Indoor Air Cartoon Journal, December 2020, Volume 3, #113

Get vaccinated! It can help build the “ammunition” the immune system needed to fight the attack from a virus and prevent or limit its effect in altering human body structure and function to cause health problems and death. The vaccine can also help alert the immune system of the presence and impending attack from the virus with additional information on the kind of virus to fight. However, reducing the risk of burdening the immune systems in fighting virus attacks before and after a vaccine has strengthened the immune system is also very important.

This article aims to explain why investment in vaccination should be done with investment in healthy indoor environments and reduction of all vulnerabilities – exposure, physiology, psychology, social, and economic situation. The key takeaway from this article is getting people vaccinated may not be enough, especially during the COVID-19 pandemic or other future pandemics.

The first question is, is it possible to get infected after getting vaccinated? The answer is yes. According to medical experts, people can get infected between the time they are vaccinated and the time required for the vaccine to build the needed ammunition to protect the body and effectively alert the immune system of an impending attack from a virus.

Furthermore, several questions are yet to be answered or conclusively answered. Little is known in the literature whether vaccines can protect a person from being infected with coronavirus leading to the COVID-19. Can and how will getting vaccinated prevent someone from shedding viral load? A question remains on how variation in immunity level will define the dose level required for a vaccine to effectively prevent people from suffering from COVID-19.

What is the possibility of the COVID-19 vaccine wearing off, and how long will it take for it to wear off? Would there be a need for booster does? How many booster dose and frequency will be required? What are the possible side effects and variation in vaccines’ side effects taken by people with different physiological conditions? How can the extent of vulnerability – exposure, physiology, psychology, social, and economic, affect a vaccine’s effectiveness?

Very little is known about these questions. The clinical research only suggests that developed vaccines have the efficacy to reduce the risk of suffering from the COVID-19 significantly. The vaccines’ effectiveness in reducing the risk of suffering from the COVID-19 in the population is optimistically envisaged.

While vaccination is essential, especially during the COVID-19 pandemic, we can’t rely on vaccination only considering unanswered questions. Investments in healthy indoor environments and the reduction of all vulnerabilities are essential. Why? The following paragraphs will attempt to provide the answer to why.

Where do most of the exposures to the coronavirus and other kinds of viruses, known and unknown, occur? The answer is the indoor environment. Exposure to air pollutants in indoor environments is a concern because people spend greater than 90% of their time indoors. This means the human presence in the indoor environments for a long period increases vulnerability due to exposure to any pollutants, including viruses, which may be present.

It is important to note that vulnerability due to exposure may also occur outside, especially during the transit period. Air pollutants may be chemical (organic and inorganic), biological, or particulate matters – a summation of solid and liquid particles in the air. When the particles are in the air, they are called aerosols. Inorganic chemical air pollutants are in the gaseous state, while volatile organic compounds and biological air pollutants may become aerosolised.

Existing aerosols could provide a platform for coronavirus particles to reside on them. Thus, existing aerosols can increase the resident time of coronavirus particles in the air. The longer the resident time of coronavirus particles in the air, the longer their airborne status. The longer the airborne status of viruses, the higher the human vulnerability due to exposure.

Higher human exposure and inhalation leading to higher doses of viruses or any other air pollutants can weaken the immune system, i.e., increases physiological vulnerability. For example, a respiratory organ’s weakened immune system caused by particulate matters may make an exposed person susceptible to being infected with the coronavirus.

A compromised physiological condition can lead to psychological stress. Unhealthy conditions of other indoor environmental conditions, e.g., light, acoustic, thermal, and spatial, may also lead to psychological stress. Evidence in the literature suggests that psychological stress could disrupt the immune system and its functions. A dysfunctional immune system will further increase physiological vulnerability, making the immune system unable to fight viruses or other air pollutants attack effectively. Therefore, we should be careful about how we manage our psychological or mental stress, as there are many sources of such stress in our daily lives.

So, who is responsible for creating healthy indoor environments? What to take into consideration in ensuring healthy indoor environments? Individuals, groups of people, family and society level, building professionals, and policymakers and enforcers are responsible for achieving healthy indoor environments.

The existence of poor indoor air quality (IAQ) and the risk of experiencing the harm it causes necessitates the need for actions to reduce the vulnerability of people that may be present in the vicinity of the indoor air pollutants. The vulnerability due to exposure can be prevented if the source of indoor air pollution is prevented. No source means no exposure, and no exposure means no vulnerability due to exposure. The elimination of an air pollutant source will lead to eradicating vulnerability due to exposure over time.

The management of the source to reduce its emission rate or its effect will reduce the extent of the vulnerability, but it will still be present. The management of the source of an indoor air pollutant instead of preventing or eliminating it will lead to an economic burden involved in providing engineering solutions, such as ventilation and filtration, to reduce indoor air pollution.

Sometimes, the management of source instead of preventing or eliminating it might be the only option available as infrastructure, such as building, are holistic in nature with many systems linked together. Design decisions made on material or system might not be from IAQ point of view only but taken to address other building performance concerns. Therefore, adopting an engineering solution(s) to compensate for IAQ deficiency might be inevitable. Additionally, in many cases, identifying or knowing the source present in the indoor environment in immediate and future occupancy might be very difficult.

The adoption of ventilation at an appropriate rate will effectively reduce air pollutants concentrations that compromise human health and wellbeing. Air filters and other appropriate air-cleaning strategies with little or no side effect in term of generating air pollutants should be used to complement ventilation adoption, and not replace it, will further improve IAQ needed for healthy indoor environment achievement. Poor management of a known or potential air pollutant source will further increase the economic burden of adopting engineering solutions. Everyone responsible for ensuring healthy indoor environments must have the basic knowledge needed to improve IAQ. In between, don’t forget to use a mask in public spaces to reduce inhalation of the coronavirus.

The other vulnerabilities yet to be discussed are social and economic. Behaviour, decision, and culture at individual, group of people, family and society level, and that of building professionals and policymakers and enforcers in charge of ensuring healthy indoor environment delivery can influence people’s social condition. If these factors are poor, the social condition people find themselves in will be poor.

Poor social conditions and the low economic status of indoor occupants will lead to poor building system conditions and how they are managed and used. The results of these are compromised indoor environments that increase vulnerability due to exposure, physiology, and psychology. As the COVID-19 pandemic experience has shown, there were high COVID-19 infection rates and deaths among people experiencing poor social conditions and low economic status.

In conclusion, this article’s message is investing in vaccine development and vaccination alone without investing in healthy indoor environments, and reducing all vulnerabilities may do little in preventing people from getting infected or reducing the rate of COVID-19 infection. It is recommended that policymakers have a policy that invests and ensures the achievement of vaccination of the populace, healthy indoor environments, and the reduction of vulnerabilities.

Do you want to learn more about this topic? Read Acharya and Porwal (2020), Nwanaji-Enwerem et. al. (2020), and linked articles to learn more about this topic.