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so [Music] [Music]
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foreign
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so [Music] so [Music]
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hmm [Music] two
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[Music] before we start we would like to remind everyone of the house rules to be observed during the entire webinar
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and to please settle down as we will begin our webinar shortly good morning everyone
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so [Music]
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[Music] so
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[Music] good morning everyone and welcome to hashtag kovitis airborne understanding and implementing the paradigm shift a two-part webinar
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discussing the history and science of airborne virus transmission and protection against airborne coveted transmissions i am dr paulo victor medina assistant professor at the college of medicine university of the philippines manila and again i will be
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your moderator for the webinar we welcome our esteemed guests and participants from different sectors and industries science and technology medical and allied sciences environmental education government
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agencies and other sectors we are also live on facebook and youtube with youtube having automated closed captions in late 2021 the world health organization officially acknowledged the
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overwhelming evidence suggesting that covet 19 is transmitted through aerosols this two-part workshop aims to detail the paradigm shift and its implications not only to medical professionals who
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are accustomed to the old theory of droplet transmissions but also to the general public the second part of the webinar today will focus on the implications of kovit 19 being airborne it also aims to focus
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on equipping the medical professionals and the public with the knowledge on how to protect oneself and the measures against airborne transmissions that being said i again have the privilege to introduce our guest speaker
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he is a professor of chemistry at the university of colorado boulder and he obtained his phd in mechanical engineering at the massachusetts institute of technology in 1999.
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during the covet 19 pandemic he was one of the experts who signed an open letter to the centers for disease control and prevention and the world health organization urging them to acknowledge that airborne aerosols play an important
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role in transmitting kovid 19. without further ado let us again all welcome dr jose luis jimenez professor thank you thanks for that that kind of introduction
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and without further ado i will start with the presentation and share my screen and thanks again for everyone i this is actually has been a lot of work for a
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lot of people to to organize it so i'm very grateful uh i'm very grateful for that let me get myself organized okay so you should be seeing my screen now and i put
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a copy of my slides in the in the chat uh maybe someone since more people keep joining maybe someone can can put it in a little bit so that people who join later can can see it
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um it seemed that that last time most people uh liked the the system how i did it but they said i talk very quickly and sometimes not loud enough so i will try
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to talk louder um it's difficult to talk less quickly because i have a lot of material to cover but if you if you have more questions on some details you can look at the slides the slides have links where you can go
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and see more information and and also i have other pieces of reference and you can also see the talk again on youtube and listen again to the specific specific areas and we will have more
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than one hour to to deal with questions after the webinar okay so anyway so anna this is the link that i just put in the for the presentation for today the one for last week is at this link
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and i'll put the all of these links again in the chat at the end of the presentation so this is the outline of what we're going to cover today which is also reproduced at the bottom so you can you can get oriented these are the links
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from last week to the slides and the youtube so we're gonna briefly um remind ourselves what do we mean what are we protecting against with urban transmission and then we're gonna go through six different types of things
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that we can do that will that will reduce uh transmission okay so without further ado let's go on to the reminder so um um
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the professor was who introduced me was was talking about um how uh there was overwhelming evidence and this is just one example a paper that we published in the landsat about a year ago that has had a huge impact where we
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summarize a lot of the evidence that the dominant transmission of this virus is airborne that we said that at the time that the urban route is dominant now a year later i think it's it's probably the only important route not the only one but
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probably the only important one and um and that's what we're going to be working from in order to um to think about the different measures and if if you disagree with this or you
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then you have to go back and see the seminar from last week so what does this mean in practice well in practice this means let me see if i can get a pen yes okay then basically we have transmission
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especially into situations one is this one in close proximity so when we are talking to someone especially without the mask the respiratory results are very concentrated in this region in between
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the two of us okay just like if this person had eaten some garlic and then this person is smelling some garlic because it's breathing in the air that has left the infected person right that's transmission and close proximity
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accounts for a lot of transmission but as we saw last week there is also this transmission in in shear room air when we have a person who is not close to the infected person but the box which is the room is
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trapping the virus and then over time they can breathe enough virus and they can get infected and these are all the super spreading events throughout the pandemic um you know this is the two slide summary
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of what i discussed last last week in in 45 minutes uh here you have a lot of links uh you know if you want to read more about that type of thing or find out more
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but i'm gonna i'm gonna use that information to um try to explain what i think should be done what the measures are effective against the dominant type of transmission and the first one actually is communication
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we have to explain to people what i just explained to you um you know and this is doesn't have to be very difficult and there is for example these cartoons that have been made by by a friend
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where you see you know the the aerosols are more concentrated in this region but over time they're gonna reach people who are far away just another cartoon like the one i did you can download them from from the web from those links
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and then for example here it's showing the dependence on time and distance of the beginning around the person kind of like if this person was smoking the smoke this invisible smoke that is the
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the other cells that contain the virus are near the person but over time more and more of them accumulate and they basically fill the room just like if you had a smoker in the room over time it will the smoke will fill the whole the whole room right
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and that's why one thing that that people sometimes do is that they they have a mask but they only put the mask when someone else is going to come in the room or in the taxi and by then if that person is
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infected the room or the taxi are completely full of virus right so for example like this that's depicted in this situation and here is like wait a second i'm gonna put my mask and open the door but now this situation is
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pretty risky if this person had been wearing a mask all along because they knew that people were gonna come in that would be a lot safer so as i was saying really um smoke is really the best analogy we have we have
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discussed with the other scientists many many different analogies but really smoke is is not perfect but is the best one we have found and it works in close proximity you see the smoke is very concentrated but in a room you see how
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the smoke is kind of chaotic but eventually you will smell the smoke as it mixes around and if the room is more ventilated there will be less smoke the windows are open otherwise there'll be more smoke right
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when i say it's not perfect is is for two reasons especially and and it's worth explaining so that people don't get confused what we see here are aerosols but what we smell are not aerosols are gases and those gases stick
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to surfaces like to the walls and then they come back slowly so you can come in into a room and it smells like smoke because someone smoked there last week or something like that but the aerosols are gone you know so so
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the resources stay much less those are gases and that's that's something else that's not important for for transmission the other thing is that smoke from a cigarette is very strong and we don't think the virus reaches as far you can
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be on the street and sometimes you smell smoke and you don't even see who's smoking but we don't think the virus has such a reach okay but it is very useful um at the beginning when the person is exhaling it and it's spreading as a way
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to understand what they do in the air because because it's very similar okay so i wanted to remind um also people of something i said last time
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unfortunately the communication is very poor from most governments and from who why because because these professions have been um you know a little confused because of history because of the the droplet dogma
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and um i mean there is also there is still some people that think that if we say it's in the air people are going to panic i don't think so i think people are afraid and may panic if there is a lot of cases and a lot of death not if not
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not with details of transmission at this point there is also some governments that don't want to say clearly because they want to save face you know because they they don't want to say that they they have said the wrong thing before and i mean what we always tell
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them is just use technology the science has changed at the beginning of the pandemic you know people thought other things now we know it goes this way you know but also the other reason why many governments don't want to say this because it is convenient
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it's much easier to tell people to wash their hands you know it's something they do it's their responsibility but if you say the virus is in the air suddenly is the responsibility of the government to clean the air in the schools or or the
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government buildings or is this responsibility of companies and that can cost some money so they there is a lot of resistance for for all of these reasons okay okay so
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we're gonna then talk about uh barriers like plexiglass barriers or or facials and disinfection and for the most part i'm gonna tell you these are things we shouldn't do these are things we did at the beginning of the panda
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makers because we thought we were trying to stop projectiles that were coming from one person to the other and then if they were not hitting a person they were hitting a surface and then that's how we were going to get infected and now we know that's not
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important okay so when are these plexiglass barriers i mean that's how we call them here i'm not sure how they but it's basically just putting a barrier in a room when are they useful they're useful in a in a conversation a situation like a cashier
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or something like that because you see the air in this case is going like that but if this person was closer this person was here they would be breathing some of that exhale there on the other hand if you put a barrier this
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air is going to hit the barrier and it's going to go up and down so this person is protected from this direct highly concentrated stream of the virus now eventually the air is going to
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make it this way so they they both still need to wear a mask and all that but in this situation like if you work as a cashier in a supermarket or in a bank or something like that this is this is useful now when they are not useful is when
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they are lateral okay because basically they trap the air and they impede ventilation right so like in this situation we see the air um is going here and then is is going it's being trapped here and he's being
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trapped there again this this is um assimilation but there are there are many studies this is you know this has been done in many places this is the parliament in switzerland and they have all these barriers and really this is this is not useful
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um and in fact there is a study that was published in science more than a year ago where they looked at schools in the u.s and different things the schools had done and then they saw which schools had more or less transmission
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so the schools that had installed these barriers they called them here desk shields had more transmission because about twice the transmission because the again the trapping of the arrow impeded
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the ventilation we see here there the black line is is when there is no no effect we see many things that help that we will talk about later for example masks produce transmission
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um reducing the time the the students extend at school also reduce transmission doing things outdoors also mostly reduce transmission and we will come back to those things
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now what about face shields a face shield is something something that we wear that is like our own portable um plexiglas barrier and these things are designed for hospitals and they are based on the old
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droplet dogma so the idea is that if you're a nurse in a hospital and someone some patient coughs on your face and those projectiles are gonna come at you and they can hit you in the eyes or in the nostrils that situation can be
