This article was written collaboratively by the Advanced Industries Practice. The authors include Stephanie Balgeman, Ben Meigs, Stephan Mohr, Arvid Niemöller, and Paolo Spranzi.

Although much remains unknown about COVID-19, scientists have established that the coronavirus is highly contagious and transmitted via air. Studies suggest that it primarily spreads when infected people cough, sneeze, or talk—actions that expel respiratory droplets containing particles of coronavirus in combination with mucus or saliva. If these droplets land on or are inhaled by others nearby, they could transmit the coronavirus. Touching doorknobs, computer screens, or other surfaces on which droplets have landed may also lead to infection. The now-common guidelines for wearing masks and physical distancing—typically, by remaining six feet away from others—reflect these observations.

Questions remain, however, about whether tiny coronavirus particles, of about 0.1 microns in size, can become airborne and travel greater distances. Although heavy droplets, of about five to ten microns, usually travel less than one meter before settling, smaller droplets may evaporate, leaving virus particles, referred to as aerosols, suspended in the air. A recent study demonstrated that coronavirus particles may be active for up to three hours after their release. Although the World Health Organization (WHO) initially held that the coronavirus could not be spread through aerosols, it recently reversed its stance. The WHO guidelines now state that airborne transmission of the coronavirus may be possible indoors, especially for people who spend extended periods in crowded, poorly ventilated rooms. The WHO’s turnaround came after the organization received an open letter from 293 scientists asking the organization to reconsider its position on airborne transmission.

Given the concern about airborne transmission, building managers, safety experts, and others might take steps to optimize ventilation and airflow indoors and limit viral spread. Some simple moves may help (see sidebar “Low-tech strategies for preventing airborne viral transmission”). But this may also be a good time to think about improving air quality in buildings by significantly changing heating, ventilation, and air-conditioning (HVAC) systems or by making physical changes to manage indoor airflows.

Control-setting changes and upgrades to HVAC systems

HVAC systems can potentially spread a virus across rooms when high-speed air flows past an infected person to others, something that has been shown with Severe Acute Respiratory Syndrome in 2004. If airborne transmission is also possible with the coronavirus, a few control-setting changes and upgrades may help decrease the risk of spread through this route. If building managers take such actions, they might help their tenants feel more comfortable amid all the uncertainty about the coronavirus (see the sidebar “Earning the trust of tenants”).

One step that technicians could take involves configuring ducted HVAC systems to increase the rate of exchange with fresh fresh air from outside the building to reduce recirculation. Adjusting the settings may also help. Instead of shutting down overnight or on weekends, for instance, the HVAC system could run without interruption to increase the replacement of air and minimize airflow speeds.

In buildings with old or inflexible systems, technicians might consider upgrading HVAC hardware. Some of the most important might include these:

• replacing fixed-speed fan motors with variable-speed ones to enhance the control of airflow and allow for a minimum setting that produces lower speed airflow
• introducing sophisticated airflow-control systems, such as those that are sensitive to pressure, to allow for smoother adjustment of airflows
• installing high-performance air-purification systems, as discussed in the next section

Options for air purification

Numerous technologies can purify air. Filtration is the most common and typically the most effective method for HVAC systems (Exhibit 1). Other technologies, including irradiation and thermal sterilization, inactivate biological particles in the air without removing them. HVAC systems can also incorporate ionic purifiers, ozone generators, and other devices for cleaning air.

Filters in residential or commercial HVAC systems are usually installed either at an air inlet or outlet or within the central air-handling unit. Since external air that flows into an HVAC system may be contaminated, especially in metropolitan areas where buildings are in close proximity, technicians sometimes install a pre-filter for incoming air.

The mechanical filters in HVAC systems have tangled fibers that trap particles too large to fit through the openings. Mechanical filters have different ratings, based on the percentage of particles they remove, with the highest rated typically used in surgical or clean-room applications. Exhibit 2 shows selected filters and their ratings from organizations based in the United States. Ratings standards in other countries may vary.

High-Efficiency Particulate Air (HEPA) filters are most effective at removing small particles. To meet this qualification under the US ratings system, filters must remove 99.97 percent of particles of 0.3 microns. Minimum Efficiency Reporting Value (MERV) filters are assigned ratings according to their ability to filter out large particles (from 0.3 to 10.0 microns in size). MERV filters with ratings of 17 or higher are comparable to HEPA filters and may be referred to by that term. Like the air-conditioning systems in most homes, commercial buildings generally have filters rated MERV 12 or lower. Only some air conditioners can accommodate HEPA filters, and technicians must configure them properly and replace them regularly.

Upgrading HVAC systems by incorporating higher-grade filters can be very expensive and is not always feasible. What’s more, even a HEPA filter will not eliminate all concerns about airborne transmission. Although a NASA study documented that HEPA filters can stop particles as small as 0.1 microns—the approximate size of the coronavirus—other direct research is limited, and the official US ratings system specifies their efficacy only for particles of 0.3 microns. More research is needed to definitively determine a minimum filtration rating that will eliminate infectious coronavirus particles from air.

Airflow management

While studies are still ongoing about how the coronavirus spreads via air, evidence suggests that measures to change indoor airflow patterns could play a role in reducing transmission. Three main principles apply:

• encouraging a vertical laminar rather than turbulent airflow
• ensuring a slow, steady air speed
• directing potentially contaminated air out of rooms and away from people

In-room airflows

The World Health Organization recently acknowledged that some evidence about in-room transmission is worrisome. In addition, after analyzing a transmission event at a restaurant in China, the US Centers for Disease Control and Prevention (CDC) concluded that an asymptomatic patient transmitted the virus to families at two nearby tables (Exhibit 3). Based on the restaurant layout, seating arrangements, and smear samples from air-conditioning inlets and outlets, the CDC found that the coronavirus was likely transmitted when strong airflows from a nearby air conditioner spread large droplets from the infected person. These droplets traveled more than one meter—further than usual, but less than the distance aerosols can typically travel.

Changing airflow patterns to create laminar vertical airflow—air moving in the same speed and in a straight path—may effectively prevent the airborne transmission of coronavirus particles. This principle is already used to prevent the spread of particles in several settings. For instance, clean rooms and hospital operating rooms minimize contamination via sophisticated systems to direct air from the ceiling to the floor with laminar flow. On commercial aircraft, ventilation systems are configured to blow air vertically from ceiling to floor to reduce the spread of contaminated air within the cabin.

Creating airflows that are close to laminar will involve far more than changing HVAC settings. In new construction, for instance, builders must include a sufficient number of air outlets. In existing structures, technicians may need to upgrade the outlets in HVAC systems—for instance, by adding some outlets in the space provided by suspended ceilings. In some cases, technicians may replace outlet covers, which are normally designed to mix and distribute air, with covers that produce laminar flows. For both new and existing buildings, the placement of air outlets is critical and must be based on planned occupancy, room architecture, furniture placement, and other factors that influence airflows.

In some cases, building managers might want to add physical barriers, such as partitions that separate open space, to manage airflows within rooms. They could also install in-room sterilizers to reduce viral
concentrations, but these increase turbulence and are thus recommended primarily for offices occupied by only one person.

Inter-room airflow

Some building managers and others may want to take steps to prevent contamination between rooms—something that could occur if the coronavirus is found to spread via airborne transmission. Technicians should identify how air moves through rooms before installing new devices or upgrading HVAC systems. Their evaluations could include a blower-door test, which involves creating calibrated pressure in a room and then monitoring the flow and leakage.

Several options, some involving HVAC upgrades and others focusing on simpler changes, could address any problems detected. These solutions might include installing doors or air curtains, generating overpressure above suspended ceilings, and sealing any gaps in them (Exhibit 4).

Individual protection

In some workplaces, close physical contact is difficult to avoid, which makes viral transmission risk higher. To date, however, no commercial products protect airflows within individual workstations, such
as a specific position next to an assembly line or an employee’s desk. Innovators may introduce some solutions for individual protection, such as those that involve adapting principles from airflow-control units or ventilation hoods, especially if the evidence for airborne transmission of the coronavirus continues to climb.

As economies worldwide reopen, healthcare officials have good reason to fear a second wave of COVID-19. Offices have traditionally accommodated large numbers of people and were designed to foster interaction and collaboration. Manufacturing shop floors sometimes require employees to work in close proximity. Schools, with their historically strained budgets, will find it especially hard to separate students from one another and from faculty. Hospitals have put off many elective procedures and noncritical surgeries for months and could begin seeing more patients in closer proximity.

Governments, trade groups, HVAC manufacturers, building engineers, and regulators may want to consider optimizing airflows whenever possible. Changes to ventilation systems, air-purification systems, and airflow management will probably be the focus of their work in this area.

Disclaimer: The document summarizes a preliminary view on best practices, potential design concepts, and approaches to ventilation and airflows that could limit virus spread in buildings. At this time, more research is needed on the airborne transmission of COVID-19 and the best measures for preventing viral spread. References to specific products or organizations are solely for illustration and do not constitute any endorsement or recommendation.

The post Can HVAC steering assist stop transmission of COVID-19? appeared first on DAILY SAN FRANCISCO BAY NEWS.

This article was written collaboratively by the Advanced Industries Practice. The authors include Stephanie Balgeman, Ben Meigs, Stephan Mohr, Arvid Niemöller, and Paolo Spranzi.

Although much remains unknown about COVID-19, scientists have established that the coronavirus is highly contagious and transmitted via air. Studies suggest that it primarily spreads when infected people cough, sneeze, or talk—actions that expel respiratory droplets containing particles of coronavirus in combination with mucus or saliva. If these droplets land on or are inhaled by others nearby, they could transmit the coronavirus.

Touching doorknobs, computer screens, or other surfaces on which droplets have landed may also lead to infection. The now-common guidelines for wearing masks and physical distancing—typically, by remaining six feet away from others—reflect these observations.

Questions remain, however, about whether tiny coronavirus particles, of about 0.1 microns in size, can become airborne and travel greater distances. Although heavy droplets, of about five to ten microns, usually travel less than one meter before settling, smaller droplets may evaporate, leaving virus particles, referred to as aerosols, suspended in the air.

A recent study demonstrated that coronavirus particles may be active for up to three hours after their release.

Although the World Health Organization (WHO) initially held that the coronavirus could not be spread through aerosols, it recently reversed its stance. The WHO guidelines now state that airborne transmission of the coronavirus may be possible indoors, especially for people who spend extended periods in crowded, poorly ventilated rooms.

The WHO’s turnaround came after the organization received an open letter from 293 scientists asking the organization to reconsider its position on airborne transmission.

Given the concern about airborne transmission, building managers, safety experts, and others might take steps to optimize ventilation and airflow indoors and limit viral spread. Some simple moves may help (see sidebar “Low-tech strategies for preventing airborne viral transmission”). But this may also be a good time to think about improving air quality in buildings by significantly changing heating, ventilation, and air-conditioning (HVAC) systems or by making physical changes to manage indoor airflows.

Control-setting changes and upgrades to HVAC systems

HVAC systems

can potentially spread a virus across rooms when high-speed air flows past an infected person to others, something that has been shown with Severe Acute Respiratory Syndrome in 2004.

If airborne transmission is also possible with the coronavirus, a few control-setting changes and upgrades may help decrease the risk of spread through this route. If building managers take such actions, they might help their tenants feel more comfortable amid all the uncertainty about the coronavirus (see the sidebar “Earning the trust of tenants”).

