The NSW Department of Education was last week due to finalise an audit of 2,200 public schools to determine the ventilation requirements of each classroom. According to news outlets, The Department has already sent out a tender for air purifiers with high-efficiency particulate air (HEPA) certified medical-grade filters “to be used in the state’s classrooms to help mitigate COVID-19 transmission when students return to school1”.
As a peak body, we are equally concerned about ventilation and safety in our early education and care (ECEC) services and believe that in order to ensure the safest environment for children and educators, ventilation should be on every service’s COVID safe plan.
As part of our advocacy and provision of clear information to our members and the wider sector, we believe that urgent guidance and clarity on this topic is needed,” says CELA CEO Michele Carnegie. “I am urging the government to include our sector in their planning and advice and have written a letter to Sarah Mitchell, Minister for Education and Early Childhood Learning, seeking guidance around best practice, which we are yet to hear back on.
“While the Delta strain is circulating amongst the community, we need to apply multiple layers of defence to protect children and the workforce. The Doherty Report estimates 276,000 Australian children will be infected in the first six months after reopening in the most likely scenario, with 2,400 hospitalisation, 206 ICU admissions and 57 child deaths in that time.”
With the announcement of a return to early education and care from 18 October, we invited occupational hygienist Kate Cole and built environments expert Adjunct Professor Geoff Hanmer of high profile science group OzSAGE to provide clarity around important questions pertaining to ventilation and air quality in our sector.
Why is ventilation important?
We know that COVID-19 is airborne — this means that it can spread by aerosols suspended in the air.
The virus that causes COVID-19 spreads more readily indoors than outdoors. Evidence has also shown that viral particles spread between people more readily indoors than outdoors.
When lots of people are in an indoor space, a focus on indoor air quality is crucial in preventing transmission of COVID-19,” says occupational hygiene and ventilation expert Kate Cole of OzSAGE. “That’s because when we breathe, talk, sing, shout, cough or sneeze we produce very small droplets called aerosols. If someone has COVID-19, then those aerosols will contain the SARS-CoV-2 virus. Aerosols can stay in the air, build up over time, and travel large distances. Ventilation helps remove contaminated air containing aerosols and delivers fresh air from outdoors into our indoor spaces, thereby reducing the risk of infection.
OzSAGE is calling for a “Ventilation and Vaccine-Plus” strategy for safely lifting COVID-19 restrictions, including urgent ventilation upgrades for schools and businesses, vaccination of children, continued mask wearing and third-dose booster vaccines for front-line health workers.
“We have many members operating early education and care in vulnerable communities,” says CELA CEO Michele Carnegie. “Regional and remote communities are more vulnerable, given that they have fewer health services and the tyranny of distance to access care. Aboriginal communities are particularly vulnerable to COVID and getting severe disease and there is often a high percentage of children under 12 in the community, resulting in a much higher proportion of the community that will remain unvaccinated. In addition to this, many of our members educate children with disabilities and health conditions.”
What OzSAGE thinks of The NSW Department of Education’s recommendations around ventilation
The NSW Department of Education currently recommends the following actions be taken for ECEC services in relation to ventilation:
- Use outdoor settings wherever possible. In most cases, outdoor settings have better natural airflow than indoor areas.
- Use large, well-ventilated indoor spaces. If you must use an indoor space, avoid crowded or noisy indoor spaces as: a crowd generates more droplets and aerosolised particles and noisy spaces encourage people to shout or talk loudly, increasing the generation of aerosolised particles, and therefore the risk of transmission of COVID-19.
Indoor ventilation can be most easily improved by opening doors and windows. Other ways to safely improve ventilation include to:
- Avoid directing fans towards children’s faces, aim them continuously towards the ceiling or floor.
- Limit oscillation and turbulence of fans.
- Regularly inspect, maintain and clean heating, ventilation and air conditioning (HVAC) systems.
- Avoid using only recirculated air in HVAC systems, and increase the outside air intake.
- Consider disabling ventilation controls with automated settings that reduce air supply based on temperature or occupancy.
- Ensure exhaust fans are operational if in place.
If you can’t modify the ventilation or choose an outdoor location you could consider:
- Reducing the number of people in an indoor space at any one time by splitting children into groups and encouraging them to use different areas around the centre.
- Reducing the length of time that children spend indoors all together.
Source: education.nsw.gov.au
Kate notes that in general, most of these recommendations would help to improve indoor air quality. However, she has concerns around the inclusion of fans in the Government’s advice, noting that: “Fans will only push contaminated air around indoors unless there is a place where the air can be expelled outside and fresh air can be provided inside.”