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very dangerous and you have you spend all day close to to people who may be infected now in society when people are not coughing or doing so very very infrequently and when there aren't that
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many of those large droplets that are projectiles when we talk at wheels last time really what you need to protect is against cyrus against smoke and then these facials don't really work you know this is this is a simulation
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where someone has his knees by a group in japan and these black dots are all the aerosols and you see how the aerosols are getting here you know and through there and because it's like a smoke you know at the beginning kind of like a barrier will
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stop it for a second but then it will get around and and you're gonna breathe them just the same okay um and this is a study that the cdc did on aerosols a quantitative study and they
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test different types of masks we'll come back to that but you see here the face shields and this is as a function of which particle size and here is basically facials are zero here basically zero
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here basically zero so no protection at all and then as things get bigger they protect a little bit but only against this first when they first arrive then later later they don't so it's really it's really
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not worth the money in most situations okay now there can be transmission through the eyes right and that sometimes people say well we need the facials to limit transmission through the eyes the question is is not so much these
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droplets that are these projectiles but the smoke right and then you need to do something else what you really need if you want eye protection or goggles so something like this these are ones from 3m
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in the us this costs between 10 and 15 dollars and you probably have them cheaper from china but the idea is some kind of glasses that are closed that they don't let the air
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easily go around your eyes right so they block the flow of air that's what you want you know when to use this i would say definitely in higher risk situations so for example in a hospital or people
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who drive a bus or or who work in a supermarket or something like that i would recommend them everyone thinks every scientist i've talked to with one exception i guess thinks that transmission to the eyes is
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a much smaller fraction than uh than transmission through breathing because there is just so much more air than we breathe goes in and out and the size of of the of of these or tissues
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that it's in contact with is the size of a tennis court well the eyes are small and they are not breathing they are not drawing air in and out right so so really everyone thinks most of the transmission is when we breathe okay
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so but anyway for some people we could recommend if you are gonna invest on something then wear goggles don't wear a face shield okay you know you can also people who are at
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risk of money com more complications if they are immuno compromised or sometimes people who want to be extra cautious you know myself during this omicron wave when i go indoors i do wear something like this on goggles and you
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know this makes me feel a little better is it really needed i don't know but okay what else is not worth the time so disinfecting surfaces okay we said last time transmission through surfaces there
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are zero demonstrated cases and the cdc has been telling us nature has been telling us so it's just there is all this waste all this theater of you know people spraying this infectants here in the theater or even here they were spraying
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disinfectants from drones and in mexico they spray people when they're gonna go into a church or anyways absurd it's really absurd things and because it's a waste of time it's a waste of money and it's pollutant and
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it's toxic and for example these were the cause at the beginning of the pandemic is where they calls to the lines where you call when you when you have a poisoning and they really these poisonings really increase when the
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pandemic started because people started using a lot more bleach and things like that at home okay so that's something that you know only in the hospital and only where the copic patients are and maybe the the door handles
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and the light switches things that a lot of people touch but otherwise it's not just wash your hands that's fine now since we have such poor communication there's a lot of this that has been done this was uh
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the prime minister in the uk was disinfecting the chair a month ago as he was as he was gonna get uh i guess the booster of his vaccine or something and he's like this makes no sense he's like he's gonna see it the virus is not gonna
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come through his through his pants or something like that this is just but this was you know on tv and i was saying here in mexico they were spraying disinfectants and this is really this can be toxic and this does nothing you know this is
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this is totally useless but it costs money it costs time and then people gives people a false sense of security you know and this is some some more communication these are some cartoons that we have made and that you are
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welcome to use about about these things that we shouldn't we shouldn't be doing and this makes it very clear you know the virus is in the air and these people are just wasting their time okay
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so that was uh number three so number four is gonna be things we do and places we go what can we what can we do in that department okay so as we saw last time the most effective thing is outdoors because you
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have dilution because the exhale rises and doesn't hit the ceiling and come back it keeps rising or there's always much more wind and 20 times more wind outdoors even if it doesn't feel like there is any wind there's always much
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more air motion you can just experiment with a match in more than most places indoors okay so this was in 1910 in in new york they did schools outdoors in the winter and this
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the winters in new york are really cold you know if you if you've been there it's really painful um but yet it worked well you know this was from from an article um you know and uh about that thing in
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the um in the same children that were too tired to play are beginning to show some interest in life this was because of tuberculosis at the time and they reduced early transmission a lot and the kids were more attentive
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and they did better in school now we find a lot of resistance depending where you are in canada they say it's too cold in spain is too hot in the summer too cold in the winter you know a lot can be done if you try you know you set up some shadow and you
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cannot do it every day or whatever but but if you put some effort you can do a lot of activities outdoors not all of them not all the time not for everything but a lot can be done and it is worth the effort but we we're not used to it
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anymore you know so that's something to to work on now if we are gonna go indoors we need to do many things okay and one of the ways this has been represented is with this what they call
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the swiss cheese model so the swiss cheese is these cheese that has holes and the idea is that you have you know the virus is coming and then maybe here is going to make it through this hole and then it's going to make it through
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this hole into this hole but here there is no hole so this this this barrier is gonna stop it okay so we have many things that we can do none of them work very well but the sun does work pretty well okay
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so because sometimes people think oh i'm gonna i'm gonna be indoors i'm gonna be working indoors all day but i'm wearing a mask and then i'm safe no no no no the mask reduces the chance of infection but you need to do more things okay
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and these are some posters that that we did that uh you know say what to avoid is similar to the to the japanese three three seas but has more details so you wanna avoid places where there is a lot of people indoors where there is low
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ventilation when people are closed a long time there is no masks or when people are talking loudly those are all the things that that don't help okay you know i'll use that for later but now
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one one practical example so this is the case of the skagit choir that we we wrote a paper on and we have a model and i showed you last week that the model works not just for this case but for many others to predict how many people
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got infected okay so this is now the attack rate so this is how many people got infected in this case it was like 80 something percent and this is the real case you know 80 some percent got infected now in these four situations
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we're gonna do only one thing okay we're only gonna do one thing to try to reduce infection in this one we're gonna increase ventilation here we're gonna add a filter here we're gonna put surgical masks and here we're going to make the
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rehearsal half the duration we see all of them help all of them reduce the transmission from 80 some percent but only to 50 right so this is still a big super spreading event now let's say
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that we do all four things ventilation a filter less time and surgical masks and uh and um here sorry so then that already that now when we
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have many layers now instead of eighty percent we are at eight percent okay so that's um that's much better and here we have uh if we were to move the event outdoors i mean the calculation is hard to do but in that case
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maybe none maybe one or two infected so you will have much much less cases so this is the idea you need to you it's not just a mask or not just ventilation you need to do many things because neither of them is going to be
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perfect okay this is now about the most effective measure is not talking okay why because we emit 10 times more aerosols and more virus when we talk and about 50
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times more when we when we shout or when we sing and i'll show you some some data later okay so what this is showing is as a function of the decibels how loudly we're talking the probability of transmission
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depending on ventilation so this is a low ventilation so you see if you talk less loud the probability is much lower you talk more loudly you know private is much higher if you don't talk you know then the private is really very
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small you know we have a lot of outbreaks in choirs thousands and thousands and as far as i know not one outbreak in a library or in a movie theater where people don't talk okay so
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so something that can be very effective like this scientist in spanish is from from mexico city is to have us to have signs for example in public transportation telling people to not talk you know
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of course you cannot i have a colleague that said we should ask everybody in the world to be silent for a month and then covet will go away and i think is he's right covet will go away but you could never convince people to be silent for a month there's too
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many things we have to do you know but but in certain circumstances you know for example in public transportation or in some situations you know it can be done you can the people instead of talking on the phone why don't you
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text on your phone or something like that you know and it is very a very effective measure okay now in terms of looking you know how much if i shorten the duration where am i
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how risky is risky mr activities you know so as i said it's like there is more risk of transmission if there is louder vocalization and exercise here if you spend more time if there is
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less mask or the mask are less good if the space is smaller because the air is trapped into a smaller volume so you're going to breathe more of it or if ventilation is poor and we published a paper where we quantify you know if we
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say if there is a person that's infected where you are you know or with um i guess this one this is for that for a high prevalence of infection of omicron and if you meet
00:33:02
um with different people then uh this is your chance of infection and if you are outdoor and there is good ventilation and it's a short time and you're wearing a mask and silent basically your chance of infection is
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zero right on the other hand if you are with a lot of people and is fully ventilated and um and you are kind of shouting or singing or or is a gym or something like
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that you know then your chance of infection is is 10 20 you know so this changes enormously depending on these things and we know what's risky restaurants bars gyms
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uh schools you know places that are fully ventilated where people talk a lot you know that's that's um where a lot of the risk is if you want to do you want to see the numbers that were used in those
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calculations or you want to do the calculations for other cases this is online and it's free it's available you can make a copy at this link and um
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now it's a little what i have found is this works for people who have a quantitative background so for engineers or scientists or science teachers or something these work well from for my mom or someone who doesn't
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do these kind of things it's really confusing you know so so work with with someone try to find someone if you want to do this that has you know is is used to quantitative things and and and
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it can be very useful especially for the trends okay so next thing we're going to talk about are masks so before we talk about masks i need to
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say a couple of things again too so what are the masks a mask is a filter what are we trying to filter you know there is a lot of a lot of things that you see in social media and even on the press that are
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completely wrong about mass completely wrong and people say oh must don't work and they don't know what they're talking about okay for several reasons and this is one of them i showed this last week but this is not how the aerosols really
00:35:02
come out you know this is the virus has a diameter of about 0.1 microns right so this droplet this water droplet that has the they are so let's say this would be something like 0.2 microns or something
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like that that's not what happens they come mostly in larger um in larger droplets with mucin and respiratory fluid and saliva and not just with water and this error appeared
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on a prominent medical journal you know um so it's more like this you know you have a droplet that maybe you know maybe this is these diameter maybe two microns or something like that um and then it has a few values most of
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the droplet is something else it's mucin and sodium chlorides and like that has a few virus and is this much bigger droplet that you're trying to filter with the mask and this bigger thing is much clumsier okay
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now where is the virus because we know that there is smaller aerosols there is bigger aerosols and then there is the large droplets that are like projectiles so there is people who have been researching this for other diseases for a long time and
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for coping for a couple of years so these are some of uh some of our colleagues from the group of don milton and christian coleman from singapore and the university of maryland so they have
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this machine which is basically sat in the air and they take people as soon as possible as they they think they have copied or even people who may have covered but they don't have symptoms yet and they talk here you know so they they
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will talk or they sing and then the air goes there and they collect so here the cone collects the very large droplets and then there is an impactor to collect the coarser aerosols and somewhere else it collects the fine aerosols and then
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they do biology they do pcr and they try to see if they can cultivate right so what do they see when they do it with people with covert is that basically i mean it's a little complicated but 85 percent of the virus
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is in the fine aerosols meaning fine means less than 5 microns much bigger than the virus you know 50 times lower in the virus but in in diameter but still much smaller than the
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large droplets that are several hundred microns and even the corsair results that between five and a hundred are only 15 okay and you know there are details here
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this is more the case when talking or singing you know which is um which is uh when we have more transmission okay so really we have to filter aerosols that
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are you know we have to think a few microns is why we're trying to fill them because all of the filtration efficiencies and different things depend on the size and knowing that size more or less is very useful okay
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now filters are not colanders or sieves a lot of a lot of times people think okay my my mask or my filter has a hole and the virus is much smaller than the hole so it's going to go through first is going on a bigger aerosol
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but then it's not a sieve you know this is microscopic physics that is not intuitive it's not we're not trying to do this i mean this could happen but it's not generally what i'm trying to do there is
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things like impaction or interception or diffusion or electrostatic attraction which is why m95s work so well and here you have two very good links to we'll talk about that okay so you know so when people talk is like all
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the holes that that then you you know they don't know what they're talking about okay now one thing is going to be the filtration efficiency if the air is going through that cloth of the mask what's the filtration efficiency the other one is
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going to be the gaps you know through gaps that are very small one percent or two percent of the area of the mask you know 50 of the air is gonna go without filtering right so holes that are very
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small like a lot of people have in the nose on the sides with surgical mass half of the air is gonna go through there so this is is really the two problems filtration and fit and this is a video from a colleague that you can see there on youtube and
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they put masks on a mannequin that was exhaling some some smoke and here it was um you know going going through the gaps here it was a kn-95 but they didn't fit it and it was also going through the
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gaps and this was a cloth mask but it was a good one that was big and it was closing all the gaps and they they had much less leaks you couldn't see them right now there is some videos that you will see that the the anti-maskers send
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around and they say oh look i'm vaping so i i take air from from vaping and now i exhale through the mask and there is all this aerosol that seems to make it through the mask you know and they say it doesn't work they are so is
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traversing the mask this is an error okay vaping is a vapor which is a gas inside of you because you're warm when it comes out very quickly mixes with cold air and
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it forms a vapor form sorry it goes from a vapor to an aerosol it condenses just like in a cold day you exhale and the water condenses right then you see so this is this is an error it's repeated a lot but you know again these people
00:40:05
don't know what they're talking about okay now what are the masks that work okay so we want the mask to be a good filter to be breathable you know not not oppose a lot of resistance sometimes you buy some of the
00:40:17
cloth masks and it's really hard to breathe through them you know so again a lot of the air is going to go through the gaps and it has to be a good fit without gaps you know so the best are the n95 which are this is one example there are
00:40:30
many models and by definition they always have these straps behind your back okay these are the ones that work the best and and there are different models you have to find one that fits well for you then you have the er loop ones which are
00:40:43
like the kf-94 from korea k and 95 from china these ones always leak more than the one than these ones that have the straps behind the back so they are less preferable but it's all you have is the next best thing the other thing to be aware for the
00:40:57
kn-95 the chinese ones there is a lot of fakes okay so you have to be careful and try to avoid those fakes okay and um i i have some links i forgot to put it here but i'll come do it at the
00:41:10
end now surgical masks um it depends but they are mediocre because they tend to have a lot of gaps on the sides and around the nose and also some of them in the us there is the regulations say they have to be good
00:41:23
filters so if the air that goes through this is filtered well in europe it doesn't have to be a filter it's used to protect you if you are doing surgery and they and their blood splashes or something like that so then they are
00:41:35
even worse okay anyway here is there is a study that the study was showing earlier from the cdc and you see the n95s when they are well sealed against your face basically they remove all the aerosols
00:41:48
you know the facials remove almost nothing and this other procedure mask is a surgical mask these are different cloth masks you know as the particles get bigger there is a trend they're easier to filter you know but as i said a lot
00:42:00
of the viruses here so you can wear a surgical mask and filter 50 or you can wear an n95 and filter a much larger number and that's much preferable okay now if you don't have access to n95 or
00:42:13
kn95 there is something you can do with surgical mass that improves them a lot which is to close the gaps okay and these are these braces okay so you see is this basically this thing that you put here and it closes the gaps there
00:42:26
you see it may be better here and it closes the gap here on the side okay and there is there is this these people sell them in the u.s i think they cost 10 dollars but they also give you a template that you can make yourself with
00:42:39
a piece of with a piece of rubber okay so now it is especially good if you have a surgical mask that's a good filter if it's not a good filter it's not so good okay now the last type of mask and generally
00:42:52
the best is what we call elastomeric mask okay the problem with the n95s is that it's a good filter and it's very breathable but now you're asking a material that you have chosen because it's a good filter and it's breathable that it should also seal
00:43:05
against your face and that it doesn't do as well okay so the elastomeric mask is you take an n95 filter but then you put it in a plastic support and you see here how this person is is
00:43:17
pushing on this basically bead of silicone which is over a centimeter thick and this will push against your face and really you can talk you can move and you don't have any leaks this is one
00:43:28
particular model this is the one i use but there are many other models and this existed before cover this use there is some new development so and these are cheaper over the long term for hospitals because because replacing
00:43:40
the filters is less expensive than keep buying n95s now when two people when everybody uses the mass then you get the square of the benefit because let's say
00:43:52
10 of the virus escapes but now only ten percent of this virus that has escaped is breathed in by the other person that is now one percent okay so there is this study in pnas where they they did different combinations and
00:44:06
and and um they and they illustrate this effect that you get the square but then everybody has to wear it if you are the only one then you only get the linear effect okay and there are other studies in the real
00:44:17
world this one came recently where they were doing in california and seeing you know people who were wearing a cloth mask have the chance of transmission so they come at 66 percent respirators um 83 percent now remember
00:44:32
you have to do this square one minus this square sorry the pointer is i'm not doing very well but the difference is actually quite big you know so a respirator is four times better if everyone wears it and then 95 than a
00:44:44
surgical mask this is another stereo i'll skip in the interest of time you know so my summary is this something that uh some people i follow on twitter said recently so he's an infectious this is doctor at harvard
00:44:56
and he was saying frankly cloth mask should not be allowed in high-street settings we should use n95 and this person is the former head of the cdc with obama and again he's saying we should use n95 so i think it's
00:45:09
now the problem is the cost you know but we we shouldn't lie and tell people that surgical mass are okay because n95 are expensive we should tell people the truth and 95 is the best if you cannot
00:45:21
afford it whatever then you know uh you know you can ask tracey if your employer will buy it or do the best you can with what you have access to right but but we should tell the truth about what's the best okay
00:45:33
one other thing is is these respirators you know they need to seal against your face they need to they need to put pressure on the face so they don't seal on top of a beard okay so the cdc has all these examples of mustaches and
00:45:45
beers that work and don't work with with typical respirators now there is some people that would say in medicine so these are not necessarily anti-masters but some people say you know we don't know um
00:45:58
or people with a medical training is um the same as don't work because randomized control trials haven't shown it then and this uh these are this type of real-world studies that are
00:46:10
invaluable for vaccines or for drugs or whatever for things that they are too complicated there is no other way to learn if they work than to do one of these random trials right but remember what we said last time
00:46:23
that um there is um you know when the virus is the side of the body we can use physics and in the physical world we can do lots of other things and there is you know there is many these physics is how we got people
00:46:35
in the moon or how parachutes work or airplanes or the cell phone you have and really you know we have to trust people who know about these things in things like masks or ventilation and not rely on tools from anything that are really
00:46:49
for other types of problems okay okay so the next thing i'm going to talk about is removing the virus from the air and how can we do this okay the virus is in the air the worst thing we can do is
00:47:02
have a be in a closed room where the air is trapped and the virus is trapped much better is to open two windows if we can and then the so the red is the virus the block is is co2 so then now
00:47:14
we have ventilation and and then the concentrations are much lower another thing that we can do is to keep the air but remove the virus this is filtration the same that the mask is a filter we were we can have a
00:47:27
machine in the room that's a filter and you see how here the virus is getting trapped and the air is coming out and the air doesn't have uh doesn't have virus okay so this also works and it can be done in a few ways
00:47:40
the last one we can do is this infection and this starts to be more problematic that means we keep the air but we kill the virus so we're still going to breathe that virus but we hope we have killed it right and this is a lot more
00:47:52
problematic there is there is ultraviolet light which is the one that's shown here that does work there is many other types that some don't work and most of them are dangerous okay now i'll skip this i mean we know that
00:48:05
ventilation works this is a study for tuberculosis but i see that i'm going short of time a question i always get and i got last time here in the philippines is about air conditioning okay so now if you have an air conditioner
00:48:18
that looks like this so a unit in a window or that looks like this one of these mini split units this is not ventilation this is just um [Music] cooling this is cool in the air but it's
00:48:30
not ventilating okay so this is like if you have a fan indoors this is not really doing what you want okay sometimes you can put a filter but most of the time you don't have a filter now you can have also ventilation in a
00:48:43
building and there is you know openings in the wall and air comes in and out in that case there is always a filter and we should make that filter as good as possible in the u.s as good as possible normally means mer-13
00:48:55
in other places they may have different names and some of these systems allow you to introduce outsider and then if so you should increase it as much as possible during the pandemic period so that the
00:49:08
virus that maybe there is gross outside the next thing we'll talk about are filters okay so filter is like a mask and this is the efficiency versus size the virus is here but as we said
00:49:20
really the virus and the filters are very efficient at the size of the virus you know but but it's not going it's not going into the air alone it's really in this this other range
00:49:31
um where most of the viruses are and really then you see for example here the mark 13 is a lot better than the murph eight which which is a lot cheaper these are now the hepa filters the yellow line which is basically a hundred
00:49:44
percent at all sizes but it's more expensive and and you cannot put it in in all the systems right but but they work there's no question about it okay now this is a hepa filter it works it's
00:49:56
just expensive you know and and then this is a cheaper thing that you can build and is a lot cheaper and here in the us people are building they call them corsi ross and fel boxes from the two scientists that have pioneered them and
00:50:09
the idea is you use a fan and then you use blower through filters and the thing is that when you look at here at the dollars per amount of clean air is eight times cheaper
00:50:22
it's eight times cheaper than the um than the than the other filters my am i looking at the right one uh i'm not i'm not understanding the plots
00:50:39
oh yeah no no okay sorry yeah i was getting confused these are the hepa filters and the hepa filters are eight times more expensive these are the coarser horizontal boxes different models and they're a lot cheaper you know so i know joshua agar there at the university of the philippines is
00:50:52
exploring how to do these people in different countries are exploring it unfortunately these supplies like to do the one in the picture are more common in the us and less so in other countries but there are ways to do this and this is very effective we should have the
00:51:05