One step that technicians could take involves configuring ducted HVAC systems to increase the rate of exchange with fresh fresh air from outside the building to reduce recirculation. Adjusting the settings may also help. Instead of shutting down overnight or on weekends, for instance, the HVAC system could run without interruption to increase the replacement of air and minimize airflow speeds.

In buildings with old or inflexible systems, technicians might consider upgrading HVAC hardware. Some of the most important might include these:

• replacing fixed-speed fan motors with variable-speed ones to enhance the control of airflow and allow for a minimum setting that produces lower speed airflow
• introducing sophisticated airflow-control systems, such as those that are sensitive to pressure, to allow for smoother adjustment of airflows
• installing high-performance air-purification systems, as discussed in the next section

We strive to provide individuals with disabilities equal access to our website. If you would like information about this content we will be happy to work with you. Please email us at: McKinsey_Website_Accessibility@mckinsey.com

Options for air purification

Numerous technologies can purify air. Filtration is the most common and typically the most effective method for HVAC systems (Exhibit 1). Other technologies, including irradiation and thermal sterilization, inactivate biological particles in the air without removing them. HVAC systems can also incorporate ionic purifiers, ozone generators, and other devices for cleaning air.

Exhibit 1

We strive to provide individuals with disabilities equal access to our website. If you would like information about this content we will be happy to work with you. Please email us at: McKinsey_Website_Accessibility@mckinsey.com

Filters in residential or commercial HVAC systems are usually installed either at an air inlet or outlet or within the central air-handling unit. Since external air that flows into an HVAC system may be contaminated, especially in metropolitan areas where buildings are in close proximity, technicians sometimes install a pre-filter for incoming air.

The mechanical filters in HVAC systems have tangled fibers that trap particles too large to fit through the openings. Mechanical filters have different ratings, based on the percentage of particles they remove, with the highest rated typically used in surgical or clean-room applications. Exhibit 2 shows selected filters and their ratings from organizations based in the United States. Ratings standards in other countries may vary.

Exhibit 2

We strive to provide individuals with disabilities equal access to our website. If you would like information about this content we will be happy to work with you. Please email us at: McKinsey_Website_Accessibility@mckinsey.com

High-Efficiency Particulate Air (HEPA) filters are most effective at removing small particles. To meet this qualification under the US ratings system, filters must remove 99.97 percent of particles of 0.3 microns. Minimum Efficiency Reporting Value (MERV) filters are assigned ratings according to their ability to filter out large particles (from 0.3 to 10.0 microns in size). MERV filters with ratings of 17 or higher are comparable to HEPA filters and may be referred to by that term.

Like the air-conditioning systems in most homes, commercial buildings generally have filters rated MERV 12 or lower. Only some air conditioners can accommodate HEPA filters, and technicians must configure them properly and replace them regularly.

Upgrading HVAC systems by incorporating higher-grade filters can be very expensive and is not always feasible. What’s more, even a HEPA filter will not eliminate all concerns about airborne transmission. Although a NASA study documented that HEPA filters can stop particles as small as 0.1 microns—the approximate size of the coronavirus—other direct research is limited, and the official US ratings system specifies their efficacy only for particles of 0.3 microns.

More research is needed to definitively determine a minimum filtration rating that will eliminate infectious coronavirus particles from air.

Airflow management

While studies are still ongoing about how the coronavirus spreads via air, evidence suggests that measures to change indoor airflow patterns could play a role in reducing transmission. Three main principles apply:

• encouraging a vertical laminar rather than turbulent airflow
• ensuring a slow, steady air speed
• directing potentially contaminated air out of rooms and away from people

In-room airflows

The World Health Organization recently acknowledged that some evidence about in-room transmission is worrisome. In addition, after analyzing a transmission event at a restaurant in China, the US Centers for Disease Control and Prevention (CDC) concluded that an asymptomatic patient transmitted the virus to families at two nearby tables (Exhibit 3).

Based on the restaurant layout, seating arrangements, and smear samples from air-conditioning inlets and outlets, the CDC found that the coronavirus was likely transmitted when strong airflows from a nearby air conditioner spread large droplets from the infected person. These droplets traveled more than one meter—further than usual, but less than the distance aerosols can typically travel.

Exhibit 3

We strive to provide individuals with disabilities equal access to our website. If you would like information about this content we will be happy to work with you. Please email us at: McKinsey_Website_Accessibility@mckinsey.com

Changing airflow patterns to create laminar vertical airflow—air moving in the same speed and in a straight path—may effectively prevent the airborne transmission of coronavirus particles.

This principle is already used to prevent the spread of particles in several settings. For instance, clean rooms and hospital operating rooms minimize contamination via sophisticated systems to direct air from the ceiling to the floor with laminar flow. On commercial aircraft, ventilation systems are configured to blow air vertically from ceiling to floor to reduce the spread of contaminated air within the cabin.

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Creating airflows that are close to laminar will involve far more than changing HVAC settings. In new construction, for instance, builders must include a sufficient number of air outlets. In existing structures, technicians may need to upgrade the outlets in HVAC systems—for instance, by adding some outlets in the space provided by suspended ceilings. In some cases, technicians may replace outlet covers, which are normally designed to mix and distribute air, with covers that produce laminar flows. For both new and existing buildings, the placement of air outlets is critical and must be based on planned occupancy, room architecture, furniture placement, and other factors that influence airflows.

In some cases, building managers might want to add physical barriers, such as partitions that separate open space, to manage airflows within rooms. They could also install in-room sterilizers to reduce viral
concentrations, but these increase turbulence and are thus recommended primarily for offices occupied by only one person.

