Can we just have less respiratory viruses now?

Covid has been very not great, but, one potential long term upside is if we actually mitigate the spread of all respiratory viruses thanks to what we’ve learned from Covid.  That would be great if we’re smart enough to learn the lessons.  Alas, it’s a pretty big “if” when you see how many places are still, somehow, fomite and surface cleaning obsessed while the air gets ignored.  That said, some of us– including some people who actually make important decisions about indoor air (for example, I recently learned that my county school system had installed Merv 13 filters in all schools– hooray!!) have learned important lessons.  And this could absolutely mean less people suffering and, yes, dying, from influenza in coming years.  And hopefully fewer common colds and other respiratory viruses.  And when it comes to lessons about the air, nobody’s been a better public scientist than Linsey Marr.  Here she takes to the NYT Op-Ed pages on the matter:

When Covid-19 first appeared, public health authorities worried mainly about the new coronavirus spreading through large fluid droplets — like from a cough or a sneeze. The guidance for individual behavior followed: Wash your hands, stay six feet apart and maybe even wipe down your groceries.

But a detailed understanding of flu transmission — developed over decades and recognized by precious few scientists until recently — laid the basis for scientists’ awakening to the reality of airborne transmission of SARS-CoV-2.

Research has found that, as with SARS-CoV-2, flu virus is exhaled in small particles by infected people while breathing, talking and coughing; and the flu virus has been found in aerosols in indoor environments, including hospitalschildren’s day care centers and airplanes. As with the new coronavirus, people can spread the flu even when they don’t have symptoms, which is further indication that transmission can occur without coughing or sneezing and doesn’t require large, wet droplets.

If recommendations to combat the flu continue to rely heavily on hand washing and surface cleaning, without recognizing the role of aerosols in transmission, we are unlikely to make a dent in the 12,000 to 52,000 deaths in the United States per year caused by the flu. But if we take a page from the Covid-19 playbook, the United States could drive flu cases down and prevent missed days of school and work, as well as death…

I’ve long believed, based on years of research, that the role of aerosols in the spread of many respiratory viruses is underappreciated by the medical community. I hope that Covid-19 has catalyzed a shift in thinking about the air we breathe. You wouldn’t drink a glass of water full of pathogens, chemicals and dirt. Why should we put up with breathing contaminated air?…

It will be a challenge to rethink the design and operation of buildings to account for air quality, but it is not insurmountable. Around the turn of the 20th century, the proliferation and modernization of water and sewage treatment systems helped make common waterborne diseases such as typhoid and cholera a rarity in the United States and Europe. The results of investments in water infrastructure are considered one of the greatest public health achievements of the 20th century. Making air quality healthier as a way to cut down on disease should be a public health focus for this century.

Anyway, it would be awesome if we could actually implement these airborne lessons and actually save some lives from influenza– which kills tens of thousands a year– simply by meaningfully limiting community spread.

Also, I followed that “don’t have symptoms” link, and I know I’ve posted this before, but I still find it mind-blowing that basically half of flu cases have no symptoms.  And, about 6% of those cases transmitted to a household member (definitely not nothing, but also, only about half for those that have symptoms).  But, still, you can get flu from a family member that nobody ever knew had it.  More like Covid than we realized.  We’re of course not just going to wear masks indoors all the time forever.  But we can damn sure pay more attention to indoor air quality. 

%d bloggers like this: