Ventilation revolution: reduce the spread of disease to save lives
OzSAGE, a multi-disciplinary network of experts, has released a preliminary advice paper with recommendations on how Australia can safely reopen in the COVID-19 pandemic.
First published 3 September 2021
QUT’s Distinguished Professor Lidia Morawska, an international air quality expert, is part of the executive of the national group inspired by UK Independent SAGE (Independent Scientific Advisory Group for Emergencies).
Professor Morawska has been leading the international call for a “paradigm shift” in combating airborne pathogens such as COVID-19 through improving indoor ventilation systems.
“Most infections occur in shared indoor spaces,” Professor Morawska said.
“The most fundamental measure to eliminate the virus from indoor air is ventilation: every public building must have control measures to provide adequate ventilation.”
To highlight the message, Professor Morawska has worked with OzSAGE members including Professor Raina MacIntyre, professor of global biosecurity at UNSW’s Kirby Institute, to produce a video on the need for a ventilation revolution.
“Vaccines matched to Delta and other variables will become available, and boosters are on the horizon. This changes the game in favour of herd immunity,” Professor MacIntyre said.
“But there needs to be a multi-pronged approached with ventilation. In an indoor space where the ventilation isn’t adequate, somebody with the infection could have come and gone, but the virus is still lingering in the air.”
The OzSAGE list of initial recommendations are:
Live with occasional outbreaks – not widespread disease: COVID-19 is here to stay, but we may not need to live with widespread disease or lose all the gains won in 2020. We may feasibly achieve control of COVID-19 in the same way we have with measles, a more contagious virus. For now, that requires Ventilation and Vaccines-Plus to manage outbreaks. The vaccine pipeline is not static. When boosters or vaccines matched to variants are available, herd immunity should be possible by using a smart and agile vaccine strategy.
Ventilation and "Vaccine-Plus" are the pillars that will support safe lifting of restrictions. Ventilation (and filtration) is about providing safe air and mitigating airborne transmission in shared indoor spaces. This includes workplaces, borders, health and aged care, schools, prisons, social venues and homes, especially where overcrowding is present. COVID-19 is airborne, so prevention requires safe air. Vaccines are essential to our pandemic exit strategy, but overseas experience from countries with vaccination rates similar to our national targets , shows that current vaccines alone are insufficient against the Delta COVID-19 variant. “Plus” refers to testing, contact tracing, masks and other non-pharmaceutical strategies, which will continue to be required in the medium term to fight Delta, and may need to be scaled up or down depending on severity of the epidemic.
No-one left behind: Vaccine targets must be met for all population subgroups recognising structural and social disadvantage. This includes all Aboriginal and Torres Strait Islander people, remote and regional Australia and other high risk and disadvantaged groups. While vaccination is not available yet for all children, we recommend additional steps to protect them from infection and make schools safe.
Protection of the health system: Despite having one of the best health care systems in the world, already, urgent non-COVID care is impacted in NSW. A range of strategies are essential to prevent health worker loss and protect hospitals, patients and the health system in city and regional areas. The best laid plans to re-open society may be disrupted if the capacity of the health system to deal with COVID and non-COVID care is exceeded by a surge in cases.
The full list of OzSAGE members, and a quote of support by AMA WA president Dr Mark Duncan-Smith, can be found at the OzSAGE site.
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