A multi‐layered strategy for COVID ‐19 infection prophylaxis in schools: A review of the evidence for masks, distancing, and ventilation

Abstract

Implications for the academic and interpersonal development of children and adolescents underpin a global political consensus to maintain in-classroom teaching during the ongoing COVID-19 pandemic. In support of this aim, the WHO and UNICEF have called for schools around the globe to be made safer from the risk of COVID-19 transmission. Detailed guidance is needed on how this goal can be successfully implemented in a wide variety of educational settings in order to effectively mitigate impacts on the health of students, staff, their families, and society. This review provides a comprehensive synthesis of current scientific evidence and emerging standards in relation to the use of layered prevention strategies (involving masks, distancing, and ventilation), setting out the basis for their implementation in the school environment.In the presence of increasingly infectious SARS-Cov-2 variants, in-classroom teaching can only be safely maintained through a layered strategy combining multiple protective measures. The precise measures that are needed at any point in time depend

Airborne infections related to virus aerosol contamination at indoor cultural venues: Recommendations on how to minimize

“…With a refined keyword search (“cultural,” “event,” “concert,” “singing,” “choir,” “ventilation,” “face mask”), the number of potentially interesting publications was limited to 367, although only a small proportion directly related to the risk of infection at cultural events. As far as possible, the findings from other studies, for example, in school classrooms [6], were applied to the recommendations for this topic. The flowchart of the systematic literature selection according to PRISMA [7] is shown in Figure 1.…”

Requirements to minimize airborne infections related to virus aerosol contamination at indoor cultural events

“…No studies were taken into account that deal with the economic situation of the cultural scene and venues or with the mental state of artists. As far as possible, the findings from other studies, for example in school classrooms [2], were applied to the recommendations for this topic. The flow chart according to PRISMA [3] of the systematic literature selection is shown in Figure 1.…”

Measuring Indoor Air Quality Does Not Prevent COVID-19

“…42 Portable air cleaners can reduce particles in the air, but do not replace mechanical ventilation in providing infection control. 40,41…”

“…Carbon dioxide is frequently used as a surrogate for the risk of transmission of SARS-CoV-2, the virus that causes COVID-19. 40 In addition, inadequate outside air may contribute to the accumulation of solvents from dry erase markers, cleaning products, pests’ allergens, endotoxins, chemicals from air fresheners, perfumes, and other odorants.…”

“…Peer-reviewed studies conducted in the past 2 years have evaluated the contribution of ventilation in schools to reducing COVID-19 transmission as a component of multilayered strategies. 18,[38][39][40][41] Buonanno et al 38 showed that mechanical ventilation installed in 56 Italian schools reduced infection risk by at least 74% compared to over 10,000 classrooms with only natural ventilation. A recent literature review reinforced this finding, defining a maximum acceptable average value for CO 2 of 1,000 ppm, which should be lowered to 800 ppm during a pandemic, using carbon dioxide as a surrogate for infection risk.…”