The importance of checking air quality
Kate suggests that a key element that has been missed relates to checking the air quality within ECEC services, stating that this can be done through engaging mechanical engineers or occupational hygienists to help determine if all indoor spaces are adequately protected, or through simple tools to enable facilities to check their rooms themselves using CO2 monitors.
OzSAGE has released advice on Safe Indoor Air which is a useful start for services to reference.
When should HEPA grade air purifiers be employed, and are they effective?
“Air purifiers fitted with high-efficiency particulate air (HEPA) filters are a very effective way of removing aerosols from the air,” confirms Kate, who says that they are a practical solution to situations where indoor ventilation can’t be otherwise improved.
Air purifiers consist of a fan and a layered filter, and work by pulling in air from within a room and filtering out the aerosols before returning clean air to the room. HEPA filters can trap very small particles that are invisible to the naked eye such as dust, smoke, mould and respiratory aerosols. Studies3 suggest that some HEPA filters can remove up to 99.97% of particles of over a certain size.
However, she suggests that in order for them to be effective, it’s very important to make sure that the unit used is sized to the space correctly. Most models will list a recommended room size in their specifications.
It’s important to remember that while air cleaners provide filtration they do not provide fresh air. It’s optimal to combine them with improved ventilation, as outside air can help to dilute aerosols, like virus particles.
Can existing re-circulating air-conditioning systems be rectified to improve ventilation?
Many ECEC services rely on re-circulating air-conditioners for ventilation, and members may be wondering if they can be made COVID safe through rectification. The short answer is no.
Kate notes that re-circulating air conditioning systems will simply re-circulate contaminated air, and that “The key is to bring in outdoor air into the space and have a way to push out contaminated air.”
Can services continue to use an evaporative cooling system?
Direct evaporating cooling systems will take air from outside, cool it via evaporation, and bring it indoors. Because that increases the rate of ventilation indoors, Kate says that these systems can help to reduce the risk of infection. “However, they shouldn’t be confused with portable evaporative cooling systems as those do not typically supply outdoor air.”
Air quality monitoring and HEPA purifiers will be vital for internal rooms with no access to external ventilation
Many services have internal rooms with no access to external ventilation such as doors and windows. These often function as staff rooms or rooms where babies sleep. Many of these rooms are likely to use re-circulating air conditioning units, which can increase the likelihood of aerosols spreading.
Kate again notes that in these cases it would be of benefit to consult with a mechanical engineer to work out how to increase the amount of outdoor air being brought in along with the volume of air that needs to be provided through an HVAC purifier system.
“Carbon dioxide (CO2) monitors are a useful tool to help assess whether there’s good ventilation in an indoor space,” Kate confirms. “Simple measurements can be collected inside a room with a small hand-held monitor. If the concentrations of CO2 are higher than 800ppm, you can look to reduce the number of people inside the space and increase the amount of fresh air being brought inside. If that’s not practical, then bringing in portable HEPA filter air purifiers is a great way of improving indoor air quality.”
Note regarding ventilation and construction regulations:
OzSAGE’s Geoff Hanmer, Adjunct Professor at the University of Adelaide and Managing Director ARINA architecture and planning reminds us that under the National Construction Code (NCC), staff rooms and cot rooms should be provided with ventilation.
“If they are not, the rooms are illegal as they do not comply with the provisions of Section F of Volume 1 of the NCC. Childcare centres are Class 9b buildings under the provisions of the NCC, but have often been converted from Class 1 buildings, which are in Volume 2. From experience, adapted buildings and many new childcare centres have poor compliance with the NCC.
“If there are no openable windows the NCC requires that there should be a mechanical ventilation system that complies with AS 1668.2. If there is not, the building is in serious breach of the NCC. Mechanically ventilated rooms can be measured in the same way using a CO2 monitor as naturally ventilated rooms. Only store rooms or plant rooms are permitted to be provided with no ventilation; these may have been converted to other uses at some stage without anyone getting a Construction Certificate.”
Do the National Regulations need to be reviewed?
The EDUCATION AND CARE SERVICES NATIONAL REGULATIONS - REG 110 states the following in regard to ventilation and natural light in ECEC services:
The approved provider of an education and care service must ensure that the indoor spaces used by children at the education and care service premises--
(a) are well ventilated; and
(b) have adequate natural light; and
(c) are maintained at a temperature that ensures the safety and wellbeing of children.
We question whether these standards are sufficient in light of COVID and have asked the government to undertake a review.
Prof Hanmer notes that the regulation may suffice “if ‘good ventilation' is defined sufficiently”.
OzSAGE is suggesting the use of CO2 monitors to check ventilation levels; a serviceable portable CO2 monitor will cost between $80 and $200 with some models costing more because they are more accurate, more durable or better able to be connected to recording devices. Prof Hanmer says that accuracy (and therefore spending more on more accurate models) is not essential for this purpose.