army doing it in all the countries um now there is information on the web and here you have different links for characteristics of commercial filters and this is too small to see but you can go into the links and basically
00:51:18
this is how much they cost and how much cleaner they give you and you see here you know this one doesn't cost a lot and it gives you a certain amount of cleaner but you can also buy this one that costs four or five times more gives
00:51:31
you the same cleaner and on top of it the color is red tells us it's no easier so you really have to shop around as i'll say later this there is all kinds of things being sold with with the pandemic that you know so i've seen some of these
00:51:45
filters that normally cost a couple of hundred dollars i've seen them people selling them for 2000 and they are not any better it's just people taking advantage of off of people's fear yeah now where does the cleaner go i don't
00:51:57
know if this video will play [Music] this was a video but it's not it's not playing but basically the the idea is that sometimes people say well if i put
00:52:08
a filter or if i have the windows open what's happening you can light a match and see where the air goes so you have this smoke generation machines and these are some parents in a school in australia and they were basically taking a video and putting smoke and seeing
00:52:21
what happened with the smoke depending what they opened and depending here they have one of those filters and they were seeing is the smoke going in the filter ideally you want the filter in the middle of the room but it's not always possible you know but
00:52:33
but this this can be studied you know and and it's not it's not hard okay one other question people ask all the time what happens if if i'm with someone at home that has covered and the idea is that whichever air that person is
00:52:46
exhaling you don't want to inhale so in this particular case the sick person is here in this room here okay the sixth person is here and and then what we want we open the window
00:52:59
and then we open this other window so the idea is that the air is going to be ventilated it's not going to go to the rest of the house and here for example if there is a door towards the rest of the house then we put the towel or we do whatever so that we close
00:53:12
that flow of air and then if we have a filter we put it here in the room and you know if the person has to go out or something then we all wear masks during that period so that's that's how you apply to that particular situation
00:53:25
now ultraviolet light works and this was shown for missiles 60 or 80 years ago so it works it's just more expensive and complex these are some of the data for missiles it works just as well for covet but it's more
00:53:38
expensive and complex and it has more risk if it doesn't do well so it can be useful i would say for a prisoner for a hospital i wouldn't do it in the schools and certainly not at home now i'll leave this for reference just
00:53:52
i'm doing a short of time now there is a lot of things that are being sold with ions plasmas photocatalysis or sunilizers foggers that put hypochlorous acid or different things the idea is that all of
00:54:04
these things are variations of the same idea is this disinfection you put chemicals in the air that are gonna somehow encounter the virus and i'm gonna react with the molecules of the virus which are lipids proteins and nucleic acids and they're gonna kill the
00:54:17
virus they're gonna be activated okay some work for that some don't okay but there is two problems if we are breathing that air we are made of the same thing as the virus lipids proteins nucleic acids so this is gonna do damage
00:54:30
to us and on top of that they are gonna react with indoor contaminants and this they can produce more dangerous contaminants so even though they are being sold a lot this is dangerous okay and this is one example where we see you
00:54:43
know this is the production of contaminants when things go up i'm gonna skip it again for time uh now let's skip this one over the humidity okay so the last thing i was going to say was about carbon dioxide commercial and carbon
00:54:55
dioxide which is something very useful okay what's the idea the idea is we exhale these cytosols so whoever is infected means excellent results that we said are small like five microns and they follow
00:55:06
the air just like the co2 that we exhale the food that we eat we turn into co2 and we exhale it and it accumulates indoors okay so they accumulate in a similar way not exactly the same but it's the best thing we have that we can
00:55:19
measure easily okay and here there are details and links but i'll skip that briefinger with a lot of co2 is not only bad to get infected we also get dumbbell you know this is a study from harvard
00:55:31
where they see that when people are trying to solve a problem you know at 500 ppm they solve it better when they are at 1500 ppm which is very common indoors they are a quarter as smart so we shouldn't do that in schools
00:55:43
or in offices yet we do it all the time okay so a co2 meter and this this is one this is the the best one although it's expensive it's called the iron net i i don't have anything to do with them or any other company
00:55:55
anyway so this is what you measure outdoors it's like 400 and then in a place that's fully ventilated in this case my car with my wife my son you get to 4 000 and that means 10 percent of the year you're breathing for
00:56:07
the second time and that's the dangerous situation now we open the windows something and then it goes down a lot so the i need and the measure very quickly every minute um this is more expensive there is this link
00:56:19
um there where some colleagues have tested many and basically what you want is these ones that are ndir non-dispersive infrared most of those work you know there are cheaper ones that cost twenty dollars
00:56:32
but then those you put alcohol in your hands and the co2 goes up because they are not really measuring co2 so you really want the infrared ones now the levels these are some schools in spain and they were i was telling you 1500 is bad
00:56:45
you know every school was above a spanish low and many were at a few thousand what we recommend really is 700 and the cdc recommends 800 and there is different recommendations is something
00:56:57
of that order okay now we think that going forward in every place where we share the air there should be one of these in the world you know in every restaurant in every school this is already a law for example in taiwan
00:57:10
in the schools you know and it should be everywhere and now in belgium and some places in spain and argentina and it can be done and it's cheap you know okay so what can we do with co2 so i think i only have a couple more slides
00:57:22
sorry if i'm going a little longer um so you can monitor ventilation and make sure you open your windows enough so for example it's very hot in the philippines in the summer you don't want to open the windows because you spend more air conditioning you're hot
00:57:34
it's muggy you know so sometimes people say i'm going to open the windows and then close them and then open and close and that doesn't work you know because this is when you close them the co2 the exhale that accumulates now your open goes down but then it accumulates again and really you have to
00:57:48
be opening them all the time and what works better is you open them a little so instead of opening them a lot open them a little but keep them open continuously how much is a little you master co2 and you don't need to
00:58:01
master co2 every day you know you need to associate to you know a couple of days and then you get to learn how that is you know if it is green or a winner whatever so you can have one of these co2 meters and every person doesn't need one you can share it with
00:58:14
20 friends or with a school or things like that okay and that's another example of the same thing this is an airplane that someone was asking last week so this is a trip from uh from a colleague and you know here the colleague was in
00:58:26
the bus and the air was was pretty clean but then they went into the into boarding and when when they board normally the ventilation is not on so the co2 went quite high now then later they turn on the ventilation
00:58:39
and then when the plane was in the air it was pretty good but now they landed and they and they again they turned off the ventilation and the co2 started to accumulate now my colleague was in the first row so he left very quickly he
00:58:51
went outdoors and outdoors is this level you know and then he went into a train and it was uh it was like that so when you think about the trip you have to think about all the periods where you're sharing the the air
00:59:03
and when you are flying is not the most dangerous it's often boarding and boarding and that kind of thing okay okay so then then unfortunately you know the theories is good but in the real world we have a lot of problems besides
00:59:16
technical problems okay so there is lies fraud and corruption there is a lot of this many many governments just openly lie you know many companies they use they want to keep responsibility on their individuals
00:59:28
they don't want to take responsibility they don't want to take costs and they want and they want to reduce restrictions because because of the economy you know otherwise the economy will have problems you know so there is still many governments that say that washing your
00:59:41
hands is one of the most important things you can do that's a lie that they say that surgical masks are just as good as n95 that's a lie our ventilation meets the standard in this school you know what's the standard you know
00:59:53
that's often you can always improve it because they say that when they they don't want to put hepa filters a hypothetical is always going to make it better you know or they say the hepa filters don't work or they move the virus around you know these are all lies
01:00:06
but but they are repeated worldwide now there are many companies like i mentioned earlier that are selling useless or dangerous products like these ionizers also nicest they're selling like hot cakes and they often tell you oh the hepa filters is the old thing and
01:00:19
my thing is the new thing and nasa likes it and don't don't pay attention or these co2 meters that are not in the ir even some of them say they are in the ir even though they aren't so it's fraud
01:00:31
and also this fake kn-95 mask there are a lot of cloth masks that are very poor in performance and there is a lot of corruption i've been surprised during the pandemic but even in places like the uk the government was gonna buy
01:00:44
hepa filters for the schools and they bought from one manufacturer and it was ten times more expensive than the other ones and they were not any better and they were noisier you know or you know and many similar cases you know and
01:00:56
people who are politically connected suddenly get the contract for the filters for the co2 meters whatever and suddenly they're more expensive and worse than they should be you know so so anyways this is sad but that's the word we live in so um
01:01:09
in terms of more references every question i've always been asked is in these frequently asked questions at this link and there is an automatic translation so you can translate into tagalog or other languages these are links for for more information
01:01:22
again you can get them from the slides and and that's um that's all i had sorry i went a little long and but we still have an hour for questions and thanks for your time and for your attention
01:01:40
thank you very much professor jimenez um maybe a bit of a breather while the team also uh tries to curate the questions that have been coming thank you very much again for that very excellent presentation and
01:01:53
very insightful presentation a reminder to all of our participants uh the q a box is open so kindly search through quickly browse through the q a box and just stop vote
01:02:06
your questions if you find that there are similar comments or questions already posted and then what we did the team has been trying to collapse and combine questions that are similar
01:02:18
based on the feedback from part one of the webinar so we do apologize if you feel that your questions might have been lost in the q and a portion if you really feel strongly about your question just
01:02:31
keep on putting them in the q a box and we'll try to see if you can attend to those comments and questions all right so professor jimenez are you ready for the next round of q a i'll let you drink a bit of water first
01:02:44
sir to help you catch your breath and be ready all right so with that thumbs up let's begin the q a portion of the webinar so professor jimenez um
01:02:55
there's question here what happens when my mask gets wet when i talk so much can i use a surgical one under an n95 and in general when should we double mask
01:03:08
oh let's start by the end in general we do not recommend double masking the idea of double masking is if you have um two masks that are not very good like a cloth mask and a surgical mask you can
01:03:21
put one on top of the other and that may close the gaps that was the way the cdc was recommending them but it may close the gaps it may open the gaps and it also makes it hard to breathe now you have to breathe through
01:03:33
more cloth so then more air goes goes through the gap so um in hospitals i mean there is one exception in a hospital you can wear an n95 below as well seal against your face and then a surgical on top and that's
01:03:47
used to protect your n95 from getting dirty you know like if someone is gonna cough or you're doing surgery or something that that is uh that can be useful but otherwise an n95 that's that's well fit is all you need
01:04:00
you know and then don't don't make things more complicated uh if it gets wet that matters for um for the surgical mask or especially the n95 then they start to work less well
01:04:12
you know so if they get very wet then then you wanna you want to change it you know after a certain period of time and you shouldn't wash it i mean some people watch the n95s that that's really making them worse
01:04:24
because because they use electrostatic charge and that doesn't go so well with getting them wet thank you very much professor um another mask question and we collapsed several
01:04:36
comments and questions here um since high quality masks are expensive professor can we reuse these high quality masks and if so do you have any tips in terms of the ideal way to do this
01:04:48
um you were mentioning do not wash the masks so that's good but there's a question here can we sanitize or uv sterilize these n95 masks and if uh when to replace this n95 mask professor if
01:05:01
you have an idea about them thank you yeah so this is at the beginning of the pandemic there were regulations that ind5 should be worn once in a hospital and then thrown away or one for a day or whatever
01:05:14
but really i mean that's that's exaggerated really the tests show that you can wear it for at least 40 hours so you can wear it on your work week and it's fine and even if you don't have access to more
01:05:26
wear it a second week it's okay as long as they don't get very wet they keep working okay so so rather sometimes people rather than buy many surgical masks machines and all the time get 195
01:05:38
and and and wear that one now with respect to if you're you know if you're working in a classroom or something like that i would just say you know then take take it off at night hang it somewhere wash your hands and just just be careful if
01:05:51
you work in a hospital or somewhere where there could be a lot of infected people what some people do i mean you can do that you'll be disinfecting something but you don't need to you can have five masks one for every day of the week and you put them in a paper bag or
01:06:03
you hang them and then today i take monday's masks then i put it back in the in the and i wash my hand and tomorrow i take tuesday mass and from one week to the next any virus that may have been there is dead
01:06:15
you know so that's that's simpler than trying to do the other things thank you very much professor jimenez i'm not sure so the team can you just monitor my feed i think my internet is
01:06:28
not stable but hopefully it resolves itself soon um another mass question uh professor jimenez i think this is in relation to the fit um what is your comment here if we had
01:06:41
headbands or ear savers on kf94 or kn95 masks will it have the same performance as an n95 hello sir uh oh was it me the head sir i got disconnected for a second could
01:07:04
you repeat the question uh sorry sir yes i thought it was me so the team could you please monitor our connections um sir if we add headbands or ear savers on kf94 or k95 masks do they affect i think
01:07:18
they're asking about the fit will they have the same performance as an n95 sir would you recommend those headbands or your savers or not on a surgical mask
01:07:28
uh on an en on kf94s or or kn-95 masks so so to use the things that make it they work better right i mean so the the problem with the kn-95 is that the
01:07:42
material is a good filter but they tend to have gaps around the edge because they don't i mean the ideally you will have it go on your face like this like an n95 if it's going on
01:07:54
your face tangentially that tends to leak more you know but but if they are tighter like with those cr savers that's better you know so so if that's what you have access to then that's better yeah
01:08:06
okay sir um sorry uh sorry i think this is another practical question about masks since the n95k 95 or kf-94 masks are fitted for adults uh
01:08:19
what masks would you recommend for children or those with smaller faces um so there are there are some like for example um [Music] one of the three masks that has the the
01:08:32
bf b flex this is one of the three mk95s and they they sell them on big size and small size and the small size fits well for for older children like 12 13 14 so that's one option
01:08:45
for smaller children there is the the korean kf94 they do sell uh children's sizes and my son has used those i have a seven year old uh they also sell elastomeric masks for
01:08:58
children and that's what he wears now and it's it's called flow mask so similar to that other one is and you know it's basically again something that that seals well in the face with an n95 filter so i would i would suggest something
01:09:11
like that there are there are fewer options but there are options for for children thank you sir uh for for that and i hope that the audience is listening and starting to um make those connections
01:09:25
where do we search for these things locally um and of course hopefully the regular government regulators are also here um tuning in so that we can also start uh
01:09:37
demanding for a better policy in terms of these masks and making them available thank you sir um this is now a filtration question sir how long should uh the hepa filters run
01:09:50
inside the closed room before a gathering and how long can it be turned off during an event to reduce the noise so very practical question sir um so before a gathering i mean unless
01:10:03
there was someone there before it doesn't need to run so the idea again is is when the people are there that the virus is going to be coming out that's when you need the ventilation and the filtration sometimes like there were some schools in in spain
01:10:15
and they were opening the windows for two hours before the children arrive then close the windows when the children are there and then open the windows when the children left that was a complete waste of energy because you were ventilating
01:10:28
when when the kids were not there and then you were making the children breathe the virus so so the idea is you have to ventilate when the people are there thank you very much for that very very practical answer sir um
01:10:40
again for filters sir merv filters are not commercially available here in the philippines instead several hipaa filters are sold in online stores with prices ranging between two to 100 us
01:10:54
dollars do you have any tips sir how can we separate the authentic and fake filters is there an immediate test we can do to access hipaa filters you were mentioning something about alcohol and those carbon
01:11:07
dioxide measuring machine measuring devices so would there be a similar test that can be done sir for hepa filters um well i mean so first one one precision
01:11:19
one thing is the filter itself so when i say mr13 is not a box with a fan it's just a filter itself and those are the ones you would put in a building for air conditioning and i'm sure there is something like that in the philippines
01:11:30
it may have a a different name now if you are talking about a box like a hyper filter that has a fan and a filter inside and when how to find a good one or a bad one um
01:11:43
there are there are fake ones and then normally the fake ones are the no name brand from from china there are some of them are okay but some of them are not and often you see that the quality is not very good and they may
01:11:56
have gaps and things like that um so i would say you know if it's a brand that that you know like xiaomi or from china or honeywell or some brand like that they can be tested and
01:12:09
they can be tested with these portable meters that are called condensation particle counters but this would be someone will have to do this in a laboratory at the university i don't know if there are people i mean this equipment costs five thousand dollars so
01:12:21
it's something that we have in research labs is not something you can do at home so i think the message there service we have to be collaborating with these academic institutions if they do have
01:12:33
the capability and complexity one more thing is that there is i mean people have been doing this and there is people who have been doing this in the us in australia and in spain and i put all three links
01:12:45
are in the presentation so you can see you know there are many of the filters are the same because they are the either chinese or honeywell whatever so you can see how they recommend what they recommend and what they have tested
01:12:58
thank you for that reminder sir and uh i think going with the presentation there are people in the q and a box who are asking will the slides be available and will the recordings be available for the two
01:13:10
parts of the webinar series the answer to that is a resounding yes and so the organizers will just keep on promoting the links and typing them in the chat box or uh in the in the links um
01:13:23
shared on social media so kindly just watch out for those they've already been shared but we will share them again so that the people who've been asking can benefit thank you very much uh
01:13:34
sir this one is a communication question um and maybe uh you can share as a scientist i'm pretty sure you're quite used to communicating to fellow academicians and scientists but when you
01:13:47
talk to lay people sir although they are already aware of airborne transmission people still continue to spray disinfectants alcohol sanitizers in the air is a real value for that and uh do
01:14:00
you have any tips on how that can be communicated better to people yeah i i meant to to say a little more about that but spraying these infections in the air is
01:14:12
is dangerous is this infection of the air that is dangerous you should never do that when people are there and as i told you it only matters when people are there you know otherwise it doesn't matter why why would this infect the air
01:14:24
that nobody's gonna breathe so definitely we shouldn't do that i mean there is a problem and it's it's not science it's sociology right when at the beginning of the pandemic we were all very scared and we all were ready to
01:14:36
do whatever they told us and they told us it's on the surfaces wash your hands these infect everything i was the first one who disinfected everything now the problem is afterwards for the reasons i mentioned a lot of the governments either they've
01:14:49
been confused or they haven't been wanting to explain it clearly to say face or because they don't want responsibility or whatever and and we have to say it really strongly because really what we learned at the
01:15:02
beginning of the pandemic is really we learn when we were really scared with fear it's really deep into our brain it's very hard to unlearn it you know and now we've heard so many things and so much contradiction and so much misinformation so now you need to say it
01:15:15
really clearly and really say it again and again and and i mean that's that's what is my part-time job i have a on twitter i have this hall of shame where anytime i see
01:15:27
someone disinfecting the air or whatever i put it there and from different countries and whatever and i have another one where i see someone doing things well i put it there too you know and you know it's one way to try to get the word out but you know but there is
01:15:40
there is a need for very large campaigns and in my mind that is the biggest need what we have to do is not so difficult if people just understood that it is like a smoke that the infected are exhaling like some
01:15:53
smoke and you know at some point i was talking early in the panama with someone in india and they i was trying to explain the ventilation and we were both very confused because the houses there are very different than what i'm used to and
01:16:04
i've never been to india but then i explained to them it's like smoke and then they were like oh it's like a smoker oh okay thank you they never asked me again because they understood what they needed to understand thank you very much for that professor
01:16:18
um again uh this has been maybe just uh so that the team can all put the questions again in the google in our google sheets it's nice that you mentioned that sir uh about the campaigns i think we should
01:16:32
now start to really figure out how to get the message across and really say that this is how it's transmitted and we can come together better thank you very much for that reminder sir um sir another practical question for
01:16:45
individual households since not all can afford to retrofit their homes nor by air filters here in the philippines what are practical ways aside from keeping our windows open
01:16:57
that we can do to ensure that the air we breathe at home is clean i mean the keep the windows a little open try to
01:17:08
borrow a co2 meter or buy one with um with your friends or i mean in some countries what people are doing is they basically have like libraries and you can check out a co2 meter for a day and then measure a lot of things
01:17:21
that can be really useful maybe the university could do that or or someone could do that um so that you know how much to open the windows because the problem is not opening the windows a little which is normally what you need but when people
01:17:33
open the windows a lot now a filter you can always try to build a filter with a with a fan if you have a fun not to be hot again joshua agar was showing me some kind of filter material that you can use tape around and you can make a filter
01:17:46
that doesn't cost you very much because you already have the fan otherwise you can wear a mask is difficult to do at home but but if you you know if you think someone could have
01:17:57
copied or there is a riskier situation it's a good idea to wear a mask especially when you are talking you know you don't need to wear when you sleep or when you're working on your computer but with your talking may not be a bad idea and if
01:18:09
for example if you live with someone who who would be at very high risk and is not very well vaccinated and i would say that person should wear a mask and and should eat separately from the others because when we eat and we talk that's
01:18:22
that's when it's riskier so these are some of the some of the things you can do thank you very much for that professor i think this question is uh again about hipaa filters uh you were starting to
01:18:35
explain this during your presentation but felt that you didn't have the time so maybe this is uh the time to be able to do so um can hepa filter sir work with covid virus given the particle size
01:18:46
some say of the virus some say hepa filters cannot filter the virus because they're too small totally wrong both i mean and i mentioned that in in the talk hepa filters work very well remove all
01:18:59
the virus from the air because the virus is present in much bigger aerosols that also have saliva or mucus or you know different things so you are trying to filter something much bigger than the virus and the hepa
01:19:12
filters filter everything they filter almost completely everything you know bigger than smaller than the virus and you know so um sometimes governments would say that
01:19:24
sometimes people are confused and they will say things like that but they have a colleague at the university they put filters in classrooms and then they took the filters back to the lab and they analyze the filters with pcr
01:19:37
and they find the virus the the covet virus the sarcophagus virus was in the filter that can only happen if the filter works otherwise it will go through right so definitely they work and there is a lot of this information i have some
01:19:50
colleagues i think i link put some links to some of the things i have colleagues who have written long threads about all the wrong things that are said about hepa filters or
01:20:01
about filters then thank you very much for that professor maybe uh this is now a personal interest question in terms of these hipaa filters um where do you place them sir in a room uh
01:20:14
i heard that uh you need to have the air flowing through them to for them to be effective so um some people would place them in certain areas of a room uh would you have any advice where to place these
01:20:27
hipaa filters sir yeah so what you want again the idea is that it depends what's going on in the room right and who's at risk or something so for example my mom is 80 some years old so i bought
01:20:41
a hepa filter and i told the caregiver that lives with her the air the clean air from the filter that comes from the top should always go towards my mom so that she's always breathing cleaner and in fact she had one of the
01:20:53
caregivers was infected but my mom didn't get infected maybe partially due to that you know now if you are in a in a classroom and there is a lot of people you know you if you can you will put it in the middle you know
01:21:06
now if the middle is not possible then you put it maybe to the side but you don't want to put it in a corner what can happen in a corner is you can get short circuiting and then you're filtering the air of the corner over and over but you're not filtering the air in
01:21:18
the middle sometimes what people do is to avoid that problem or the room is bigger instead of buying one very large filter you buy three smaller ones and then you put them in in three parts of the
01:21:29
classroom things like that um again you can do the experiment if there is a classroom and you and there is maybe some ventilation you open the windows light a match and then you switch you uh extinguish it and you see what the
01:21:41
smoke does or with a cigarette if you can do that or one of the smoke machines and then see what the air is doing and what you want is the air to go to the filter as quickly as possible thank you very much for that professor
01:21:53
jimenez a question here on wearables uh wearable air purifiers or are they effective like for example the lg recare necklace types that that are very popular here in
01:22:07
the philippines actually do they have a filter or do they have a uv light uh i'm not i'm not uh that familiar sir uh would you have any comments on either
01:22:19
yeah yeah yeah and then do people wear them with masks or without a mask no sir people just people would often have masks because they're required but people just wear them as necklaces sometimes
01:22:32
so it depends on the type there are some that have a filter and then they are good for the person who's wearing them but if that's the infected person they are not good at all for everybody else if that person went a
01:22:45
must because the virus that that person because the air is filtered that person is breathing filter there now if they use uv light which there is some that were being made in europe that one i would recommend less because the uv light is producing some chemicals
01:22:57
that may be not good for you and then there are others that use ionizers uh professor agar is telling me that on the chat those don't work don't work at all ionizers don't work they are scam
01:23:08
and uh so that's a scam basically thank you very much for that sir um a related question do air purifiers with the advertised uv light work or does uv
01:23:20
only work for sanitizing masks and how about those advertised as ozone air sanitizers or uv sanitizers so those are different if they have uv and not ocean
01:23:33
um it works very well for surfaces in a room it can work but you you kind of have to have it in the ceiling and then so that the uv doesn't go to people and whatever and they work they
01:23:46
work for this virus they work for their pathogens they are more expensive than filters you know so so if you you know normally money is a big concern so in some place that's very dangerous like very risky
01:23:58
for transmission like a prison or the emergency room or the you know something like that you can invest in the uv but in most places ventilation and filtration are gonna be cheaper and less dangerous
01:24:10
and um and then you mentioned the the oceanizers the ones that make ozone that is straight dangerous ocean works to disinfect surfaces if nobody's there and you have time to ventilate
01:24:23
okay but when nobody's there and you have time to ventilate that's not relevant to this virus this virus almost doesn't go through surfaces this virus we're breathing it in when we're shedding the air of a room and ozone is
01:24:34
a very toxic gas it kills almost half a million people or more a year from outdoor pollution and these machines that make ocean make enormous amounts of oceans so that is very dangerous that should be outlawed in my
01:24:47
