Episode 1: Airborne Transmission of COVID-19 with air quality expert Brian Fleck, P.Eng.

Host Jerome James, P.Eng., sits down with Brian Fleck, P.Eng., a professional engineer and professor from the University of Alberta about indoor air quality and its impact on health, happiness, and productivity. Brian, along with a team of medical scientists and engineers, is currently studying ventilation and how it impacts the transmission of COVID-19. 

Transcript

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This podcast is brought to you by OSPE, the Ontario Society of Professional Engineers, the advocacy body for professional engineers in the engineering community in Ontario.

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Jerome:                  [00:00:52] 
Welcome to Engineering the Future, a podcast presented by the Ontario Society of Professional Engineers.  I am your host, Jerome James.  Today, we’re joined by Doctor Brian Fleck, a professional engineer and professor from the University of Alberta.  Along with a team of medical scientists and engineers,  Brian is currently studying ventilation and how it impacts the transmission of COVID-19.  [00:01:21 ] He is passionate about indoor air quality and its effects on health, happiness, and productivity.

Thank you for joining me today, Brian.

Brian:  [00:01:30] 
Thank you for having me today.

Jerome:                  [00:01:33] 
To start, why don't you tell the audience why is indoor air quality such an important issue to you?  Or an important issue to begin with.

Brian:                     [00:01:42] 
Wow, that’s a great way to start.

Jerome:                  [00:01:45] 
Yeah.

Brian:                     [00:01:45]
Yeah.  So why it’s interesting and important to me is the same reason it should be important to all of us, is that indoor air quality is becoming a greater and greater issue in society today and has a very important impact on health and the economy.  We see over time an organisation that many of our engineer members are familiar with called [Ashray? 00:02:11], a lot of discussion on how [00:02:14] we should be putting more effort into improving indoor air quality, IAQ.  

And as we move into the future, we see growth in the concern around things that can make the air quality, or the air we breathe, lower.  We see a greater and greater need to put scientific attention and professional attention on this very important factor.  Climate change and things like that [00:02:44] increase human activity and pollution.  We’re all putting pressure on the quality of the air we breathe, and we need to take it seriously.

Jerome:                  [00:02:51] 
And, OK, interesting.  We all know that HVAC systems move air around our buildings and help us to breathe, essentially, indoors.  How does that system impact the spread of COVID-19?

Brian:                     [00:03:13]
Great question.  So if the folks listening right now are engineers, they’ll often know what HVAC means.  But HVAC is heating, ventilation, and air-conditioning, and those are the mechanical systems that take care of the supply of fresh, breathable air inside the built environment.  And so we all know that there are a number of things that can be in the air we breathe, both indoors and outdoors.  An HVAC [00:03:43] system has the ability to move air around, remove contaminated air, or air that has particles or chemical species that we don’t or shouldn’t breathe, and remove them out of the building, remove them with filters, destroy them with ultraviolet light and things like that.

[00:04:04] So the HVAC system is really the thing that helps you breathe in the building.  And you're there in the building trying to enjoy, or work, or be productive, and if that air you breathe isn't acceptable, that has a great effect on the performance of people in those spaces and how good they feel, and therefore the productivity of society in general. [00:04:30] An important little detail I like to remind people is today, people are spending almost 90% of their time indoors.  We'd like to think we love the outdoors and –

Jerome:           [00:04:42] 
Wow.

Brian:                     – [00:04:42] 
Things like that, but, you know, we're mostly spending our time inside, and that air is usually delivered to you by a mechanical system designed and built by engineers.

Jerome:                  [00:04:53] 
Right.  Interesting.  So what exactly is your research in ventilation hoping to achieve?

Brian:                     [00:05:02]
Oh, good question too.  So we were actually funded by the Canadian Institutes of Health Research, which is the funding body for health research in Canada, to look at the current literature that tries to trace or find the interaction between HVAC, indoor air quality, and the transmission of viruses.  Specifically at the time of the funding, the COVID-19 [00:05:30] outbreak was just beginning, and there was a shortage of information on this.  So we're working through what's called a systematic review, that means we have a traceable recorded way of doing all of our searches and making sure which research papers are included.

