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The year 2020 has seen the emergence of a global pandemic as a result of the disease COVID-19. This report reviews knowledge of the transmission of COVID-19 indoors, examines the evidence for mitigating measures, and considers the implications for wintertime with a focus on ventilation.
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The SARS-CoV-2 virus has so far infected more than 31 million people around the world, and its impact is being felt by all. Patients with diseases such as COVID-19 should ideally be treated in negative pressure isolation rooms. However, due to the overwhelming demand for hospital beds, patients have been treated in general wards, hospital corridors and makeshift hospitals. Adequate building ventilation in hospitals and public spaces is a crucial factor to contain the disease (Escombe et al. 2007 PLoS Med. 4; Escombe et al. 2019 BMC Infect. Dis. 19, 88 (doi:10.1186/s12879-019-3717-9); Morawska & Milton 2020 Clin. Infect. Dis. ciaa939. (doi:10.1093/cid/ciaa939)), to exit lockdown safely, and reduce the chance of subsequent waves of outbreaks. A recently reported air-conditioner-induced COVID-19 outbreak caused by an asymptomatic patient, in a restaurant in Guangzhou, China (Lu et al. 2020 Emerg. Infect. Dis. 26) exposes our vulnerability to future outbreaks linked to ventilation in public spaces. We argue that displacement ventilation (either mechanical or natural ventilation), where air intakes are at low level and extracts are at high level, is a viable alternative to negative pressure isolation rooms, which are often not available on site in hospital wards and makeshift hospitals. Displacement ventilation produces negative pressure at the occupant level, which draws fresh air from outdoors, and positive pressure near the ceiling, which expels the hot and contaminated air out. We acknowledge that, in both developed and developing countries, many modern large structures lack the openings required for natural ventilation. This lack of openings can be supplemented by installing extract fans. We have also discussed and addressed the issue of the 'lock-up effect'. We provide guidelines for such mechanically assisted, naturally ventilated makeshift hospitals.
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In order to suppress chronic inflammation while supporting cell proliferation, there has been a continuous surge toward development of polymers with the intention of delivering anti-inflammatory molecules in a sustained manner. In the above backdrop, we report the synthesis of a novel, stable, cross-linked polyester with salicylic acid (SA) incorporated in the polymeric backbone and propose a simple synthesis route by melt condensation. The as-synthesized polymer was hydrophobic with a glass transition temperature of 1 °C, which increases to 17 °C upon curing. The combination of NMR and FT-IR spectral techniques established the ester linkages in the as-synthesized SA-based polyester. The pH-dependent degradation rate and the rate of release of salicylic acid from the as-synthesized SA-based polymer were studied at physiological conditions in vitro. The polyester underwent surface erosion and exhibited linear degradation kinetics in which a change in degradation rate is observed after 4-10 days and 24% mass loss was recorded after 4 months at 37 °C and pH 7.4. The delivery of salicylic acid also showed a similar change in slopes, with a sustained release rate of 3.5% in 4 months. The cytocompatibility studies of these polyesters were carried out with C2C12 murine myoblast cells using techniques like MTT assay and flow cytometry. Our results strongly suggest that SA-based polyester supports cell proliferation for 3 days in culture and do not cause cell death (<7%), as quantified by propidium iodide (PI) stained cells. Hence, these polyesters can be used as implant materials for localized, sustained delivery of salicylic acid and have applications in adjuvant cancer therapy, chronic wound healing, and as an alternative to commercially available polymers like poly(lactic acid) and poly(glycolic acid) or their copolymers.