Inter-room airflow

Some building managers and others may want to take steps to prevent contamination between rooms—something that could occur if the coronavirus is found to spread via airborne transmission. Technicians should identify how air moves through rooms before installing new devices or upgrading HVAC systems. Their evaluations could include a blower-door test, which involves creating calibrated pressure in a room and then monitoring the flow and leakage.

Several options, some involving HVAC upgrades and others focusing on simpler changes, could address any problems detected. These solutions might include installing doors or air curtains, generating overpressure above suspended ceilings, and sealing any gaps in them (Exhibit 4).

Exhibit 4

We strive to provide individuals with disabilities equal access to our website. If you would like information about this content we will be happy to work with you. Please email us at: McKinsey_Website_Accessibility@mckinsey.com

Individual protection

In some workplaces, close physical contact is difficult to avoid, which makes viral transmission risk higher. To date, however, no commercial products protect airflows within individual workstations, such
as a specific position next to an assembly line or an employee’s desk. Innovators may introduce some solutions for individual protection, such as those that involve adapting principles from airflow-control units or ventilation hoods, especially if the evidence for airborne transmission of the coronavirus continues to climb.

As economies worldwide reopen, healthcare officials have good reason to fear a second wave of COVID-19. Offices have traditionally accommodated large numbers of people and were designed to foster interaction and collaboration. Manufacturing shop floors sometimes require employees to work in close proximity. Schools, with their historically strained budgets, will find it especially hard to separate students from one another and from faculty. Hospitals have put off many elective procedures and noncritical surgeries for months and could begin seeing more patients in closer proximity.

Governments, trade groups, HVAC manufacturers, building engineers, and regulators may want to consider optimizing airflows whenever possible. Changes to ventilation systems, air-purification systems, and airflow management will probably be the focus of their work in this area.

Disclaimer: The document summarizes a preliminary view on best practices, potential design concepts, and approaches to ventilation and airflows that could limit virus spread in buildings. At this time, more research is needed on the airborne transmission of COVID-19 and the best measures for preventing viral spread. References to specific products or organizations are solely for illustration and do not constitute any endorsement or recommendation.

The post Can HVAC steering assist stop transmission of COVID-19? appeared first on DAILY SAN FRANCISCO BAY NEWS.

When the COVID-19 pandemic hit, many hospitals struggled to find negative pressure rooms approved by the Centers for Disease Control and Prevention (CDC) for the sudden influx of COVID-19 patients. However, many hospital systems had a very limited number of negative pressure rooms (Table). One of the main considerations was the recirculation of air. If the air used is not 100% outside air, would the air being recirculated transport viral-containing particles from one patient room to the next?

A recent study, “Requirements to Reduce Viral Pathogen Transmission in Health Care HVAC Systems,” presented at the Society for Healthcare Epidemiology of America (SHEA) Spring conference, held April 12-14 in Colorado Springs, Colorado, explained that the viral-containing Particles can be transported through the HVAC system even with high efficiency particulate air (HEPA) filters. The study was presented by Werner Bischoff, MD, MS, PHD, MS, the medical director of infection prevention and health system epidemiology at the Atrium Health Wake Forest Baptist Hospital System and a professor at Wake Forest School of Medicine.

“CDC sets [a limited] risk of transmission of pathogens that are emitted from one patient inside a patient room that is then transferred through a heating, ventilation, and air conditioning (HVAC) system back to maybe an adjacent patient room or an entire unit,” Bishoff told Infection Control Today ® (ICT®) in an exclusive interview. “What you don’t want is to have a tone of transmissions and in a very closed-up area through the HVAC system.”

For the first time, this study demonstrates that “viral containing particles can be transported via a hospital HVAC system from one patient room to the next,” Bishoff wrote in the study. “Taking into account the loss of virus within the HVAC system, the combination of MERV8+MERV16 filters reduces the virus burden reaching an adjacent room to levels well below the human infectious dosages for influenza and other highly infective viruses. Our findings indicate that MERV8+MERV16 filters provide protection against virus transmission through HVAC systems and are a cost-conscious alternative to HEPA filters.”

Considering future investigations, Bishoff said to ICT®, “I think it would be nice to look at the more novel technologies that are coming out [like] neurons that are highly promoted, especially by industry—that is ionization…Mechanical ventilation isn’t established [with] These newer technologies, we need a lot more data to say that [air filtration systems] are really safe and do what they promised to do.” Previously, ICT® has reported on this topic here, here, and here.

The post HVAC Programs Show Enough to Cut back Viral Pathogen Transmission Inside a Hospital appeared first on DAILY SAN FRANCISCO BAY NEWS.

San Francisco now has the third-highest coronavirus transmission rate in California, with a daily average case rate of about 104 per 100,000 residents.

The county recorded a seven-day average of 896 cases per day on Dec. 30, the most recent available data. That is more than double the previous peak of 388 cases, a seven-day average recorded on Jan. 12 last year.

At least one Bay Area county, Napa, is out of available intensive care beds as the virus once again tightens its hold on the region.

San Francisco’s transmission rate ranks in California behind only Los Angeles County, with 118 cases per 100,000 residents — the highest reported there since the start of the pandemic — and Mono County with 109 per 100,000. Across California, the seven-day average is 75 cases per 100,000, and in the Bay Area, it is 63 cases.

San Francisco officials said infections among staff members are starting to affect city departments. The Municipal Transportation Agency said Monday in a memo obtained by The Chronicle that it is implementing COVID protocols at its offices on South Van Ness Avenue after an outbreak involving several staff members.

COVID-19 hospitalizations in the Bay Area also hit their highest number since mid-September over the weekend.

Coronavirus Resources

COVID-19 map: Data on trends in the Bay Area and across California

Latest news: Complete coverage of the coronavirus pandemic

Data analyzed by The Chronicle shows 746 Bay Area hospital patients testing positive with the coronavirus as of Sunday — a figure not seen since the tail end of the summer delta surge. Of those patients, 149 were in intensive care unit beds — a 50% jump since Christmas.