The OzSAGE advice on ventilation is available here.
Have you considered bathrooms and nappy change stations?
Prof Hanmer notes the importance of ensuring that toilets and nappy change tables are operated to minimise transmission because of virus shed in faeces.
“This requires additional attention to ventilation, plus precautions when flushing toilets or disposing of nappies to reduce the risk of ’toilet plume’. Staff should be very cautious in these environments and wear N95 masks or respirators as children can shed virus for some time after they test negative following infection.”
Open windows and fresh air are best practice, but for some it will be a balancing act
The NSW Department of Education is currently focusing on 'natural' ventilation such as open windows. We are mindful that many early education services are located in areas where open windows and predominantly outdoor programs are not always possible. This could include extreme heat, dust storms, extreme cold and danger of pollution due to proximity to main highways.
In Prof Hanmer’s opinion, the solution depends on striking a balance between competing risks.
“If it is dangerous or impractical to ventilate the building adequately, it does not comply with the regulations,” says Prof Hanmer. “The designer of the centre should respond to the conditions that impact the centre and if they have not, one option is to provide a retrofitted HEPA filtered mechanical ventilation system or operate standalone air purifiers with a HEPA filter to remove contaminants including virus from the air.”
What we are advocating for
Vaccination, cleaning, hand washing, wearing masks and staying home with even the slightest sign of illness, provide multiple layers of protection for early education environments; making indoor air safer through ventilation is a vital layer that we need to address. CELA urges the government to include our sector in further guidance and clarity around this topic.
“As a peak body, we are incredibly concerned about ventilation and safety in our early education and care services as we prepare for large-scale reopening and higher participation,” says Michele Carnegie, CELA CEO. “We are seeking urgent guidance on best practice beyond accessing fresh air, including the use of existing air-conditioning units, CO2 monitors and air purifiers, so as services can operate COVID-safe across the seasons
“Some services may need to close off internal rooms and reconfigure services in the interest of COVID safe environments. This is likely to result in a capital cost and impact the viability of services who may also need to reduce the number of children who can attend the service. Services need to be provided with clear information, from reliable sources, so as they can manage risk and plan for identified modifications."
There is a valid case for financially assisting ECEC providers through the transition, specifically including our sector in the NSW Government's air ventilation review process, and providing funding for rectification and any potential capital works or reduction in fee revenue.
We will continue to update you as information becomes available.
About OzSage
OzSAGE is a multi-disciplinary network of Australian experts from a broad range of sectors relevant to the well-being of the Australian population during and after the COVID- 19 pandemic to assist the safe opening up of Australia.
From OzSAGE:
“We aim to be an additional resource for federal and state governments, opposition, business, community and non-government agencies in Australia. We will formulate independent advice on public health, health systems and other policy matters relevant to COVID-19 control, with diverse and multidisciplinary perspectives. We will provide decision support, underpinned by the best scientific evidence, modelling and other research, to inform the choice between policy alternatives. We will be agile and responsive in providing rapid advice during emergencies. We are guided by the values of respect, diversity and inclusion, justice, equity, transparency, authenticity, compassion and solidarity.
“We use the precautionary principle, ethics, real-world examples and understand that recommendations may change over time as evidence or needs change. Ventilation and "Vaccine-Plus' are the pillars of safe lifting of restrictions. “Plus” refers to testing, tracing, masks and other non-pharmaceutical strategies. Ventilation is about providing safe air and mitigating airborne transmission in high-risk settings (borders, health and aged care), in our schools, workplaces, social venues and homes.”
About Kate Cole
Kate is an Occupational Hygienist, AFR Top 100 Women of Influence, Churchill Fellow and passionate advocate for worker health & safety.
She has been supporting the COVID-19 pandemic in a voluntary capacity through providing specialist expertise on ventilation, respiratory protection, and health and safety more broadly.
About Adjunct Professor Geoff Hamner
Geoff is Adjunct Professor at the University of Adelaide and Managing Director ARINA, an architectural consultancy specialising in buildings and campuses for tertiary education.
He has been active in researching and writing on the issue of construction quality, particularly for multi-unit housing, and has been regularly interviewed on radio and television about this ventilation in relation to the COVID-19 pandemic as a member of OzSAGE.
Footnotes:
1. https://www.smh.com.au/national/nsw/nsw-education-department-scopes-10-000-air-filters-ahead-of-return-to-school-20210929-p58vun.html
2. https://www.doherty.edu.au/uploads/content_doc/DohertyModelling_NationalPlan_including_adendmum.pdf
3. https://www.sciencedirect.com/topics/engineering/high-efficiency-particulate-air-filter