BOMA New York Seminar – Living with CovidDeborah L. Birx, MD
BOMA New York’s year-end blockbuster event, “LIVING WITH COVID,” featured a captivating two-hour presentation by Deborah Birx, M.D., former White House Coronavirus Task Force Coordinator, and Amy Carenza, chief commercial officer at ActivePure – a Texas-based company offering a 21st Century remedy to neutralize airborne and surface pathogens in interior spaces.
In a new auditorium located at 30 Hudson Yards, BOMA New York Chair Hani Salama welcomed the room filled with executive level operational professionals from the largest and most influential owners in New York City. The power duo was introduced by Tom Krol, a Fitwel® Ambassador and VP at M&S Mechanical. They immediately got into COVID-19 data since March 2020 and the science of mitigating a virus.
As of Dec. 25, COVID-19 has taken the lives of more than 800,000 Americans. Hospitals across the country are again struggling with increasing caseloads.
Dr. Birx said the recent uptick was largely a result of the Delta variant and people gathering for Thanksgiving and would soon be followed by the Omicron variant. “When did the NFL players have the biggest number of positives? After Thanksgiving and social gatherings, not when they were on the field playing or in the locker room.”
Birx noted that the data used in her presentation was up to date, and at the time, it was still too early for precise forecasts for the Omicron variant, which is 3-5 times more infectious than the original variant (Delta is 2½ times more infectious than the original).
A CRE executive in the audience asked, “Is Omicron the beginning of the virus transitioning to something more like the flu?” Dr. Birx reminded attendees that while many people get sick from the flu and some die, the flu never overwhelmed our hospitals the way COVID did. She said, “We can’t have this level of hospitalizations and sustain healthcare in this country.”
Answering another question roughly phrased as “So, who’s doing it better?” Birx immediately replied, “Bahrain.” In that nation, she reported there is universal antibody testing, and residents carry vaccination cards with their antibody score, as well.
Birx followed her reply with, “When you don’t test, you’re flying blind.” She continued, “The U.S. is under-testing and additionally needs an antibody-based strategy to know the protective level of our immunity and individualized boosting not national boosting in the future.”
Dr. Birx, who is one of the world’s foremost immunologists, explained that the United States is fortunate to have both a significant number of brilliant minds and innovative technology. One of the major points in her presentation is that America, moving forward, must develop a mindset that leverages our unique medical talent, the private sector and existing technology.
A case in point is that for more than 40 years, we have had the ability to test for discrete respiratory illnesses. For some reason, however, our collective medical community decided not to test for discrete viral pathologies and instead diagnosed viral respiratory disease based on symptoms or a clinical exam. For example, unique tests exist today for the flu and Respiratory syncytial virus.
Dr. Birx said that if testing for every common viral respiratory illness were routine in the United States, we would have recognized something different when COVID-19 came upon our shores. She said, “We would have seen COVID and have been ready for it sooner. We also could have had 30% less deaths if we aggressively mitigated and tested.” Birx further explained that testing asymptomatic people is equally important since they could spread the disease without knowing it.
Dr. Birx brought the audience back to the initial outbreak, saying that she was impressed with the private sector’s immediate and positive response to the White House’s call for assistance. She said, “I’m used to walking into a room filled with scientists. This time, I was pleasantly surprised to have been joined by a room filled with CEOs, and there was immediate progress.”
As Dr. Birx praised the private sector for its efforts almost two years ago, she added that the present-day situation will require the private sector to step up again and lead by example with a commitment to improve the frequency of testing throughout the nation.
Both Dr. Birx and Carenza emphasized that people are far less likely to be infected in the workplace, where people mask and mitigate. Shared data illustrates that most infections occur in homes and indoor gatherings where people are in very close contact with each other. Accordingly, Dr. Birx noted the effectiveness of wearing masks in public spaces, and was disappointed that America has not “layered on” access to testing, as did universities and professional sports teams to find the early spread.
Both presenters praised educational institutions that were willing to share data from their experiences with the pandemic. Dr. Birx cited Boston University, which re-opened its doors in 2020. By mandating weekly COVID testing, the university never experienced more than 20-50 cases per day in a student body numbering in the tens of thousands – except after the Thanksgiving surge, when everyone went home.
ActivePure has been engaged more by schools than office buildings. Carenza said, “Schools are great case studies for office buildings,” since they exhibit how ‘active’ technologies are effective in the built environment.
Carenza addressed the room by saying, “We want people back in the office enthusiastically.” She continued, “What is happening now is C-suites across America are saying, ‘If we stay home, we’ll be home forever.’ I think there is a lot of introspection happening across C-suites, but it’s happening from a standpoint of No. 1, we’re going to have to learn to live with this, and then No. 2, If we’re going to live with this, how do we live with it safely’?”
Like most infectious disease, Coronavirus is spread on surfaces and in the air. Surfaces can be regularly and proactively cleaned, but how do you clean the air, especially when you can’t see it? Carenza continued with a review of some of the operational strategies in place to date, coupled with a deep dive on active remedies for all buildings.
She explained that while indoor air exchanges occur to variable degrees, these systems cannot bring in enough fresh air to mitigate the effects of people exhaling every few seconds into enclosed rooms.
Carenza noted that upgrading existing filtration systems, such as using a MERV-14 filter, is only effective to a point. However, upgrading from a MERV-8 filter to a MERV-14 filter both taxes legacy systems and increases a building’s carbon footprint as the equipment requires more energy. Added material costs and amplified energy costs are unwelcomed budgetary increases. She added that some systems were not designed to handle MERV-14 filters, and those systems will actually allow air to bypass the thicker filtration. She called the aggregate situation “The MERV-14 blues.”
Carenza outlined how ActivePure’s science-based system assesses indoor spaces to be protected before installing any mechanical equipment. Technicians will take air samples using a portable system that casts the samples onto Petri dish-like plates for laboratory analysis. Based on those analyses, a benchmark is established. The test is repeated once the active systems are installed to measure the remedy’s effectiveness. The system works by replicating the same filtration process that occurs in the atmosphere with sunlight and natural air. By recreating this process indoors, the technology adds back to the built environment the same therapeutic molecules found outdoors, which in turn “find the pathogens in the air and neutralizes them.
Carenza praised the school districts who have been early adopters and validators of active technologies. In one case study, a school compared airborne pathogen levels under two scenarios. They used a higher filter efficiency and compared it to utilizing their former filter (MERV-8) together with ActivePure. The latter setting reduced airborne bacteria in the high school and elementary school 72.97% and 79.45%, respectively.
In another deployment of ActivePure’s technology, this time in a private school, absenteeism dropped 53% from the historical baseline established over the prior three years. Carenza’s primary message with these case studies, “passive measures are not enough.”
Carenza said, “We thought when the vaccine came out, that would be the end. We’d all get vaccinated, and everything would go back to normal. It doesn’t look like that. It looks like we’re in this for the long haul.”
In conclusion, both presenters made it clear that COVID is here to stay, just as is the flu, strep and other contagious diseases. They stressed that if we embrace the lessons learned about the mitigation of COVID, we will also be able to mitigate other viruses indoors, which in turn will reduce sick days and absenteeism in the workplace.
Dr. Birx urged building owners and managers to “get testing for your building,” or at least provide access to testing. She said, “testing regularly is essential to the fight and is the best way to be ‘present’ versus being ‘concerned’.”
One thing is for sure – it’s a new world – and we will need collective participation to mitigate viruses and ultimately realize our mutual goal of getting people back to the office, enthusiastically.