That is already putting stress on some hospital systems in the region. Napa County has no ICU beds currently available, said Leah Greenbaum, the county’s emergency services coordinator.

“The current surge is driving more patients to the health care system, and it is also impacting staff,” she said. “When staff become infected with COVID-19, they cannot come into work and care for patients, which can cause significant strain on the health care system.”

The number of hospitalizations in the Bay Area, a lagging indicator of pandemic trends, has risen sharply since mid-November with the spread of the omicron variant and the persistence of the delta variant, and it shows no sign of abating.

Bay Area health officials expect the number to continue to surge as people return to work and school after traveling and gathering over the winter break, with students at most Bay Area schools returning from holiday on Monday.

“The combination of the omicron variant being highly transmissible and holiday gatherings are contributing to the increase in the number of COVID-19 cases in Solano County, in California, and across the nation,” said Jayleen Richards, public health administrator for Solano County.

Home kits to test for coronavirus infection are ready to be handed out by Alameda County health officials to families at Canyon Middle School in Castro Valley ahead of students’ return from winter break.

Bronte Wittpenn/The Chronicle

By comparison to San Francisco’s reported daily average of 104 new cases per 100,000 residents, Marin County reported about 80 cases per 100,000 people as of Dec. 30, with San Mateo County at about 68, Napa at 66, Sonoma at 59, Contra Costa at 58, Santa Clara at 57, Alameda at 55 and Solano at 43.

“We are seeing a rapid increase in cases in Napa County,” said Greenbaum. “We have exceeded the peak of the delta surge, and we have nearly as many cases as we did during the winter surge last year.”

Schools in Napa County will not reopen for another week, she added, “but we know many residents resumed more traditional holiday gathering and travel plans this year.”

The good news within the escalating figures is that the number of hospitalizations remains well below what it was a year ago, with a peak of 2,210 on Jan. 10, when vaccines were still just emerging. Some health officials warned, however, that a continuing upward trend may stress medical facilities.

“We are seeing substantial increases in the numbers of adults in hospitals with COVID-19. But with high levels of virus circulating locally, at least some of these people are likely hospitalized for other reasons and had COVID-19 diagnosed on routine screening,” said Neetu Balram, public information manager for Alameda County.

People stand in line to shop at Ver Brugge Meat-Fish Poultry along College Avenue in Oakland, masked up as the highly transmissable omicron variant of the coronavirus takes hold in the Bay Area.

Jessica Christian/The Chronicle

“Intensive care unit COVID-19 hospitalizations are also rising locally, and this may put our hospitals under stress in the coming weeks.”

About 25% of the Bay Area’s intensive care unit beds remain available, according to state data.

“We still have capacity in our hospitals, but continue to monitor the situation,” the Santa Clara County health department said.

Nationwide, there were 103,329 patients hospitalized with COVID-19 as of Monday, according to data from the US Department of Health and Human Services. About 20% — 18,557 — are in intensive care unit beds, among hospitals reporting to the agency. The number is almost approaching the benchmark of 104,000 hospitalizations reported in September at the peak of the delta COVID surge.

As Bay Area students flooded back into schools Monday, the Food and Drug Administration approved Pfizer booster shots against the coronavirus for children as young as 12, to enhance protection in the face of the omicron variant’s ability to evade vaccines. The Centers for Disease Control and Prevention expects to rule on the recommendation later this week.

The FDA said everyone 12 and older eligible for a Pfizer booster can get one as early as five months after their last dose. Boosters already are recommended for everyone 16 and older.

Children tend to suffer less serious illness from COVID-19 than adults, but child hospitalizations are rising during the omicron wave — most of them unvaccinated.

“Hopefully, this will be not just a call for people to go get their booster shot,” but for the tens of millions of unvaccinated Americans to rethink that choice, said FDA chief vaccine Dr. Peter Marks. “It’s not too late to start getting vaccinated.”

San Francisco Chronicle reporters Erin Allday and Mallory Moench contributed to this story.

Aidin Vaziri is a San Francisco Chronicle staff writer. Email: avaziri@sfchronicle.com

The post San Francisco now has third highest COVID transmission price in California appeared first on DAILY SAN FRANCISCO BAY NEWS.

As the COVID-19 pandemic increases in other locations around the country, cases and deaths are declining in California, and the San Francisco Bay Area is doing particularly well. But how low are the transfer rates in the nine-circle region exactly?

The well-vaccinated region is generally better off than the rest of the country. Here’s a look at the seven-day positivity rate, the seven-day average of cases per 100,000 people, or

California: 3.4% test positive (seven-day rate), 20.0 cases per 100,000 (seven-day average), 0.2 deaths per 100,000 (seven-day average)
Alameda: 2.3% test positive, 11.1 cases per 100,000, 0.01 deaths per 100,000
Contra Costa: 3.2% test positive, 15.2 cases per 100,000, 0.2 deaths per 100,000
Marin: 2.1% test positive, 8.3 cases per 100,000, 0 deaths per 100,000
Napa: 3.8% test positive, 18.8 cases per 100,000, 0.2 deaths per 100,000
San Francisco: 2.0% positivity, 10.1 cases per 100,000, 0.2 deaths per 100,000
San Mateo: 1.9% test positive, 9.5 cases per 100,000, 0.04 deaths per 100,000
Santa Clara: 1.7% test positive, 11.3 cases per 100,000, 0.1 deaths per 100,000
Solano: 4.1% test positive, 19.9 cases per 100,000, 0.4 deaths per 100,000
Sonoma: 2.6% test positive, 13.2 cases per 100,000, 0.1 deaths per 100,000

The numbers are all going down, nearing where the state and the Bay Area were in June, when the pandemic experienced a lull just before the state reopened and most restrictions were lifted on June 15, an average of 2, 1 cases per 100,000 and 0.04 deaths per 100,000 over seven days. On June 1, the 7-day positivity rate was 0.8%.

