The science behind why schools should be removing COVID-19 from the air

Paloma Beamer is an environmental engineer, scientist, and former president of the International Society of Exposure Science. She’s also the mother of a public school student.

In the pandemic’s third year, it is still not widely understood that coronavirus is airborne, Beamer said, and that lack of understanding makes it hard to limit people’s exposure.

The public should care about indoor air quality in schools because experts who study the indoor air environment have worried about it for a long time, she said, and documented the benefits of improving the quality of indoor air.

For example, researchers at the Lawrence Berkeley National Laboratory almost a decade ago found a strong association between carbon dioxide levels and student absenteeism in California schools, and that schools with poor ventilation were more likely to have students who are absent.

“We think the reason is that when you start to re-breathe air, you get a higher concentration of CO2 in a room,” said Nissa Patterson, a former New Mexico Department of Health employee with a master’s degree in children and family public health. Basic biology tells us that CO2 is not great for the brain, she said.

Add in COVID, and if ventilation were to be improved, there would not need to be such a big reliance on masking and testing, Beamer said.

Beamer points to the government’s hierarchy of controls, which is used to determine the effectiveness of different kinds of health and safety interventions. The most effective controls are at the top, while the least effective are at the bottom of the hierarchy from the Occupational Health and Safety Administration.

The best option is elimination, according to OSHA. That’s physically removing the hazard from the workplace, and it includes ventilation.

“Opening doors and windows is always better,” Beamer said. “I think if you really handled the ventilation as much as possible on the front end, and having kids wear masks when the rates are higher, it can help a lot.”

At the bottom is personal protective equipment like masks, the least effective kind of intervention.

“If you start at the bottom with all the controls that rely on people doing them correctly, like wearing a respirator or things, then there’s more likely to be human error and issues,” Beamer said.

That’s why Beamer has been arguing for ventilation as a key to reducing transmission in schools since the start of the pandemic.

“We need to understand that whatever you can do to eliminate the source as close as possible to the source, and to address it systematically — rather than relying on individual people to do something — is gonna have the best benefit for everyone,” she said.

Beamer’s work is cited in a June 2020 report by the Healthy Buildings program at the Harvard T.H. Chan School of Public Health. Joseph Allen and co-authors were some of the first scientists to establish that coronavirus can infect even people who haven’t had close contact with the infectious person, through long-range airborne spread.

They went on to publish research recommending building managers improve air ventilation by bringing in clean outdoor air and enhancing filtration to remove viral particles from indoor air. Schools can also use CO2 monitors to track air buildup in different classrooms, Beamer said.

“I think for this group of scientists, we’ve been saying the same thing the whole time,” Beamer said.

It’s been hard to get traction with policymakers on this point for a long time, she said. Efforts generally have gone instead to sanitization of surfaces.

Hundreds of scientists wrote to the World Health Organization in July 2020 telling them that COVID is airborne. But the organization did not recognize airborne spread as a key way people are infected until April 2021, and the Centers for Disease Control and Prevention didn’t officially acknowledge it until a month later.

“I think that there’s a lot of old infrastructure that if we took the time to invest in it for COVID right now, because it’s acute, we’ll have much more longstanding benefits to our school,” Beamer said.

Those benefits would extend beyond COVID to other respiratory illnesses like the flu, Beamer said, and even to things as basic as improving people’s cognition by making sure they have enough oxygen indoors.

“There’s a lot of work that has been done to show the importance of indoor air quality, it’s just I think we’re seen as a little niche science that has been trying to jump up and down for 30 years,” Beamer said.

No follow through

While New Mexico required schools to make improvements to indoor air quality, there is no systematic tracking of whether those schools actually installed new filters or better air systems to be able to, for example, keep fresh air moving through the building.

In response to questions from Source New Mexico, the New Mexico Public Education Department said it does not collect data on which schools have installed high-quality filters, which ones have actually improved ventilation in their buildings, or even which ones have written policies in place to govern those improvements.

The only known database of school facilities in New Mexico is maintained by a separate agency, the Public School Facilities Authority.

It contains about 6 million data points on every piece of equipment in every school across the state, said Matica Casias, the authority’s executive director, like the quality of the building’s roof or foundation. But the database is internal to the facilities authority and not accessible to the public.

PED Finance and Operations Director Antonio Ortiz also sits on the Public School Capital Outlay Council, which oversees PSFA.

Ortiz said the database ranks every school in New Mexico by greatest need based on the age of the building or systems inside of it and how much space the building has, among other criteria. The top 150 are eligible to apply for state funding, he said, which could pay for remodeling or building an entirely new facility.

There is nothing in the database that accounts for indoor air quality, Ortiz and Casias said.

That information could include which schools have installed the right filters for catching viruses, which schools have heating, ventilation and air conditioning systems that are compatible with those filters, or which schools have systems that would still function with doors and windows open — a basic but very important part of ventilation.

Unfortunately, that is the reality of environmental and occupational health, Beamer said.

“We have great policies written, but when you actually look at the enforcement, the follow through of them — we’ve had OSHA for 50 years, but yet look at what it’s done to workers during the pandemic,” Beamer said. “It’s sad because it’s like, ‘Oh that sounds great,’ but then there’s no follow through on keeping track. That’s just mind-boggling.”