opinion thank you very much professor jimenez um you mentioned this in your talk earlier but maybe a bit more clarification sir what defines high occupancy in assessing risk
01:24:59
is there a certain percentage of usual occupancy um well i mean it depends on depends on what you're doing right and and you know how much time and are you
01:25:12
talking or are you quiet or you know so um if you are in a place that's well ventilated like often the metro the subways tend to be very well ventilated and people are not talking and they're very much so you can have a lot of people and
01:25:26
they're still not very risky you know because there is not a lot of virus in the air and if there is virus is ventilated very quickly on the other hand you can have a choir or something like that and they're putting a lot of virus in the air and if they're not
01:25:37
wearing a mask you know even in a big church or something like that it's still going to be dangerous you know so as i said if you want to have an idea quantitatively i would suggest that you go to this estimator
01:25:50
and then you can see you know the risk of different situations thank you very much for that professor i'm i'm at the risk of being you know criticized but uh
01:26:03
it's good that you mentioned that that in a subway or in the metro that particular setting you can actually do that as a low risk activity um i think i hope that people in our transport sector are listening
01:26:16
are tuning in in the webinar and maybe thinking of these ways to reduce the risk i'm not just looking at saying oh there are so many people it's inherently going to be risky and i think you already shared a lot in your talk too
01:26:28
for them to start thinking about those thank you very much professor um professor this is some a question that's very specific now to dentists they are among the high-risk individuals
01:26:40
for infection due to their exposure to oral procedures um would you have any best practices for mitigating transmissions in dental offices can we remove the lateral barriers between
01:26:51
dental chairs as long as we keep co2 levels to around 1000 parts per million um i mean i think the the recommendations would be similar to other places so
01:27:05
um ventilate use a filter if you can something that works very well because really where the aerosols have been produced are in the mouth of the person you know when they are
01:27:17
torturing you with those things and uh you know so there is something that's called localized extraction which is basically a filter that's sucking a lot of air right from the mouth right and it doesn't need to be very
01:27:29
expensive and again you can make it yourself and and then it sucks a lot of air from the mouth so if you are producing any virus is going to to this thing to this fan and to a filter so that works really well
01:27:41
but then you you also can have the windows open if you can or have a filter in the room if something if that system is not catching everything then the dentist should wear a good n95 mask and eye protection because there
01:27:54
can be some splash so some goggles and uh what i do is i've had to go to the dentist a few times during covert so what i had was one of this a surgical mask but i just put it over my nose
01:28:07
and i made sure that i was always breathing through the nose so to protect myself in case someone else there was in fact you know as as a patient that's as as much as as you can do probably
01:28:20
thank you very much for that tip professor again going back to the first principles of the thing thank you sir sir here what do you recommend for large
01:28:31
low ceiling malls uh shopping malls where many filipinos go to all the time banks offices and other establishments with inherently poor ventilation there are no windows or air conditioned for
01:28:44
the whole day um the only the entrance doors are open and they're open a lot of times because people come in uh go in and out what can people do for their safety maybe it's a two-part question sir what can the
01:28:57
establishments do and then for the people sir what can they do so in that type of of building there is normally some system in the ceiling or whatever that that circulates air for the whole building so
01:29:10
then they can do two things they can put a better filter there is always a filter so the air that's recirculated that may have the virus it goes through a filter and then they can take more air from outdoors
01:29:22
that costs money because you use more energy for example in a very hot day in the philippines if you throw the cold air from inside outdoors and you take hot humid air you have to spend more energy but during the pandemic is worth
01:29:35
taking that extra cost of energy and taking as much air from outdoors as possible that's for example what we told our university and that's what we did so that's what the establishment can do the establishment can also distribute
01:29:47
good masks for example and for example if and i would say if uh if you are a mall and you say okay i'm gonna give you 195 or something that or or so or a claim if i that may be an
01:29:59
incentive for people to go shopping there right and they should and they should require that people were at least okay and 95 if they're distributing them so if someone is coming with a with a surgical mask say can you put the k at 95 while you're
01:30:12
here you know things like that and make sure everyone wears masks if you are the customers i would say you know go as little as possible you know but and if it depends you know if you but if
01:30:24
you happen to work there and you have to be there all day you know get a good mask and an eye protection i would say and measure the co2 i mean sometimes it can be surprising you know there's buildings that people think oh my
01:30:35
building my office has no ventilation and they're very scared and then they measure the co2 one actually is very low and the building actually has good ventilation but it's ventilation is very confusing that's why the co2 measurement
01:30:48
is really eye-opening you know and there are other places that that you know are new and shiny and whatever and you think oh this place must be very well ventilated but then the ventilation system this happens very often has
01:30:59
failed and it's off and and there's no there's no ventilation at all but the place is very shiny and they'll you know say that's kind of with the co2 meter you immediately realize this and then you go tell them and they say it's impossible and then they check and of
01:31:13
course it's possible thank you very much for that uh professor immense regarding uh co2 sensors can you point us to protocols that can be adopted in our workplaces
01:31:26
is it possible to just use these sensors to determine max room capacity one time rather than doing real-time monitoring for all rooms in the workplace which would require more units
01:31:39
i mean i ideally ideally you mess it all the time but but uh if you're gonna be doing the same thing for example you are in a classroom and you're in the same classroom every day you know my colleagues have done this and
01:31:51
i'm basically or i always i'm always measuring co2 at home it's very boring it's the same every day you know it's like if you do the same thing you see the same thing so the only thing if you open the windows
01:32:04
you know it's different if a day is very windy or if a day is very sunny or you know so you kind of have to do it a few days but then you learn and you say okay in a day that's that's not windy i have to open my windows this much in a day that's
01:32:17
really windy i can open them a little less and you know say and then you can share it or sometimes you can have it one per school and you can make it a project for the older students like a science project and you say okay one
01:32:28
hour a day you're gonna go through all the classrooms and you're gonna write down what they're doing whether and and then you report the data and the students get very excited and then you learn very quickly you know they they are very motivated to do these
01:32:40
measurements and so so you can do things like that but yeah i mean i recommend against sharing them or using them some kind of library or something because they're too expensive for most people to have
01:32:52
to have use one for themselves thank you very much for that uh professor um in terms of dining experience or how can we make the indoor or outdoor dining experience safer while
01:33:05
still enjoying the experience um well i'm sure there is some restaurant owner that's gonna not be very happy with my answer but i haven't gone indoor indoor dining
01:33:17
since covered i think it's it's just it's just the most dangerous situation because people are talking and then you are indoors and there is a lot of people or whatever i mean if you were in a place that were very few people
01:33:30
maybe you know but i but that said i've gone outdoors to restaurants many times you know so when you're outdoors and you're not very close to other people and it's a little windy especially during periods that there is
01:33:41
not a huge number of cases then you know i feel i i feel safe with something like that and i will have the mask when i'm not eating and then i remove it with it and that has worked fine so i would say
01:33:53
outdoors as much as possible thank you very much professor um going back to the co2 sir can you please comment on carbon dioxide as a surrogate indicator of how clean or coronavirus laid in the air is
01:34:08
particularly for 24 7 environments such as hospitals and offices with multiple shifts the questionnaire is of the impression that recommendations are basically from studies of single work shift
01:34:20
environments um for your information philippine tlv for co2 is 5000 parts per million i will not pretend to have answer uh understood the whole question sir but
01:34:33
maybe it's more familiar with you go ahead sir i mean the 5 000 per million is is outside of the pandemic and that's to you that because above 5 000 per million you will start hurting your patients or whatever because you get you
01:34:46
get saddam with so much co2 but but that's that's very unsafe in general you know you should never have more than 1500 even now it doesn't matter one shift or another shift because really the virus as we were saying the other day is only going
01:34:58
to last an hour in the air or something like that because it's losing infectivity is being so really you know if you are you have three shifts or of eight hours during the first hour there is some co2 and some riders maybe from the previous
01:35:11
shift but most of the shift is the people you are with that matter you know so so i would say i mean the limitation of co2 you know ideally we would have a machine that measures the virus right as you go so
01:35:23
this and goes ping ping there's the virus you can buy those people will sell them to you i don't know how well they work they cost thirty thousand dollars you know if we're saying that a hundred dollars here to meter
01:35:34
is difficult now how many thirty thousand dollar things we're gonna have i haven't seen anyone even in the us which is a richer country you know um so i mean i mean maybe they have one in the office of the president of the
01:35:47
philippines that the you know that's the kind of thing or the president of the big companies but for most of us co2 is what we have to use right and then the only problem is it's not measuring the virus you know and many people are
01:36:00
exhaling co2 but they are not infected you know but it gives you the best indication of whether the air is being trapped or is being ventilated you know so that's that's what's what is what is useful
01:36:13
thank you very much for that sir so what i got from there is we have to also review our standards in terms of the work environment and again maybe we really hope that people are tuning in in
01:36:24
these particular um places of influence and authority and we can start moving that conversation forward thank you professor jimenez sir oh go ahead sir sorry go ahead
01:36:40
actually that uh you know people may say oh we have a standard 5000 and this uh american is telling me to lower it to 1 000 outside the pandemic but you know if you own a company
01:36:53
and you have engineers or you have people doing tasks or you have whatever they are a lot number at five thousand i mean there is many studies where people make much better descriptions much worse decisions so why
01:37:06
would you keep your people that you are paying them a salary and now they are doing stupid things because you have them in this toxic this uh lethargic environment and the same in a school you know people go to the university to learn and you put them
01:37:18
in in a room where they are not learning very quickly because their brain is intoxicated with co2 right so there is there is huge benefits for society besides less transmission of copper or
01:37:30
other respiratory diseases from better ventilation so again sir that that emphasis that we have to be thinking also long term these things have benefits even beyond the pandemic thank you very much
01:37:42
professor jimenez for emphasizing that um sir uh this one's a bit controversial here in the country at least uh have you heard of copper masks uh they've become popular for a time here in the
01:37:54
philippines and so what are your views on their effectiveness that's um that's a waste of money they were popular in other places and and um the idea was at the beginning of the
01:38:06
pandemic uh again the idea with musk was that you know people may cough on your face and then their virus is there and if you touch it you're gonna get infected then but we know now that that's not that
01:38:18
important so then the idea with copper is that there were studies that show the virus survives less time in copper but again if the virus is in in your mask just you know when you remove your mask
01:38:30
you wash your hands doesn't matter to you so so why waste time on copper mask and there and there is other types of masks that they that they sell and they tell you oh it kills the virus or something don't waste
01:38:41
your money on that get a good n95 that's what you need thank you very much professor fit infiltration again uh to the people who are listening um before i continue with the last maybe um
01:38:54
six questions sir that the team has curated and combined there are things in the q and e that are still unanswered so um we apologize if we didn't prioritize those but now that we are towards the
01:39:07
end of the combined questions we just wanted to cover sir or all of these questions and comments and then we will go to the questions um if we have time so just to reassure the
01:39:19
people who have upvoted that we are not ignoring your inputs uh we're just trying to manage the time because we have a limited time thank you again to everyone for understanding um professor jimenez uh in terms of these respirators
01:39:33
you mentioned them in your in your talk is it advisable to wear the industrial 3m gas respirators the ones with exhaust valves or similar equipment no those are thought for something else
01:39:46
so the let's imagine you are working working with wood or working making holes drilling concrete and it makes a lot of dust so that the source is always on the
01:39:57
outside and you just don't want to breathe that dust into your lungs then having a valve is fine because then when you inhale the valve closes and is safe when you exhale the valve opens and and
01:40:09
then you breathe more easily right that's that's the idea now uh for this you know since anybody can be infected you shouldn't use the ones with valves if it has a valve you
01:40:21
can close it like i show the one i use has a valve because by law it has to have a valve but they send you a plug so i just put the plug and then it's like you didn't have a while so yeah thank you very much for that uh
01:40:33
professor emanus this is a very common question also even from last time sir finally sir uh our personal protective equipment like gowns for patients a waste of time and resources for dental
01:40:46
visits or doctor visits would you say sir for patients yeah i mean i mean maybe for the maybe for the dentist but not even i think it's you know everything costs
01:40:58
money and uh less and we we have limited money all of us you know so you sit on what's really important so a good and 95 mask and eye protection
01:41:09
and and anything else and then wash your hands and i said that's that's all there is to it thank you very much for that sir uh sir in for both public and private transportation should we open all
01:41:22
windows always would that be your recommendation if possible i mean it depends in the in in the in the subways sometimes i mean it's better if you can open them in
01:41:36
in the buses sometimes you cannot open it others you can i mean in general if it's tolerable if it doesn't get really hot or really cold it's better to open it in fact sometimes people are very scared of the subway or the of the metro
01:41:48
but then they go four or five people in a car with the windows closed without a mask that's much much more dangerous than the subway so you have to be you have to carefully if you share the car with other people that you don't live with