The Bay Area has some of the toughest COVID restrictions in the country. All counties in the region mandate indoor masks, with the exception of Solano.

San Francisco and Berkeley require proof of vaccination to enter indoor bars, restaurants, clubs, gyms, and large indoor events. Customers under the age of 12 are excluded. A negative COVID-19 test is not a substitute. Contra Costa County on Tuesday issued a similar mandate for entering indoor restaurants, bars and gyms, although proof of full vaccination and a negative coronavirus test are both acceptable.

CDC released this map of the current seven-day case rate for the percentage of tests that were positive for COVID-19.

CDC

The Centers for Disease Control and Prevention’s COVID Data Tracker card also provides an overview of how the counties are doing. The map is based on a county’s moving seven-day number of new COVID-19 cases and the percentage of positive COVID-19 tests.

The severity of the pandemic in each county is represented by four levels: high, significant, moderate and low.

CDC released this map of the current seven-day case rate for the percentage of tests that were positive for COVID-19.

CDC

In the San Francisco Bay Area, Marin, San Francisco, San Mateo, Santa Clara, and Alameda are all in the formidable category starting September 16. Contra Costa, Napa, Solano and Sonoma are in the top group. Just south of the Bay Area are Monterey and Santa Cruz.

The rest of the state is largely a sea of ​​red, with the exception of a few counties with low transmission: Lassen, Modoc, Mono, and Sierra. While central California is a sea of ​​red and the majority of the counties have high levels of COVID-19 community transmission

The post How low precisely is COVID-19 transmission within the San Francisco Bay Space proper now? appeared first on DAILY SAN FRANCISCO BAY NEWS.

Katie Machado, RN, Studentin der UCSF Nurse Practitioner, führt COVID-19-Tests durch, die von Unidos En Salud durchgeführt wurden, einer einzigartigen Partnerschaft zwischen Organisatoren der Missionsgemeinschaft in der Latino Task Force für COVID-19, UCSF-Forschern, der Stadt und dem Landkreis San Francisco und das San Francisco Department of Public Health (DPH). Foto von Barbara Ries

In den ersten sechs Wochen der San Francisco Shelter-in-Place-Verordnung konzentrierte sich die fortgesetzte Verbreitung von COVID-19 zunehmend auf einkommensschwache Latinx-Personen, die nicht in der Lage waren, von zu Hause aus zu arbeiten San Franciscos Missionsbezirk Ende April.

Ein Bericht über die Ergebnisse sowohl von Nasentupfer- (PCR) als auch von serologischen (Antikörper-) Tests wurde in einem von Experten begutachteten Journal eingereicht und aufgrund der Ergebnisse am 17. Juni 2020 auch öffentlich auf dem medRxiv-Preprint-Server veröffentlicht ‘Bedeutung für die öffentliche Gesundheitspolitik und betroffene Gemeinden.

Die Testinitiative mit dem Namen Unidos En Salud wurde von Experten für Infektionskrankheiten der UC San Francisco und Organisatoren der Community der Latino Task Force für COVID-19 geleitet. Zusammen mit den jüngsten Initiativen zur Durchführung von Tests in der Stadt Bolinas sowie für untergebrachte und nicht untergebrachte Personen in den Stadtteilen Bayview, Sunnydale und Visitacion Valley im Südosten von San Francisco ist die Zusammenarbeit Teil der eng koordinierten Arbeit der UCSF mit dem Gesundheitsministerium von San Francisco. der Bundesstaat Kalifornien und betroffene Gemeinden, um auf die von COVID-19 präsentierte Krise der öffentlichen Gesundheit zu reagieren.

In Zusammenarbeit mit der Stadt und dem Landkreis San Francisco bot Unidos En Salud allen Bewohnern und Arbeitern des US-Zensus-Trakts 229.01, einem dicht besiedelten 16-Quadrat-Block-Abschnitt des Mission District, kostenlose PCR- und Antikörpertests an, unabhängig von den Symptomen. das hat eine große Latinx-Bevölkerung. Die Initiative umfasste schließlich 3.953 Personen, einschließlich der ersten vom 25. bis 28. April durchgeführten Walk-up-Tests und zusätzlicher Tests von Hausbewohnern Anfang Mai.

“Wir stellen fest, dass sich die jüngsten Infektionen Ende April fast ausschließlich auf einkommensschwache Latinx-Personen konzentrierten, die an vorderster Front arbeiteten, während Infektionen früher in der Pandemie die Menschen im gesamten ethnischen und wirtschaftlichen Spektrum gleichermaßen betrafen”, sagte die Studienleiterin und leitende Autorin Diane Havlir , MD, Leiter der UCSF-Abteilung für HIV, Infektionskrankheiten und globale Medizin am Zuckerberg San Francisco General Hospital und Trauma Center (ZSFG). “Dies deutet darauf hin, dass die gesundheitlichen Auswirkungen ethnischer und sozioökonomischer Ungleichheiten in der Gemeinde während der Schutzmaßnahmen in San Francisco zugenommen haben, und erklärt, warum die Latinx-Menschen von der Pandemie überproportional betroffen sind.”

Diane Havlir, MD, Leiterin der UCSF-Abteilung für HIV, Infektionskrankheiten und globale Medizin am Zuckerberg San Francisco General Hospital und Trauma Center

PCR-Tests ergaben, dass 2,1 Prozent der Teilnehmer zum Zeitpunkt des Tests Ende April aktiv mit dem SARS-CoV-2-Virus infiziert waren, wie vorläufige Ergebnisse aus dem Mai zeigten. Die Infektionsraten waren bei Latinx fast 20-fach höher als bei Nicht-Latinx-Teilnehmern (3,9 Prozent gegenüber 0,2 Prozent) und bei nicht ansässigen Arbeitnehmern 3,5-mal höher als bei Bewohnern des Zensus-Trakts (6 Prozent gegenüber 1,7 Prozent).

