On May 5, the World Health Organization (WHO) declared the end of COVID-19 as a global public health emergency.
Cases have been trending downward for more than a year, but the WHO declaration came right when COVID cases were rising again in the Philippines. It’s therefore important to note that in the same statement, WHO Director-General Tedros Ghebreyesus said that “COVID is still killing and it is still changing. The risk remains of new variants emerging that cause new surges in cases and deaths.”
Indeed, although disease severity is now low, COVID will not be going away anytime soon. It also still has the potential to bring long-term harm, especially to those with comorbidities. Long COVID affects 10-20% of people who recover from the illness, and is leading to permanent disabilities, shorter lifespan, increasing medical costs, and productivity losses around the world.
The devastation brought by COVID compels us to keep the conversation going on measures to prevent the spread of disease. The scientific community has declared that airborne transmission is the dominant mode of transmission for COVID-19. This means that the key to healthier communities is maintaining good indoor air quality and ventilation.
Improving indoor air quality is not only useful for curbing COVID-19 infection, but it can also prevent airborne diseases like tuberculosis and the flu, leading to better health outcomes in general. Maintaining good indoor air quality should thus be at the forefront of our response to infectious diseases. This suggests the huge role that building design plays in determining people’s health.
Slowly, other institutions are working on guidelines to enforce good ventilation. It was only in May this year that the US Centers for Disease Control and Prevention (CDC) set a firm target for ventilation: five air changes per hour (ACH).
Recently, 62 organizations, composed of labor groups, medical societies, and youth organizations, signed a covenant calling on the government to put into place mechanisms to effectively enforce Department of Labor and Employment (DoLE) Department Order 224-2021, which outlines measures that workplaces and public transportation spaces must implement for good indoor air quality and ventilation.
The DoLE guidelines encourage non-air-conditioned spaces to maximize natural ventilation through the opening of doors and windows and use exhaust fans to reach an air change rate of six to 12 ACH. Meanwhile, air-conditioned spaces are encouraged to open windows. HEPA (high efficiency particulate air) filtration air purifiers are also recommended in instances where ventilation is recirculated.
Assessment measures are included in the guidelines, specifying that personnel may use the stuffiness of a room, smokiness, lingering smell, or feeling of high humidity to determine how air enters and exits the space. The DoLE encourages the use of carbon dioxide (CO2) monitoring devices positioned far away from windows and doors. This ensures that CO2 concentration does not exceed 1,000 parts per million (ppm).
The Healthcare Professionals Alliance Against COVID-19 (HPAAC) compared the COVID-19 virus to smoke, noting that reducing the risk of contracting COVID would be similar to responding to smoke spreading inside a room: opening windows, opening doors, and turning on fans to ensure good air flow.
While civil society sees the importance of the DoLE guidelines as minimum requirements for adequate ventilation and good indoor air quality, the government still has to consult labor organizations, transport groups, and all sectors involved to ensure that the guidelines are made more practical and viable.
The enforcement of the DoLE guidelines remains weak, likely because of a lack of resources on the part of Occupational Safety and Health (OSH) officers and a lack of incentives to comply.
The government needs to expand the coverage of ventilation guidelines to include schools, public buildings, and similar facilities, and enact systemic changes to consider indoor air quality as an essential indicator of occupational and public safety and health.
Scientists and engineers agree that in the long term, we need to retrofit buildings’ filtration and ventilation systems, possibly through revisiting our Building Code. This will be a great disruption, but a much needed one. The evidence is starting to point to the fact that healthy buildings are good business. Studies have shown that well-ventilated offices or schools can improve people’s cognitive abilities and productivity, and curb absenteeism. Good indoor air quality is not only a health measure — it’s also an economic measure that will keep restaurants, schools, and offices open.
View the civil society covenant on ventilation here: http://bit.ly/VentilationCovenant.
Pia Rodrigo heads the health policy team of Action for Economic Reforms.