And there are thousands of research papers on all of these topics, trying to bring this information together and catalogue what we know is actually challenging.  [00:05:58] Another part of my research is I use this information to provide input into our risk model, so our exposure risk models, that we perform on buildings at the university of Alberta.  Currently, at the University of Alberta, we have a reduced use of the building infrastructure because of concerns around COVID-19 transmission on a variety of different modalities.  

[00:06:29] We're looking at the HVAC systems and assessing what those risks will be when we open up those buildings, and it's an important decision-making tools that allow the operators of the facilities to decide whether they're going to change the operating parameters of the HVAC system, or use different rooms than they normally use.  There's a lot of people concerned, and they want to know that some quantitative scientific evidence is behind decisions that are being made. [00:07:00]

Jerome:                  [00:07:01] 
Right.  Very interesting.  Can you elaborate more of your trajectory to be doing this type of research?  How did you get [unintelligible 00:07:12]?

Brian:                     [00:07:12] 
Oh, like my background?

Jerome:                  [00:07:14] 
Yeah, and how did you get excited about ventilation, and how did it progress to get getting funding for this topic?

Brian:                     [00:07:22]
OK.  So I'm actually more of a fluid dynamicist, that sounds like a nerdy term, but I do study in fluid mechanics, and I did some work in sprays and aerosols, and I have done some research in HVAC.  I work with a team of people, so one of the people on my team is really a specialist in HVAC, we've got someone in our team who is in the Faculty of Medicine who is an expert in systematic reviews.  [00:07:55] I've got this background in fluid dynamics and sprays, and it became apparent, I guess last January, January 2020, that there was an unfolding situation where there was a lack of information, and I had a sense that things were going to escalate.  As we all know [00:08:17] they did.

So when a call came to put in a proposal for this research project, we had already been thinking about putting in a grant proposal.  So the timelines for getting that through were quite tight, and so we got that in and got going very quickly with that project.  [00:08:36]  So what makes me excited, I guess, is that this is a ubiquitous technology.  Ventilation systems are often, you know, the simple systems that people ignore or think are doing magical things in the background and we don’t pay attention to. [00:08:55]  Many of us know HVAC engineers and mechanical engineering kind of get treated like techies who are not at the very high-tech end of that spectrum of research, and that’s actually a myth.

[00:09:11] There’s a great deal of scientific knowledge and information research that goes in to understanding our HVAC systems.

Jerome:           [00:09:19] 
Right.

Brian:                     [00:09:19]
So I find it neat just thinking about how much HVAC infrastructure exists currently in Canada and the world compared to the other things we work with and play with.  You know, everyone’s super excited about cellphones and things like that, but in your home, you’ve got a lot more infrastructure for HVAC in your home than maybe [00:09:44] electronics.  And they’re extremely important for some of the challenges we’re going to be running into in the future.

Jerome:                  [00:09:54]
Right.  Very interesting.  We’re currently months into our second lockdown here in Ontario, and we’re still experiencing high transmission rates, daily numbers of infections.  Do you think that our current standards around air quality are too low?  Do we need to have a more rigorous level of refreshing outdoor air take-up in those kind of scenarios?  [00:10:33] And do you think that certain parameters should be indicators for government to make decisions on whether or not to reopen?  Or how to decide whether or not to send our kids back to school?  Should there be different standards in food processing versus in the classroom?

Brian:                     [00:10:57]  
OK.  That was about four questions, so I’m gonna take – I’m going to try to remember what you said there.

Jerome:                  [00:11:02] 
Sorry.

Brian:                     [00:11:04]
So let’s get started first on what you said about a high rate of transmission.  So compared to most epidemics that we’ve dealt with in the last few centuries, the transmission rate of COVID-19 is remarkably low if you compare it to measles, polio, things that have been – you know, Spanish Flu.  These were things that [00:11:31] were devastating.  My father had polio, and it really – he had a hard time learning to walk after he had polio back in the Thirties, right.