01:42:00
you should wear a it's a very small room it's it's a very very small room with a very very high occupancy and you are all sharing the same error as i show the co2 accumulates very quickly so you have to have the windows
01:42:12
open or the ventilation system coming from from the front and we're a very good mask because it's a risky situation and thank you very much go ahead talk less if you can't you put the radio
01:42:25
or or you listen to the hill sayo or some other song yes professor jimenez something that i need to remember because i i kind of
01:42:37
talk a lot my wife knows that anyway um since carbon dioxide sir gets through hepa filters or carbon dioxide monitoring is unable to gauge the effectiveness of air
01:42:48
purifiers will pm 2.5 concentration monitoring be useful sir so that is correct and that is one limitation of co2 so what what we say normally if you don't have filters
01:43:01
try to keep it below seven or eight hundred if you have filters you can go maybe to a thousand something like that depending if the filters are big now you can monitor with a pm monitor but
01:43:12
it's a little more specialized because for co2 co2 is easy because if you go indoors in the large majority of situations almost all the co2 is from people you can have some co2 if you're cooking with gas or you can have co2 you
01:43:26
have a dog but it is normally not very important so it's mostly from people now if you go indoors and you measure with a pm monitor like that may cost a hundred dollars or two hundred dollars most of
01:43:38
the pm is not from people it's not this respiratory resource is is our source from outdoors that come in or from from cooking or from when you walk we kind of resuspend our results so
01:43:51
and basically when people try to measure what we exhale you need to go to a clean room where there is basically no aerosols of any other kind only then you can see them because there are very few now there are very few they are very potent because
01:44:03
they have the virus right so then these monitors are useful if you want to test the filter for example you have a room and now you turn the filter on and you measure how the concentration goes down in time that is how you tell
01:44:17
that the hepa filter is a real hepa filter and that the specification so is with one of those monitors that costs i guess you you have some for a hundred or two hundred dollars not not only the five thousand dollars i was thinking
01:44:29
about so but it's more specialized i would say that's that's more for a scientist or an engineer otherwise this can be confusing you know you have to practice you have to learn you have to read about it thank you very much for that professor
01:44:43
jimenez um this might be uh this is interesting to me in particular but maybe you can weigh in on this uh sir what are the implications of the aerosol spread with regards to
01:44:56
contact tracing considering that a one meter per minute exposure might no longer be appropriate sir would you still uh what are your thoughts about the contact facing process or changes to the contact
01:45:09
tracing processor i think yeah go ahead that's very important and um i mean what i showed last uh last week was in hong kong when they had the first thousand cases until they managed to
01:45:22
control the first wave of the pandemic half of the cases they couldn't trace even though they tried to do contact racing they couldn't find i i think a lot of those were infected in shared
01:45:34
room air but they didn't trace the only trace people who were either in a cluster or they were talking close to each other so i think i mean if you want to be rigorous then you have to contact trace
01:45:46
people who were in the room for a long time but then what happens in when you have a lot of cases that becomes then there's too many people to contact trace so i would say you should use a risk
01:45:57
calculator like ours to say okay of the people who who share the room which ones should i contact tracer for example if someone was infected in a choir i would contact trace everybody if someone was infected in the library i would only
01:46:10
contact trace whoever they talked close and and that kind of thing if someone was infected and they spent a week with other people whatever without a mask definitely if it was in the room if they were for a short time and they were
01:46:21
wearing a mask then it's you know to prioritize your resources so thank you sir uh for that sir how much uh how much risk is there in theaters or cinemas are they
01:46:34
considered well ventilated in your experience um it depends i mean it varies a lot it's like buses there are some that are well ventilated and somebody poorly you know
01:46:46
now cinemas movie theaters i haven't heard of any outbreak in a movie theater and normally i mean what i would say though don't go to a funny movie because in the funny book you are going to laugh i'm going to laugh with these more aerosols go to more more serious
01:46:59
movies people may cry that's fine you know um a theater you know the people who are talking are the actors and i'm not wearing a mask so if i was in a theater i would go very far i will take a cheap seat far away from the scenario
01:47:13
from where people are acting and i would say that's and you want to have as good ventilation as possible around the actors but it varies a lot and again you you have to like there is some colleagues in mexico city and they were
01:47:25
measuring in a theater and and it was very high it was three or four thousand and they said in this particular theater it was very old and it was difficult and then other colleagues were measuring in a movie theater and was also high but then other
01:47:37
colleagues went to a different movie theater was very good it was very well ventilated and as i said it's not always the the more expensive one or the shinier place that's better it can be very surprising that's why there is nothing
01:47:50
like like measurements thank you very much professor uh professor this is a bit of a technical question i think or in my uninformed opinion as someone who's not involved in these things
01:48:04
sir how can you estimate the ach when using ventilation natural and or mechanical and filtration for example one wants to target six ech in the office
01:48:16
can you also compute maximum occupancy in an area if one is targeting 700 parts per million ie ventilation without filtration perhaps as an average or standard of space per person
01:48:30
i hope i was able to read that sir where you so that you can answer i mean i think that there are two ways i mean the problem with ventilation i mean you can always hire a ventilation company and they have more sophisticated ways but that costs
01:48:42
i mean hundreds of dollars or thousands of dollars here you know so then in terms of things that you can do i would say that there is two things and they both involve a co2 monitor one is let's say you're in a classroom and you
01:48:54
have i mean 20 students and whatever and you measure the co2 and and you know the beginning when you come in it increases but then it stays flat right now you look at that flat level
01:49:06
and with our our calculator you can now calculate a classroom and you can change the ventilation number until you see it too much as what you measure so that's one way and then you can get the ventilation number because
01:49:19
hopefully that was that was somewhat clear there is another way which is that you can in a room you can increase the co2 by people being there or sometimes with dry eyes which is basically frozen co2 you
01:49:31
put it on water you melt it so you increase co2 a lot and then you leave and you leave the co2 meter and then you record the concentrations and then the time in which it goes down
01:49:42
63 percent of the original concentration that's your ventilation rate you know so if it takes an hour you have one per hour if it takes half an hour then you have two changes per hour i i've written a post i can find it
01:49:55
i've written a post that explains this second method um again it's something i mean my wife is an artist and she has done it so it's not it's not i'm i mean she's smart but
01:50:06
but but very this is very foreign to her and yet he was able to do it so you know he's definitely he's definitely possible thank you professor uh we would love to be working collaboratively with uh
01:50:20
these people who understood everything that you said for like for example rural clinics or or primary care settings at least in my field so for the people who are listening uh please start
01:50:33
collaborating i think that's one of the key messages also of this webinar professor jimenez another uh question in terms of our dental colleagues
01:50:45
it what situations would it also be safe to go to the dentist as a possible patient what questions okay maybe i what questions can i ask the dental clinic to check if they are ventilating
01:50:56
properly or reducing the risk for patients to get proven maybe this can be extrapolated sir in many different settings as the public what can we ask uh or check so that we can say that this
01:51:09
establishment or this clinic is really taking care of its ventilation go ahead sir i mean again if um in imperials in which cases are high that's definitely i mean i i've gone to
01:51:21
the dentist as i said but i've tried to go when cases were lower and avoid now that omicron is high here i'm not i'm not going right but then if you call them you can say okay are you wearing a 95 mask is
01:51:33
everybody wearing a 95 mask do you have either good ventilation or do you have filters you know and and do you mess your co2 many places don't but you may find some that do
01:51:46
and or sometimes they they don't know what you're talking about but you can but you can ask would you would you let me open the windows and use a co to monitor and i can teach you how to do it then some people will be offended but some people
01:51:59
i mean in many different countries people report that they the dentists are maybe very curious it's like oh i can do this and you can buy the thing and you know so you may have to call a few places but but you may find
01:52:11
some are better than others i mean there is there is some people like we were talking earlier that don't want to have anything to do with you don't want to make any effort and they will think you're crazy well that's fine you know but you may find some people that
01:52:24
are that do it more safely thank you very much professor and um the last of the combined questions before we go to the q a uh again betraying what uh filipinos uh
01:52:37
enjoy uh professor jimenez korean grill restaurants have been very popular in the philippines are those with exhaust systems for their grills i the suction for the smoke of the grill safe for indoor dining are those can those be
01:52:52
considered as good ventilation system sir um they can be if they have this yeah no i i like the korean barbecue if they have this big exhaust and it's on
01:53:04
um and they have some window open or something for the air to come in then that can be a lot safer but you don't really know until until you measure the co2 you know if they if they have a good exhaust system any
01:53:17
exhaust from from the cooking should go there and and then the exhaust from the people should go there so that may be safer but again i wouldn't trust it if i didn't if i didn't go and mess with the co2
01:53:29
okay thank you sir again uh that message of measure do these measurements as often as we can okay thank you very much professor jimenez um thank you very much professor
01:53:41
jimenez for uh saying that you can stay a bit uh more so that we still have time for these other questions so we'll try to go through the most popular ones uh this is the top up voted question sir i
01:53:54
think you answered this partially last webinar but i'll just ask it again apart from airborne transmission uh professor jimenez can cover 19 spread through medical and food waste cross-contamination
01:54:07
a relevant example was what was mentioned last week the disposed swabs from rttc r and dp's being disposed in the same dump truck and landfills are where unfortunately people who uh
01:54:18
scavengers have to uh eat food scraps so what would would you be able to give your thoughts on that sir um um not easily i mean i would say
01:54:32
food scraps i mean if you have someone with kobe who has beaten a chunk of pizza and some of their saliva is there and then someone else eats the rest of the pizza it is possible and also like needles or things that
01:54:45
have been in contact with coffee virus it's possible i mean when when i say that surface transmission is unlikely you know if you touch a light switch or you touch a table or something and you know that that's difficult if you really
01:54:58
go to these higher risk situations it is possible um i don't think it's still very likely but but i you know um i would try to you know use alcohol or do something try to remember not to
01:55:12
touch my face and um if you can thank you very much for that professor a related question and again with a lot of upvotes sir uh sorry
01:55:25
um [Music] does the viruses live in water for example and again a very practical real scenario when someone coughs and the virus lands on your forehead and after
01:55:38
washing your face with just water the water drips around your eyes and lips uh would you say people can be infected in that scenario i i mean i think it's unlikely i mean
01:55:49
it's not water i mean by the you know if if you get the virus and someone kind of uh coughs on you and you have the virus here it's kind of on a surface and it's going to lose infectivity relatively quickly
01:56:02
now you know if that has happened to you or something then i i mean and you touch your face i will wash my hands if you if you wash your face i don't know like try to wash it in the water that i don't i don't know i mean
01:56:14
it's i don't think it's very risky or i mean if you are like if someone you work in a hospital and someone cough on your face and they you have some of the cuff here i mean maybe then um
01:56:26
you could take some alcohol and just put it on your forehead or something like that i don't know i mean that would be the one situation where a face shield makes sense in a hospital you know if people are coughing on your face you know then if i work in a hospital
01:56:38
like that i would probably worry too but on top of the goggles you know but but uh yeah thank you very much for that professor what about pets or dogs cats
01:56:54
are there already studies sir go ahead sir sure sir yeah um this virus seems to infect a lot of animals it depends on the variant but it seems that there are cases of cats and dogs that are infected and deer and
01:57:08
and i mean there was a zoo where a lot of animals were infected so um now and and some of them can give it back to people you know i don't know exactly with cats and dogs how likely
01:57:21
that is uh but it is possible so you you know so you you should be careful i guess i imagine you could do a test like one of these unbeaten tests with them i don't know but yeah i there are people this
01:57:35
goes a little bit beyond what i know i'm sure you can find veterinarians that know more than me thank you very much for that professor eminence uh professor uh this might be a bit uh i i
01:57:47
am interested here to pick your breed regarding this um thank you for your talk and for highlighting or reinforcing the need for interdisciplinary approach in addressing this very complex challenge sorry if you will be tasked to
01:57:59
lead the covet 19 response for a local government unit or maybe even national what would be your top three to five priority recommendations to manage the situation effectively pandemic i suppose
01:58:12
i mean i think it's you know the things i mentioned explain it give the smoke analogy some infected people not everybody some many infected people don't infect anyone but some are exhaling during a short
01:58:25
period a lot of invisible smoke and we get infected by breathing it that's the main way we want to avoid that so think wherever you are in a car in the bus at work in the mall with your family that's what
01:58:38
you want to avoid you know and then so and then tell people go outdoors if you go indoors be careful and wear a good mask i mean those would be the the top things and and ventilate you
01:58:50
know and try to ventilate them as you can you know those would be my my top things thank you very much for for that answer sir um to the team uh to the moderating
01:59:01
team can you please help me uh dismiss or uh mark has answered the things that we've already addressed earlier um but then uh just a reminder to the audience yes uh professor eman is just
01:59:14
confirming again uh but we asked you this before you can be coated right and your slides and photos can be used to communicate the science here in the philippines yeah yeah you can do you can use the video you can
01:59:27
use the slides you can do whatever is useful thank you very much for that sir go ahead sir sorry i know sometimes i i get myself in trouble being too critical of governments or whatever but you know