Zusätzlich testeten 3,1 Prozent der Einwohner des Zensus-Trakts und 7,7 Prozent der Arbeiter des Zensus-Trakts positiv auf Antikörper gegen das SARS-CoV-2-Virus.

Bereinigt um die bekannte Genauigkeit von PCR- und Antikörpertests sowie um die Teilnahmequoten an der Testinitiative schätzt das Studienteam, dass ungefähr 6,1 Prozent aller Bewohner des Zensus-Trakts entweder aktiv infiziert waren oder bis Ende April zuvor mit dem Virus infiziert waren . Diese Zahl ist niedriger als Schätzungen, die allein auf Antikörpertests in stark betroffenen Gebieten wie New York City basieren, wo 14,9 Prozent der Bevölkerung bis Ende April infiziert waren, und etwas höher als eine kürzlich geschätzte Antikörperprävalenz von 4,65 Prozent für Einwohner von Los Angeles County Anfang April.

Ein Vergleich der PCR- und Antikörperergebnisse für Bewohner des Zensus-Trakts ergab, dass die überwiegende Mehrheit (96 Prozent) der Neuinfektionen Ende April in der Latinx-Gemeinschaft auftrat, während diejenigen, die früher in der Pandemie infiziert waren, etwas repräsentativer für die Nachbarschaft waren ein Ganzes (67 Prozent Latinx, 16 Prozent Weiß, 17 Prozent Andere). Weitere Risikofaktoren für die jüngsten Infektionen Ende April waren die Unfähigkeit, Schutz zu bieten und das Einkommen, die Arbeit an vorderster Front, die Arbeitslosigkeit und das Haushaltseinkommen von weniger als 50.000 USD pro Jahr aufrechtzuerhalten.

“Obwohl San Franciscos frühzeitige Anordnung der Unterbringung sicherlich die überwältigende Anzahl von Krankenhausaufenthalten und Todesfällen in anderen Teilen des Landes verhinderte, sind die unverhältnismäßigen Auswirkungen auf Farbgemeinschaften ähnlich wie anderswo”, sagte Jon Jacobo. ein Leiter der Latino Task Force für Covid-19 und Mitautor der neuen Preprint-Studie.

Hohe Viruskonzentrationen bei Personen mit, ohne Symptome

Die Studie befasste sich auch mit der dringenden Frage, bei wie vielen Personen, die positiv auf eine SARS-CoV-2-Infektion getestet wurden, Symptome auftreten. Zum Zeitpunkt der Tests Ende April gab mehr als die Hälfte der aktiv infizierten Personen (52 Prozent) an, asymptomatisch zu sein. Von diesen Personen entwickelten 24 Prozent innerhalb von zwei Wochen nach dem Test Symptome. Insbesondere stellten die Forscher fest, dass kürzlich infizierte Personen (Personen mit positiven Nasentupfertests, aber negativen Antikörpertests) ein hohes Maß an Virusinfektion zeigten, unabhängig davon, ob Symptome auftraten, was darauf hindeutet, dass sie möglicherweise weiterhin infektiös sind.

“Diese Ergebnisse unterstreichen die Bedeutung von Community-basierten Tests sowohl symptomatischer als auch asymptomatischer Personen, um die Ausbreitung des Virus zu verstehen”, sagte Dr. Gabriel Chamie, MPH, außerordentlicher Professor in der Abteilung für HIV, Infektionskrankheiten und globale Medizin und Blei Autor der Preprint-Studie. „Symptombasierte Tests hätten nicht mehr als 40 Prozent der aktiven Infektionen erkennen können, und nur eine Person, die positiv getestet wurde, musste ins Krankenhaus eingeliefert werden, was darauf hindeutet, dass die überwiegende Mehrheit – von denen viele einen hohen Virusgehalt aufwiesen – ohne gemeindenahe Tests nicht diagnostiziert worden wäre testen.”

“Eine starke Partnerschaft mit der Latino Task Force für COVID-19 war unerlässlich, um universelle Tests mit niedriger Barriere in der Mission durchzuführen, um die weitere Ausbreitung des Virus besser zu verstehen und den Betroffenen die erforderliche Pflege und Unterstützung zu bieten”, fügte Carina Marquez hinzu , MD, ein Assistenzprofessor in der Abteilung für HIV, Infektionskrankheiten und globale Medizin, der die Hauptautorschaft der Preprint-Studie mit Chamie teilt.

Wirtschaftliche Not ist ein Haupttreiber für eine verstärkte Übertragung

Die Studie demonstrierte auch die Nützlichkeit der Analyse der genomischen Sequenzen des SARS-CoV-2-Virus, die in der Gemeinschaft in Zusammenarbeit mit dem Chan Zuckerberg Biohub nachgewiesen wurden. Es wurden mindestens fünf verschiedene Stämme nachgewiesen, die alle auch an anderer Stelle in der Stadt beobachtet worden waren. “Dies steht im Einklang mit mehreren unabhängigen Einführungen von Menschen im Laufe der Zeit, die entweder im Zensus-Trakt leben oder arbeiten, mit anschließender Weitergabe an Familienmitglieder, die sich einen engen Wohnraum teilen”, sagte Joe DeRisi, Co-Präsident von CZ Biohub, PhD, Professor für Biochemie und Biophysik an der UCSF und Co-Autor der neuen Studie.

Diese Daten unterstreichen weiter die Bedeutung wirtschaftlicher Faktoren wie finanzielle Unsicherheit und explodierende Mietkosten in der Stadt für die Förderung hoher COVID-19-Übertragungsraten, für die die Latinx-Community zu Unrecht stigmatisiert wurde, so die Autoren der Studie.