[00:11:44] The point is though, our society’s becoming more modern, and the standards are getting higher and higher for the expectations of health.  So this condition, which compared to previous epidemics is not particularly deadly, is still of great concern to our economy, because we have increased the expectations and standards of health and quality of life that we require.

[00:12:14] And so it’s good to see that we are taking this seriously.  The reason I say that is just to make sure we don’t get too alarmed by this situation.  This situation is something that can be quite problematic to a lot of people, and has caused a fair bit of death, and we mustn’t dismiss that.  And we can save many, many lives, and, as you know, we’re over a million deaths right now in the world because of this, we could [00:12:47] be reducing the death toll by some of the measures which are non-pharmaceutical interventions, and one of those is improving of indoor air quality.

[00:12:59] So I’ve kind of covered a lot of issues there, so one time saying this is not a deadly epidemic compared to what we’ve experienced in the past, but it is still very deadly and of significant concern, and we should be taking it very seriously without panicking.  In terms of what we can do to improve our ability to handle this, and future, outbreaks which could very well be similar to this, we need to understand [00:13:32] that the air that we breathe in buildings has a role to play.  And we’ve had the technology to improve indoor air quality for a very long time.  Why haven’t we been doing it?

Jerome:           [00:13:45] 
Exactly.

Brian:  [00:13:46] That was your question, I think.

Jerome:           [00:13:46] What’s stopping us.  Mm-mm.

Brian:                     [00:13:48]
Well, there’s a number of things.  It’s an invisible problem, not too many people understand it, and the market is not very sensitised to the need for good quality air.  And so when you buy a home, you rarely ask the real estate agent “what does the HVAC system look like?” in this house you’re buying.  You might spend more time talking about the colour of the paint or the countertop material, and that’s always a problem [00:14:17] when people are attracted to luxuries over – you know, we as engineers deal with that all the time.  Look at the automobile industry.

[00:14:26] You know, automobiles that mechanically were very substandard were extremely popular with consumers historically.  The same goes for HVAC systems, it’s not a sexy topic.  So we need to educate people so that they are sensitised when they are renting places, when they are looking for business spaces for their small businesses, that the indoor air quality is a factor in their economic productivity, their health, and their happiness. [00:15:02]  We also need the government to put the right, I guess, leverage in place, and hopefully the government will do that, and enable people to deleverage these costs, so make sure that they’re not as expensive.

[00:15:23] And we don’t want real estate owners to feel like if they make an investment and improve the indoor air quality in their buildings, they’re going to be out of pocket compared to somebody else who does nothing.

Jerome:           [00:15:36] 
Right.

Brian:  [00:15:36] 
People need incentives.  Period.

Jerome:                  [00:15:39] 
How much does it have to be on the people versus government legislating some sort of minimum allowable standard, such as when we go to buy a car, you know, we’re not buying gas guzzlers these days, but we’re still going for the colour, but we’ve trusted that a certain level of environmental quality has been legislated into the vehicle.

Brian:                     [00:16:09] 
Right.

Jerome:                  [00:16:09] 
Can we say that there's a level of standard that needs to be raised, that the government can influence?

Female Voice:       [00:16:17] 
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Brian:                     [00:16:32] 
Okay, excellent question.  And a lot of my colleagues who may be listening to this right now, are really hardworking people who work on building codes and standards, professional engineers contribute throughout Canada to the standards that inform how buildings are made.  The timeline for making change to the building code in Canada is quite lengthy.  It's a five-year cycle and the window for getting new changes for this building code have passed, so if you wanted to change it today, you'd be looking at a 10 year wait before those would change as it moves through the system.

[00:17:09] And building codes actually only apply to new construction, so they do not apply to existing buildings.  So the building code itself is not really going to quickly adjust to our increased sensitivity and awareness about airborne pathogen transmission inside the built environment.  There are other directions you can go, but people aren't crazy about having [00:17:37] strict restrictions in place.  Generally.  people who've already put a lot of money into building and owning infrastructure aren't crazy about rules come in after the fact when they may already have their budgets and costs set out for a very long period of time, for long-term real estate investment.

