Your guide to stopping COVID in your home 🧵

What you need to know to protect yourself.

Table of Contents
How it spreads, preparing your house, humidity, symptom onset, positive test, isolation room, your furnace, sharing rooms, masks, filter location, exit.

1/21
How COVID Spreads
#COVIDisAirborne

It's transmitted when an infectious person and susceptible person are sharing air. There are 3 main scenarios:
1. Close range - they share the most air. This is the highest risk.



2/21
2. If they share a room, the virus particles they exhale can build up. As you inhale a higher dose (concentration, time, breathing rate), risk of infection increases. Virus can be removed through ventilation (windows) or filtration (HEPA/CR box).


3/21
3. Long range transmission - this is transmission with a lower dose and generally further away. It's not as common but still a risk if you are in a house with someone who is infected.

4/21
Before COVID Hits your Home

The one thing you can always do is keep the air clean. Keep the windows open as much as possible and run humidifiers, HEPA filters or CR Boxes. If someone is infected, you'll breathe in a lower dose.

Here's some advice:


5/21
Humidity

You want relative humidity (RH) to be between 40-60%. Having good RH in your home does 3 things:
1. Viruses die quicker
2. With low RH, the droplet will evaporate quickly and stay suspended in the air. With good RH, it will fall.


6/21
3. Low RH makes you more susceptible to airborne diseases.

If it's cold outside, run humidifiers in your house - especially bedrooms. It's good for your health in general. Clean and disinfect them regularly.


7/21
You Start Feeling Sick

The safest thing to do is to act like you have COVID (see below) and rapid test periodically until symptoms resolve or you get a positive test.

If you can’t isolate, then be more diligent about running filters, opening windows and masking.

8/21
You Test Positive

Right away - N95s, open windows, turn on filters.

If you can, setup an isolation room.
Here are some things to do:
1. Run a filter in the isolation room. If any air escapes, it will have less virus.

cleanaircrew.org/someone-in-my-…

9/21
2. Try to block any paths that the air can leak into the house at the door.
3. Create negative pressure in the room - turn on an exhaust fan in an adjacent bathroom or have a fan blowing air out a window. This will cause air to leak into the room and not out.

10/21
4. Run a humidifier in the room if the air is dry.
5. If a return vent is located in the isolation room, block it by taping plastic around it. They look like this:

11/21
You Home Furnace

Furnace filter: If it’s a 1” slot, use the Filtrete 1900. If it's a larger slot, get a MERV-13 filter that matches the slot size. If air can't reach the far end of the house or the furnace stops working, put back the old filter and reset the furnace.

12/21
Filtrete 1000 also works against aerosols, but 1900 is better. If you have a MERV-13/Filtrete 1000/1900 filter in your furnace, run your fan all the time to get the filtration. If your furnace filter has lower rating, leave it on auto.

13/21
Sharing a Bathroom

Leave the exhaust fan running between uses and keep the window open. It's best to wait between uses, especially if you are not wearing a mask (eg. shower). 25 minutes should be fine if exhaust fan is running. The longer the better.

14/21
PSA: Close the toilet lid before flushing. Inhaling aerosolized fecal matter isn't good for you, especially if it's virus laden.
#CloseTheLid
As @DFisman says, air: it's the new poop.

When you're done, WASH YOUR HANDS!

15/21
Sharing other rooms, like a dining room is the same concept. If the infected person used it without a mask, open windows, run filters and wait before using it yourself.

16/21
Masks

Wear a N95 as much as possible, especially when not in the isolation room. If you need to take it off (eating, showering, sleeping), make sure the air is clean.

In the isolation room, it's lower risk to unmask and more comfortable for the infected person.

17/21
If you don't have a N95, use knot & tuck with a surgical mask.

Filter Location

If you only have 1 HEPA/CR Box or humidifier, I think it's best in the room with the infected person as source control and for their health.



18/21
You can place one outside their room to filter air that leaks out.

Otherwise, the best room for the filter is the one that you are in. They are portable, so you can carry them around.

19/21
Exiting

Don’t listen to US & Canadian Public Health and wait only 5 days. Best is to wait until symptoms resolve + 2 negative rapid tests on 2 days. At least wait for symptoms to resolve + negative rapid test.

