Kashif Pirzada, MD Profile picture
Emergency Physician, fighter of misfortune and disease; and better indoor air quality w/ @theRavenApp. Can code (badly). Into history/politics/tech/AI. #fella

Aug 18, 2021, 16 tweets

Listening to this phenomenal seminar by @kprather88 and others on what's at stake on the return of kids back to school this month.

@denise_dewald explains that the ICU system for kids if fragile and not designed for big shocks

Letting children get infected (and 1% of them will need hospitalization) will overwhelm this system quickly, and opens the prospect of triaging which child gets life-saving care.

@kprather88 explains that aerosol spread is the primary mode of spread of SARS2, and can float and linger in a room. Indoor spaces need to be filtered, masks need to be worn.

Vaccinated can still transmit and infect others, but for a shorter duration, so masks are going to be essential to prevent spread in schools

Next, @linseymarr shows that masks are proven to reduced risk in classrooms over multiple studies

Marr: Our kids will require better masks. Surgical masks have leaks on the sides which allow virus in. N95 masks are not made for children, but Chinese (KN95) and Korean (KF94) kid size are alternatives. Tight cloth masks with reusable filters are also effective if they fit well

Can we get classrooms ready by fall, yes! says @CorsIAQ. Classrooms right now are extremely unhealthy ventilation wise and have needed improvement for decades

Dose of infected particles depends on a number of factors, and can be mitigated by masks, ventilation and filtration. Do as much outdoors as possible, upgrade systems (though too late now), increase natural ventilation.

Filtration is a great tool, to improve the CADR, the Clean Air Delivery Rate. HEPA filters are a quick and cheap solution that can be readied in time for $10 per student per year

They can be built quickly and cheaply in the time we have left with box fans and furnace filters
texairfilters.com/iaq-research-p…

Some important factors mentioned by @DavidElfstrom and @Poppendieck:
Focus on moving air, getting a high clean air delivery rate, while also reducing noise.
ASHRAE standards encourage 2-3 air changes/hr, but this should be doubled to 6 air changes/hr

As @JimRosenthal4 explains, easy to make a simple HEPA filter with 4-5 MERV 13 filters, a box fan and some duct tape. 2-3 of these will service a classroom for <$100. Its a neat project for students, can be scaled to large spaces.

Have to stop here, but the recording I'm sure will be up soon. Each speaker is an expert in their field and all of these recommendations are pure gold to keeping schools safe this fall.

Some other great live tweets of the event:

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