But things like the fire code are ways you can change things, and we also know that health regulations can actually be quite strict and enforced very strictly.  And we have seen that [00:18:17] in this year that there is legislation in place that allows health restrictions to make draconian changes to the way we move around and do things.  So [unintelligible 00:18:33] incentive needs to happen.

Jerome:                  [00:18:32] 
Do you think that has a – mm-mm.  Do you think that incentive or motivation to invest would be spurred if we had the right data to say that, okay, the government – because everyone wants to open right now, right?

Brian:                     [00:18:53] 
Yeah.

Jerome:                  [00:18:53] 
So if they had the proper data to say, “we can lower our transmission rates in our institution if we follow the standard that this new paper has just released, and the government allows you to open because of this,” do you think that that would catch traction, these people would be more motivated if you had a forward-thinking government to understand the type of research that's happening in this space?

Brian:                     [00:19:23]
So I think the way to move forward is to create a win-win situation, lots of metaphors you can use, we make the pie bigger, we create growth in the economy by investing in the quality of our lives and the efficiency of our buildings.  It has been known for quite a long while, prior to COVID-19, that improved air quality investments pay back, but they pay back to the occupants of the building.  If the owner of the building is not the occupant of the [00:19:54] building, then the owner does not win those improvements because people become more efficient, they become happier, they're more productive.  All of this is well-documented in excellent research that's available publicly and through online and a number of different places.

[00:20:15] To get somebody who owns a building to improve in the air quality, when they do not occupy it, would require a market where renters are sensitive to the importance of why they would want to move into a building that could show some sort of accredited or standardised metrics of air quality, which we have.  We have the ability to ask people to give some information on the number of particles per cubic metre of air, to disclose information about the HVAC systems, but renters, owners, buyers, even people coming to hotels don’t ask those questions.  [00:21:03] So it’s very hard to pass that along.  And so …

Jerome:                  [00:21:07] 
I mean those patterns could change in a future where we see pandemics the new normal maybe?

Brian:                     [00:21:14] 
Yeah, and think about wildfires.

Jerome:                  [00:21:16] 
And if I’m not going to rent from a place.  Yeah.

Brian:                     [00:21:19] 
Right?  Think about wildfires, think about –

Jerome:                  [00:21:20] 
If I’m not going to rent from a place.   Yeah.  Sorry for cutting you off.

Brian:                     [00:21:23] 
What we’ve seen in a number of jurisdictions in the world, like extremely large metropolises that we see in Asia and Africa, you know, far bigger than Toronto, for example, we see cities that are tens of million in size, and the air quality in those extremely dense urban centres is quite problematic.  You can see then that having good indoor air quality would be a luxury that people would seek out once people know that it’s available and it’s not particularly expensive.

                               [00:22:00] And this is one of the reason I believe that instead of having a punitive sort of control-based approach, which is actually quite difficult to enforce until people are educated.  You know, people smoked voluntarily for ages, and didn’t stop, right?  You know, and there was significant evidence showing it was extremely bad for your health.  It wasn’t until the government went into education mode, [00:22:30] that we really got a handle on the popularity of smoking.

Jerome:                  [00:22:35] 
I can see those incentives changing if we come into an area of – like if another lockdown comes –

Brian:                     [00:22:48] 
Mm-mm.

Jerome:                  – [00:22:48] 
You won’t be able to open with this ventilation.  That could be a calculation for a small business owner to say “I’m gonna to spend a little bit more rent here, instead of staying here, because I’m hedging my bets.”

Brian:                     [00:23:01] 
Mm-mm.

Jerome:                  [00:23:01] 
"I don’t want to be closed for three months if the next lockdown happens.”

Brian:                     [00:23:05]
And there’s another point to consider, is that there are populations at risk that require a higher duty of care, and as professional engineers, those are things, if we operate HVAC systems in places – healthcare facilities or long-term residences for geriatric care, these are places where the market is sensitive, so we know now that there are concerns around [00:23:35] lawsuits and liability.  And this will spur activity in those sectors.  And I’ve seen this already starting to happen, so I see owners of long-term care facilities now starting to see that they need to be better than the average, and now they’re competing for resident dollars.