20/21
N95s, filters, open windows, isolate, humidifiers - that's it.
Some can do more than others, but do what you can.

#COVIDisAirborne
If you know how it spreads, you know how to stop it.
Exposure is inevitable, infection isn't.
We aren't helpless.

21/21
2/ 40-60% RH is the standard value. Can vary depending on location. Best to humidify up to 40% in winter and dehumidify down to 60% in summer.

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More from @joeyfox85

Mar 27
1/ English version of the study showing ventilation reduces COVID transmission by 82%.

A few comments:
The original title stated that COVID cases were cut by 82%. A more appropriate title would be COVID cases "from outbreaks" were cut by 82%.
2/ They evaluated case clusters. Reduction in outbreaks is exactly what you would expect ventilation to do. Individual cases are difficult to identify if it's from the home or from school and you can't expect every case to be stopped. But larger outbreaks are different.
3/ They indicate a failure in the environment. We need to ensure children are in a safe place where a single infected individual will not make many others sick. Engineering controls have always been the necessary tool.

From Feb 2020:
Read 14 tweets
Mar 24
COMMON VENTILATION ISSUES #2
Exhaust only ventilation

This is common in buildings from the 50's era. Long before we had modern standards, ventilation was bad.
These buildings are considered to be "not mechanically ventilated".

1/9

My previous tweet:
Some buildings might not even have a main exhaust fan, but most have at least the exhaust fan. These make up about 30% of Ontario schools.

An exhaust fan is on the roof and ducts were run to every room. This creates negative pressure in the space.

2/9

cbc.ca/news/canada/ki…
Enough air should leak in through the windows or doors to provide some outdoor air.

The main problems are:
1. It wasn't designed for enough air to leak in. For classrooms, it's usually 250 CFM where modern standards are closer to 500 CFM.

3/9 Image
Read 9 tweets
Mar 22
Unbelievable. Italian study shows ventilation can cut school COVID cases by 82% reuters.com/world/europe/i…
This study is giving me a sense of relief, but also much sadness. I told my kid's school to improve ventilation and put in HEPA filters in August 2020. My chief medical officer of health overruled me. After I tried to convince him #COVIDisAirborne , this is what he sent:
For the record, my kid’s school is awesome. They’ve been working with me. CR boxes, HEPA filters, windows, CO2 monitoring, frequent HVAC maintenance… But those emails show how this pandemic went so wrong.
Read 6 tweets
Mar 22
Just got back from the dentist. No ventilation.

What happened? All the thermostats were set to "Auto" and not "Fan".

This always happens.

1/5
I checked it the same way I always do. First I didn't hear the fans on. The people at the front desk are usually skeptical when I start talking about ventilation, but the hygienist was extremely concerned.

2/5
I took a broom, attached a tissue with some tape and showed them there's no air from the diffusers.

I also showed them the CO2 levels - 1150 ppm. I told them it should be under 800 ppm. They are ordering a CO2 sensor now to keep on top of it.

3/5
Read 5 tweets
Mar 21
I recently finished Healthy Buildings by @j_g_allen . The most important line I thought was this:

"The people who manage your building have a greater impact on your health than your doctor" pg. 14

You know who runs schools? Untrained caretakers.
It's not their fault they are untrained. They are hired to clean classrooms, set up for lunch and mow the lawn. They don't know how to manage HVAC equipment. I've seen fans broken for months and no one notices.
HVAC equipment needs to be seen as medical equipment.

Do you have tons of questions about every small thing when you go to your doctor? The same thing should apply to the HVAC system in your building.
Read 5 tweets
Mar 20
In-Room vs Out-Of-Room Airborne Mitigation 🧵

Not all engineering methods to stop airborne spread are created equal. Some are better than others. It's better to clean the air in the room than cleaning the air entering the room. Here is why:

1/14
First, there are 3 science based methods to clean the air:
-ventilation - bringing in outdoor air
-filtration - filtering particles from the air
-UV - killing microbes with UV light

These can be done in-room and out-of-room (in the HVAC unit).

2/14

In-Room Mitigation

Ventilation:
-increase air quantity entering the room
-open doors/windows
-turn on local exhaust fans

Filtration:
-HEPA Filters
-CR Boxes

UV:
-Upper room UV
-Stand alone UV

3/14
Read 14 tweets

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