“Pandemien nutzen die bestehenden Ungleichheiten in der Gesellschaft aus und belasten Gemeinden, die bereits strukturellen Nachteilen wie Einkommensungleichheit, überfüllten Wohnbedingungen, systemischem Rassismus und Diskriminierung ausgesetzt sind, gesundheitlich und wirtschaftlich stärker”, sagte Grant Colfax, MD, Gesundheitsdirektor von San Francisco. „Durch unsere Zusammenarbeit mit UCSF können wir die sozialen und wirtschaftlichen Faktoren dokumentieren, die das Risiko für COVID-19 erhöhen. Die Latinx-Bevölkerung in San Francisco ist in positiven COVID-19-Fällen überrepräsentiert, und Studien wie diese helfen uns zu verstehen, warum und informieren Sie über Maßnahmen und weitere Partnerschaften in der Gemeinde. “

Das Clinical Response Team von Unidos En Salud in der ZSFG-Abteilung 86 koordinierte nicht nur gemeindenahe Tests, sondern bot auch denjenigen, die positiv getestet wurden, fortlaufende medizinische Untersuchungen und Links zur Grundversorgung, Nahrungsmittelhilfe und anderen Vorteilen an, um sich selbst zu ermöglichen -isolieren. Das Gesundheitsministerium von San Francisco führte eine Kontaktverfolgung durch, um Personen in der Gemeinde zu identifizieren, die möglicherweise exponiert waren und Unterstützung für die sichere Quarantäne benötigten.

Die schnelle Analyse von fast 4000 Nasentupfertests wurde durch eine stark erhöhte Kapazität für die COVID-19-Probenanalyse ermöglicht, die jetzt in einem UCSF-Diagnoselabor neben CZ Biohub in Mission Bay verfügbar ist. Dieses Labor, das im März unter der Leitung von DeRisi in nur acht Tagen von Grund auf neu gebaut wurde, wurde in Zusammenarbeit mit der Chan Zuckerberg Initiative ermöglicht.

Die Initiative Unidos En Salud ist Teil der kürzlich gestarteten UCSF COVID-19 Community Public Health Initiative. Unter der Leitung von Kirsten Bibbins-Domingo, PhD, MD, MAS, Vizedekanin für Bevölkerungsgesundheit und Gesundheitsgerechtigkeit an der UCSF School of Medicine, konzentriert sich die Initiative auf Gemeinschaften und Bevölkerungsgruppen, die überproportional vom Virus betroffen sind, und auf den Aufbau dauerhafter Partnerschaften in der Gemeinschaft.

Zusätzlich zu den COVID-19-Tests umfasste die eng koordinierte Reaktion von UCSF auf COVID-19 mit der Stadt und dem Landkreis San Francisco, anderen Gemeinden in der Bay Area und dem Bundesstaat Kalifornien die Bereitstellung von Prognosen über die Pandemie im gesamten Bundesstaat sowie Beratung und Beratung Pandemie-Reaktion von UCSF-Epidemiologen; Implementierung eines landesweiten Kontaktverfolgungsprogramms in Zusammenarbeit mit dem kalifornischen Gesundheitsministerium; Bereitstellung von 1 Million US-Dollar und klinischem Fachwissen für die Stadt zur Eröffnung einer COVID-19-Einheit im Saint Francis Memorial Hospital; und Eröffnung einer neuen Isolationseinheit für Atemwege mit 53 Betten im Mount Zion-Krankenhaus von UCSF Health, um die Gesamtkapazität des Krankenhauses der Stadt für potenzielle zukünftige Spannungsspitzen zu erweitern und gleichzeitig Platz für aktuelle Patienten zu bieten.

Die proaktiven Bemühungen bauen auf dem langjährigen Engagement der UCSF zur Bewältigung von Krisen im Bereich der öffentlichen Gesundheit auf, das auf die Gründung der Universität Mitte des 19. Jahrhunderts zurückgeht und Themen wie Obdachlosigkeit und Krankheiten wie Cholera, Tuberkulose und HIV / AIDS umfasst.

Autoren: Eine vollständige Liste der Autoren der Studie finden Sie im Preprint. Die Autoren waren Mitglied der UCSF, des Chan Zuckerberg Biohub, der UC Berkeley, des College of the Holy Cross, der Unidos en Salud / United in Health, der Latino Task Force für COVID-19 und der Abbott Laboratories.

Finanzierung: Die Studie wurde vom Chan Zuckerberg Biohub, der UCSF, der Heising-Simons Foundation und einem Programm für bahnbrechende biomedizinische Forschung unterstützt. ARCHITECT SARS-CoV-2-Testkits wurden von Abbott Laboratories bereitgestellt.

Offenlegung: Die Co-Autoren Mary Rodgers und John Hackett Jr. arbeiten für Abbott Laboratories, die in der Studie verwendete Antikörpertest-Kits bereitstellten. Der Co-Autor Dr. med. Charles Chiu ist Direktor des UCSF-Abbott-Zentrums für Viraldiagnostik und -entdeckung (VDDC) und erhält Forschungsunterstützung von Abbott Laboratories.

Die University of California in San Francisco (UCSF) konzentriert sich ausschließlich auf die Gesundheitswissenschaften und widmet sich der weltweiten Gesundheitsförderung durch fortgeschrittene biomedizinische Forschung, Hochschulausbildung in Biowissenschaften und Gesundheitsberufen sowie hervorragende Patientenversorgung. UCSF Health, das als primäres akademisches medizinisches Zentrum der UCSF dient, umfasst erstklassige Spezialkrankenhäuser und andere klinische Programme und unterhält Niederlassungen in der gesamten Bay Area.

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