                               [00:23:58] And I think as they increase the indoor air quality for our seniors it will make lives for them better.  You know, these are people who we care for and love, that we don’t want to just forget about, and knowing that they’re living in excellent care is an opportunity for competitive growth in those growing markets.

                               And as you know, the age histogram of this country is looking at quite a ramp [00:24:27] for the next 10 years, so I expect that that sector of our economy will be quite enthusiastic about competing for excellent indoor air quality.  Those are growth sectors that could then create opportunities in other parts of our economy that I think would be really nice to see.

Jerome:                  [00:24:45] 
Absolutely.  We, as engineers, have a lot of technical knowledge in finite areas.  How much of an onus is on the technical community to raise awareness to the general public on these issues would you say?

Brian:                     [00:25:05]
Well, as you know, I'm a professor, and I'm very motivated to encourage people to seek out a lifelong learning.  So engineers in most of the professional or the provinces in Canada are encouraged to maintain excellent and well upgraded knowledge of technical systems.  We do have a duty to be leaders, [00:25:31] that's why we're professional engineers, and that's why we are self-governed because we have a responsibility to the public, and we see stakeholder capitalism also being a much more important concept in our society today.  We cannot expect the public to understand all of these things.  So people like me who work in education, or people like yourself who work in trying to get public awareness out, have the duty to [00:26:01] get the information out and adjust the nature of the information so it suits our audiences so that we can make it understandable.

You don't want to talk down to people.  You don't want to talk over people.  So there's all these ways that you can enter the education of the public.  And of course, lobbying to government on the value of having people with scientific credentials, [00:26:30] and of course you're going to hear me once again advocate for professional engineers having that professional designation where we have a code of conduct and we have self-government so that we can make sure that the people who are doing these critical duties in HVAC are self-governed and are watching one another in a way that a third-party body wouldn't have the ability to do.  [00:26:58] That's why we’re self-governed, right? 

So we have to, for our own benefit, for our own profession, or else someone will come along who doesn’t know what they’re talking about and sell garbage, if you pardon the sort of slang there.  And of course you and I both know that there are people all over the place who would sell things just to sell things, and it’s really up to us to set that standard higher to say [00:27:30] “yeah, sure you can buy this product, but don’t you want the choice of the product, or the installation of this product, or a system to be supervised by somebody who is governed by a body that puts a great deal of effort and vigilance into making sure its members are qualified.

Jerome:                  [00:27:53] 
Right.  Yeah.  Absolutely.  I have one last question for you.  Do you have any interesting nuggets from your research that is maybe published, or knowledge that you can share with us that was interesting that you’ve come across in your COVID research journey?

Brian:                     [00:28:17]
Sure, I mean top of my head, a lot of the things are starting to get out in the news, but we know that for a long time there were political/health organisations that seemed to be choking on the concept of airborne transmission.  And one of the things we learn about healthcare in public health is sort of half science, half politics, right?  And so we have to understand that time it took for them to admit [00:28:44] that this virus seemed very likely to have an airborne transmission route was lost time.  So we’ve learned something there, that people in those sectors who are providing advice to the entire world have to be extremely careful about what they say.

[00:29:05] So we had emerging information to give us a sense that this was an airborne pathogen, or airborne transmission was a significant concern, but it took a while for there to be guidance from the top bodies in the world.  And this really shows us that sometimes you have to act on being careful before you know, [00:29:33] as long – you know, you have to make a choice on, okay, certain interventions which are not expensive and do not impair the economy we should probably bring in right away.  And there was some hesitancy to do some of those things.  Things like masks.

Jerome:           [00:29:49] 
Oh absolutely.

Brian:                     [00:29:51] 
Right?  We weren’t exactly sure how well they worked.  We’re still not entirely sure how well they work, but knowing how cheap they are, it seemed like an easy approach and there was an odd resistance to this that might have been cultural, or people were seeing this as an attack on individuality.