01:59:41
i i say what i think and you can use whatever you whatever is useful thank you very much professor again a reminder that we we should also contextualize these things though but thank you very much professor for that
01:59:53
um sir this one uh can windows be opened if you live in an apartment or condominium or townhouse with an infected neighbor nearby it's a very practical question so uh would you be able to answer go ahead
02:00:07
um yeah it's a good question i mean and there are cases of transmission within apartment buildings there are some that have been investigated in korea and in china and i know some colleagues are investigating some in spain so this can
02:00:20
happen just like sometimes someone is smoking in a different apartment and you smell it or someone is cooking in a different apartment and you smell it that's because you are getting the air from the other apartment so that's the kind of situation
02:00:32
where you want to be more careful so you know you have to think about your situation in some cases there are apartment buildings that there is like an air shaft a patio that they share and then there is windows on the street it's
02:00:44
better to open the ones on the street you know because those are going to have less common air than in the air shaft sometimes there is um in some buildings there is conduits that communicate all the bathrooms and that
02:00:57
can be dangerous in some cases because the air can come out of one bathroom and into the next one you know and sometimes you have an exhaust and you're running the exhaust in the bathroom like a fan exhaust or in the kitchen and that actually is
02:01:10
bringing air from other apartments if you haven't opened a window so you have to you have to think about it again it's kind of confusing but you can think okay is the air coming below the door light a match and see if the air is coming below
02:01:22
the door or or you some way you know with a little piece of paper sieve you can see where the air is going you know that kind of thing and it i i don't think it's it's not it's not as high risk as talking to someone or being in
02:01:35
the same room at the same time but there is some risk and there is cases of infection thank you very much for that professor jimenez um professor for the corsi rosenthal box
02:01:47
uh what's the air flow direction from fan to the filters or air goes to the filters and then exhaust by the fan i believe yes from the fan to the filter that works better
02:02:01
but there's a comment here by looking at it it may have leaks what's your stand on it and making sure the collected dust with the virus does not spread back to the environment um i mean if you what you do is that you
02:02:13
tape it so you tape all the gaps and you can do that pretty well and people test this with one of those particle meters that we're talking about earlier and they work pretty well now the collected virus if you run it that way the fan to
02:02:25
the filter is on the inside of the filter so even you you touch the outside of the filter you are not touching the virus and and the virus the aerosols are going to stick very well to the filters there is very
02:02:36
unlikely that they're going to come back you know so i think it's um yeah and in any case it's much better even if they only remove 99 or something it's much better to leave one percent than to
02:02:49
live a hundred percent you know so um and anything that removes aerosols from the air is going to help you know thank you very much professor uh maybe a related question to what was asked
02:03:03
earlier um as a scientist sir how do you communicate to government uh huh in your experience how how how has it been communicating to governments and maybe if you can give us
02:03:14
tips as to um maybe a bit more practical i suppose from the the person who i'm gonna ask you go ahead sir it depends if the government is open-minded okay so yeah i've talked to many governments of many
02:03:28
countries national regional um some governments are open to listening you know so they really want to do things better and you know so i talk to people who who talk to the president of
02:03:40
argentina and they they convinced the president to do a campaign of a ventilation and and they convinced the governor of buenos aires to buy 30 000 co2 meters for all the schools and and i talked to someone in belgium that
02:03:53
i was mentioning last week that is like an independent commissioner and he can have rules and he mandated co2 meters and things and things now i've also talked with a lot of other governments who
02:04:06
who don't want to do anything because different reasons for the reasons we mentioned earlier and then they would look for excuses and they said but you say this but this other scientist says something else
02:04:18
so then in a way they are talking to you you so they can defend themselves better if they are so they so they know people like like what like us say so we're almost like a free training session but they don't really intend to do anything
02:04:31
and there are um and there are others i mean i had some cases where i talked to a government and they were very excited and i was telling them about the co2 meters and whatever and and then one hour after we talked to
02:04:43
them they put an announcement a press release saying they were going to buy a co2 meter for every classroom and they were going to buy you know 30 000 co2 meters you know and it was on the press it was reported everywhere and
02:04:55
the only problem is they never bought them they only did the press release so all they wanted to know were things they could say you know to score political points because there was an election coming but
02:05:07
then the election happened and they didn't do anything you know so it depends i mean i think you have to try we all have to try to hurt the governments i mean understand that they are very busy they you have to simplify things they want the evidence they want
02:05:21
the articles they want to make sure people saying it are reputable and all that but but then not all of them are open to to listen you know thank you very much for that professor i
02:05:35
i hope that uh in our country the local inter-agency task forces and the national interagency task force at least have something to really discuss and debate on at the very least and maybe we can move
02:05:48
uh these conversations and action points forward um sir i was looking at the q a and um maybe uh this is also this was also addressed earlier a bit but i think this is a valid again question from
02:06:02
people who know these things better than i do so that the full question and comment is and you partially answered this um why focus on co2 level and not on the more direct ventilation rate indicators like
02:06:14
air exchange rate through inflow of fresh air and outflow of used air to maximize the dilution and then evacuation of air in enclosed spaces uh if the inflow is from a polluted
02:06:27
source like a road with congested traffic the co2 level of the adjacent enclosed space may increase and this increase cannot be taken as a covalent parameter um you were starting to explain that sir earlier but maybe it's
02:06:39
a bit more sir i mean really when we say i mean co2 outdoors is about 400 per million so when we say like the cdc says 800 really what they're saying is
02:06:50
whatever is outside plus 400 if you are in new york city or maybe in manila in the bc sections maybe outside is 500 or 600. so and those so that's the 400 that's everywhere plus 200 from the traffic and then you add 400 on top of
02:07:03
that right so it's just a little more complicated now why do we promote co2 and not air changes per hour or something i mean at the end what matters is the air changes per hour on that but or or is it's also important
02:07:16
but that's very confusing i mean uh i mean you can do the experiment that i put uh and that's what i was telling people at the beginning but i realized nobody understood and it was then it was it was much easier to tell
02:07:28
them to measure the co2 and it's it's something that everyone can learn you know everyone i found everyone who's interested even if they you know they're the teacher of philosophy or someone who's never measured anything has
02:07:41
anything to do with science they can learn if they pay attention and it's not very complicated to quantify your changes for hours it's just i mean it's great if you can do it but it's just more more difficult much more
02:07:53
difficult thank you very much for that professor and uh maybe just to be fair there's a reaction here that i think is important also i believe there's a department order if i'm reading this correctly
02:08:06
224-21 on ventilation issued by the department of labor and employment set the co2 parameters to 1 000 parts per million so somehow sorry that's that's better than uh what it used to be for so
02:08:19
maybe just to be fair um i think the the audience really needs to search out these things and again those local interagency task forces uh have to start talking about these things more among
02:08:31
themselves so thank you very much for that comment sir uh okay i'm running through the questions professor jimenez you might uh are also looking at the q a like last
02:08:45
week i don't want to miss something that you really want to answer um but it's already 1007 here in the philippines um i think we it would be nice if we can um wrap up oh sorry
02:08:58
there's somebody here who um prompted me sir um sir in terms of the practices we have local practices like uh steaming uh we call it sue ob here where we um
02:09:10
inhale the vapors of uh of um heated liquids so that they can offer symptomatic relief um what can that do sir to the virus or the probability of the virus in the air especially that is
02:09:24
very common sir in the provinces i mean i think you mean if if you are infected not doing that or you may share the air with someone infected that's doing that yes sir i i'm not sure sir uh
02:09:38
well either way sir yes sir i mean the if it's if it's hot the heat tends to deactivate the virus faster i mean the the like anything in biology or with food
02:09:51
the cold conserves the virus the heat destroys it faster um if it's very humid that also can help the virus now um if there is some eucalyptus or some
02:10:06
smelly thing in the air some of those can be disinfectant so so it depends i i i mean overall i wouldn't say it's very important i would say it's similar as in other places
02:10:19
so there have been medical issuances regarding the dangers and benefits of these things professors so hopefully the people can put those together and the ones who can communicate these things better will do so so thank you
02:10:32
very much for that sir one last uh in the philippines since we are a very disaster pro in country um we might have to talk about this this early or actually relatedly um in terms
02:10:46
of uh evacuation centers or in terms of the adjustments um would you know of any evidence regarding infections or transmissions in evacuation centers uh
02:10:57
because of natural disasters or again the principles i in my head they do apply but if you can comment about them sir in disaster situations go ahead sir yeah so there is there are there are
02:11:11
cases in which for example there was a hurricane or yesterday a typhoon or whatever and then if people end up being indoors in a place that may not be well ventilated with a lot of people that's a situation
02:11:22
that's favorable to transmission so you know if there was a typhoon that was coming next week i would say make sure in evacuation centers that you have good masks and as people come in you give them a good mask and try to encourage them to
02:11:35
to wear it the whole time and ventilate as much as you can but it's definitely i mean it depends of course right if you can sometimes an evacuation center is a stadium and it's huge and there is a lot of delusions sometimes this is some
02:11:48
place that's smaller and there's you know so it depends but but there can be definitely can be transmission in those situations thank you very much for that sir and uh okay uh it's 10 then
02:12:02
professor you'd want to keep you beyond the 15 minutes that you so graciously offered to us um and again we are very sorry if we have reached the end of our open forum but it has been a very animated um q a with
02:12:15
professor jimenez if you do have any further questions you can um send your questions or uh to our official discord uh group chat and we will try our best to answer the questions and then for
02:12:28
those that we unfortunately weren't able to make time for in the in during this um webinar we'll forward them again to professor jimenez and um maybe if he can uh answer some of
02:12:40
the questions uh we'll try our best also to communicate these to our participants um professor yes professor james go ahead if there are questions that i haven't answered and maybe the organizers could select 10 or 20 i could then
02:12:55
respond to them on twitter and then and then send you the link and then people can read uh the answers there okay one last uh one last question sir let's
02:13:05
insert this um for the air purifiers uh in the qa box i read somewhere that uv lights located inside the component part of air purifiers are not that useful because the time that the air is exposed
02:13:18
to the said uv light is not significant enough to kill the virus can you comment sir on the accuracy of this it depends on the device it depends on you know how much air is going and which
02:13:31
speed how much light is there um often in the the things that are very cheap it tends to be the case i think it can be done so that it works but then it tends to be more expensive but but in
02:13:43
general uv is more expensive than filters for the same efficacy so i would say for for a classroom for a shop for most places go with filters it's just gonna be
02:13:55
simpler cheaper and safer thank you very much for that professor and professor uh any final words before we do formally close the the webinar sir
02:14:08
thank you thank you for listening i hope it has been useful and as i said if you compile more questions i can answer them in twitter and i hope um you know it's um this this does i mean this type of thing
02:14:22
can can help uh provide some pointers and but then a lot of the work is for you and for the government in in putting it in practice in in your local context you know and i but but uh
02:14:35
i mean i think the message is there is a lot we can do that we haven't done very well and if we do it we can reduce transmission a lot so there is low hanging fruit you know it's not like we are already doing everything so well and
02:14:47
we're talking about the one percent no no no we've been doing things i mean i don't know about the philippines but certainly in the us we've been doing things very poorly you know so so there is a lot that we could improve if we paid attention
02:14:59
and thank you very much uh for that professor and um thank you once again and before we formally end the session just a bit of webinar housekeeping certificates of attendance will be given
02:15:12
after attending both sessions of the webinar so uh we might not be able to give everybody a copy of their certificates you have to have been in part one but definitely the
02:15:24
recordings and the proceedings will be disseminated as widely as we can given what professor jimenez has shared and so we request everyone to accomplish the evaluation form of the session so that
02:15:37
we can issue you your certificate the link to the evaluation form can be accessed through the chat box and please give us time to prepare the certificate we have more than a thousand participants i think that have joined
02:15:50
the webinars and more than 3 000 who have registered so we will be issuing the certificates uh by the first week of march um we would also like to extend our appreciation and gratitude again to professor jimenez for his insightful
02:16:04
very timely and very relevant webinar to our participants show your appreciation um using the reaction bottles i think they are disabled for the zoom webinar but you can please uh show our appreciation
02:16:17
for our speaker and many other um avenues on social media in particular and we would also like to thank our partner institutions and organizers who made this webinar possible the up open university the up dilemma college of
02:16:31
science the up dilemma and college of engineering the up dilemma institute of civil engineering the up los banos graduate school the u p manila college of medicine the up manila community health and development program the up
02:16:44
manila college of nursing the yupi baguio office of the vice chancellor for academic affairs the yupi dilemma office of the vice chancellor for academic affairs and the up las vegas office of the vice chancellor for academic affairs
02:16:56
and that ends hashtag over this airborne understanding and implementing the paradigm shift webinar this has been a privilege i am dr paolo victor medina and thank you for joining us
02:17:07
see you god bless and stay safe everyone [Music] you
End of transcript