rapidly, and many people were getting sick and dying. Through careful observation of who was and wasn’t getting ill, John Snow tracked the epidemic to a single water pump on Broad Street in London.

About 30 years later, the culprit was determined by Robert Koch (now known as one of the founding scientists of microbiology) to be Vibrio cholerae, a bacterial pathogen.

By figuring out that unclean water was the way the pathogen was spreading, Snow changed history. He convinced town leaders to remove the handle to the water pump, thereby stopping the epidemic. Wide-reaching societal changes followed. In addition to the short-term, local solution, this new understanding of water-borne infectious diseases led to major investments that improved water purification systems and a complete alteration in how cities and towns managed sewage drainage.

Against the backdrop of current news reports regarding empty pharmacy shelves and overcrowded hospital emergency rooms and pediatric intensive-care units, now is the time to take off the metaphorical pump handle and begin the large-scale investments that will help to curb the spread of disease in the short-term and help create a healthier society in the long-term.

The SARS-CoV-2 pathogen is airborne. It spreads through the air. The best way to reduce the spread of COVID-19 is to avoid breathing it in.

Modelling based on wastewater and hospitalization data, our best remaining proxies for infection incidence, places Manitobans’ risk of COVID-19 infection as severe. Yet we have few mitigation measures in place, and Dr. Brent Roussin indicated recently that the province has no intention of bringing mandates back.

This leaves Manitobans in a highly vulnerable position, not only in terms of acquiring an acute COVID-19 infection, but also the risk of long COVID, which is estimated to affect approximately 15 per cent of individuals who contract COVID-19.

Last month, a Delphi study was released in Nature regarding how to end the COVID-19 public-health crisis. A panel of 386 geographically diverse experts from governments, NGOs, health and academia together came to consensus statements and recommendations, with near-unanimous agreement that indoor areas with poor ventilation present the highest risk.

According to the panel, to have both an immediate and long-lasting impact “… governments should regulate and incentivise structural prevention measures, such as ventilation and air filtration, and high priority should be given to preventing SARS-CoV-2 transmission in the workplace, educational institutions and commercial centres.”

To quote Game of Thrones, “winter is coming.” We’re closing windows and spending increasing amounts of time indoors. Through filtration and ventilation, we can remove viral particles from the air we breathe and directly reduce the likelihood of infection.

Filtration is like removing the town water pump; adding HEPA air purifiers or Corsi-Rosenthal boxes to indoor spaces will help immediately. Testing air quality and improving ventilation where required is the long-term solution to clean air, just as improved sanitation led to clean drinking water.

Yes, it will cost something. But not doing anything and letting COVID-19 and other infectious diseases run rampant through our schools, our nursing homes and our families also carries a tremendous cost. There is a financial cost to our overwhelmed hospitals treating an increasing number of acutely ill people. There will also be a financial cost of treating long COVID, the incidence of which increases with each new infection.

There are also unmeasurable costs on our collective physical and mental health as the pandemic continues.

I think many of us are feeling exhausted, and our society feels increasingly fractured. But what if the provincial government, private businesses and philanthropic organizations and individuals collectively rallied around cleaning our air? How amazing it would be if Manitoba led the country and began a province-wide push toward a future in which we took indoor clean air for granted.

The societal changes that led to the widespread availability of clean drinking water following the discovery of the tainted water supply at Broad Steet functioned not only to lessen the threat of cholera, but also to limit infection by other water-bourne pathogens such as typhoid, dysentery and giardia.

We don’t have to accept a world in which it is a given that we are constantly exposed to airborne pathogens. Earlier in the pandemic, the phrase “build back better” was thrown around a lot. This is how we do it.

Aleeza Gerstein is an assistant professor of microbiology and statistics at the University of Manitoba.