Jerome:                  [00:30:11] 
I remember that time.

Brian:                     [00:30:13]
Yeah, whereas there are other things that are just very expensive that we still aren’t sure are effective.  And so it’s odd how things have progressed in different jurisdictions.  But as a society, I would have thought it would have been easy to make the choices that were not costly, soon.  Whereas things that were quite [00:30:44] an onerous load on the economy I can understand why it took them a while to make some of those choices.

Jerome:                  [00:30:53] 
Yeah, I know that.  Yeah.

Brian:                     [00:30:53] 
And there’s still lots of odd contradictions that are laying around in policy that are just because there are all these overlapping jurisdictions.  Like I go skiing in the Rocky Mountains, and the operator at the ski lift tells me to have my mask on when I’m outdoors in a high wind area.  But you’re allowed to have your mask off, indoors, in the chalet.

Jerome:                  [00:31:16] 
Right.  Right.  That doesn’t make sense.

Brian:                     [00:31:17] 
So, you know, there’s these weird things, and you just see things that don’t make sense and go “OK, well how did we get here?”  Not everything makes sense, and we have to speak out about the things that don’t make sense without being too counterproductive, right?

Jerome:                  [00:31:34]
Yeah, it’s true what you say, is are we hearing something that is seated in science, or is it more political posturing.  I remember that first section of time when the mask conversation was not definite, and I’m like if it’s good enough for [00:32:03] the nurses in those wards to wear an N95 or something constantly and they’re in harms way day in, day out, I’m going to find a mask.

Brian:                     [00:32:15] 
Yeah, why wouldn’t you, right?

Jerome:                  [00:32:15] 
I remember wearing my mask at that point onwards.

Brian:                     [00:32:18]
Right.  And I look at that as, again, although if I were a mask manufacturer, I would be very happy about those.  But the way that those costs distribute easily over a lot of people, in particular low income people are the people we have to be very sensitive about, right?  We can’t be expecting them to buy [00:32:41] $65 respirators, right, to walk around and work in a minimum wage retail job, right?  So masks are cheap, and I think it would have been good if the public were given those, you know, provided those, or people, low income people.  But, again, that’s politics.

Jerome:                  [00:33:03] 
Yeah, I feel like there was a moment where there was a fear of shortage, and Donald Trump wasn’t helping the matter at the moment either.

Brian:                     [00:33:12]
Yeah, well there were all sorts of odd things happening at that time, and I try not to – you know, I have been involved in politics myself, and I understand when I’ve stepped over the line, I’m talking about science and engineering or politics, and I’ll stay away from that.  But, you know, I believe that as we move forward, the things that will be beneficial to everybody are going to be the things we adopt.  And if this revolution in improvement in goods and services, in indoor [00:33:47] air quality, in building engineering would be beneficial to the economy.

                               We already have evidence to show that this would be a boom in productivity, so it’s not some burden having more health people taking less six days.  This is already demonstrated prior to COVID-19 as an economic win.  Again, the problem is the people who make the [00:34:17] changes to the building don’t necessarily reap the rewards, and so we have to align that in some way to make it a win-win-win situation.

                               I do see that people are going to be more sensitive to it, sensitised people, people with lung disease, people with allergies, people with asthma, people with auto-immune disorders, the elderly.  This will drive the market, [00:34:40] and I believe then, after that, people will become accustomed to excellent indoor air quality.

Jerome:                  [00:34:49] 
Thank you so much for joining us today, Doctor Brian Fleck.  I hope that some real good insights come out of your research.

Brian:                     [00:35:01] 
Thanks very much for your time, and good luck to everybody, and stay healthy and safe.

[00:35:06 - 00:35:10 - 00:35:10 – Music]

Female Voice:       [00:35:10] 
From all of us at OSPE, the Ontario Society of Professional Engineers, thanks for listening.  Please be sure to subscribe so you don't miss an episode.

[00:35:18 – 00:35:26 - Music]

[End of recorded material at 00:35:26]