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AAQ -“Would administration agree to changing HVAC setting to higher outside air, changing a filter, or keeping a door/window open? If there is a cluster of cases tied to a place, hopefully administration will listen.”
I do that in my house.
I have no control any building in Lakewood.
Like I just posted – no one cares about Covid so they wouldn’t let me do anything in s/o else’s building.
It sounds like you mean well, but people here aren’t interested in preventing any disease!2scents -“Most inpatient protocols call for steroids when the patients are hypoxic or have elevated CRPs.
Early steroid treatment may be detrimental. Timing is key.”Let me reword my question.
I just want to prove that I know medicine.
So in a case of hypoxia or elevated CRPs – obviously an inpatient – when would you NOT give Steroids?!?For e/o else – Medicine is like Cooking.
Anybody can follow a recipe, but it doesn’t always Work. Most of the time – You need a thinking Cook.
Same with medicine – anybody can follow Protocols, but not everybody can use them correctly, or ad lib.health is right. a physician can not limit himself to protocols. he has to know where and when to apply them.
and anyone who wants to con people into thinking he is equal to a physician cannot just quote google. he has to know how to apply it to pretend it is his own.“For e/o else – Medicine is like Cooking.
Anybody can follow a recipe, but it doesn’t always Work. Most of the time – You need a thinking Cook.
Same with medicine – anybody can follow Protocols, but not everybody can use them correctly, or ad lib.”“health is right. a physician can not limit himself to protocols. he has to know where and when to apply them.
and anyone who wants to con people into thinking he is equal to a physician cannot just quote google. he has to know how to apply it to pretend it is his own.”Amen 1,000 times over.
Health,
Protocols serve as a basis and are used most of the times for most patients, its like bones without flesh and serves as an acceptable standard to rely on when appropriate.
If course clinicians bring their understanding, experience and advanced knowledge to the table which allows them to at times deviate from a protocol or an accepted standard approach.
Im not really sure how your question proves that you have an advanced understanding with regards to medicine or Managing sick covid patients.
2scents -“Im not really sure how your question proves that you have an advanced understanding with regards to medicine or Managing sick covid patients.”
This question -“So in a case of hypoxia or elevated CRPs – obviously an inpatient – when would you NOT give Steroids?!?”
Has nothing to do with the Last Paragraph.Now answer it – if you can.
It’s in some protocols – I made it easy for you!Always ask questions:
MERV 15 is such a fine mesh rate it will cause a normal residential HVAC system to run very inefficiently due to the constricted airflow over the evaporator and possibly over amp the fan motor in the air handler. I wouldn’t recommend anything higher than a MERV 11 for that reason. You are 100% right about metering outside air in based on CO2 counts, that’s how a lot of modern HVAC equipment is design for controlling outside air economizers. A lot of older commercial airbags sling equipment is also not designed to accommodate any any outside air changes.
Don’t forget UV lighting in the air handling unit. That is a lot more effective than even HEPA rated MERV 17 filters used in hospitals. UV lighting, maximum air changes per hour and maximum outside air intake is what the CDC in conjunction with ASHREA is recommending fir controlling infectious aerosols.
Health > I do that in my house. I have no control any building in Lakewood.
I understand. I am not in such a hoshuve place, but we have plenty of people who do not care. Still, a couple of Rabbis implemented some of the controls, especially those that do not poke in the eyes of the congregants who are against everything. Thus, HVAC changes went better than opening windows and opening windows better than masking.
I think if you have a good conversation opener – either a cluster of cases or a CO2 monitor in your hand with a high value – you might have a chance.
lostsparks,
yes I saw discussions of UV early on at ASHREA and other places, but I did not see a lot of follow up with that. Is this being used in practice? Does it need to be installed inside HVAC? is it a big job? Any precautions so it is not directed towards people?In most cases, opening doors/windows helps a lot. In some small rooms with no windows, add a stand alone air purifier. I think some of them are UV.
> a physician can not limit himself to protocols. he has to know where and when to apply them.
I discussed this with mathematicians who analyze how doctors work. Main view is that (great) doctors do not follow protocols and general patterns, but they implicitly find in their memory a specific case that was similar to the current one in as many characteristics as possible and use lessons learned in that case. This is, of course, not working with a novel disease and a lot of disasters are happening while following generic protocols until doctors accumulate enough knowledge.
Hospitals have air handler designed to use UV on the cold deck, or evaporator side so the air passing through is purified and sent through typically 2-3 layers of progressively finer mesh HEPA filters.
My house has a UV system, and it is becoming common. Also UV only works if the air handling fan is on. Any time a space is occupied the fan must be online for filtration to occur.
UV lighting is a very simple job, install the bulb array in the air handler ideally before and after the evaporator. The older models stayed on 24/7 but now they have designs configured to switch on if air flow is detected or if current is detected on by the motor. An added benefit of the UV system is mold, algae and bacteria won’t propagate on the damp evaporator during summer months. Make sure the bulb frequency rating is high enough to be effective for destroying virus, I will have to recall that factor.
The reverse polarity ionization technologies being pushed right now for air purification to my knowledge have not had very many compelling results. I would stay away from that cost fir now. If you are in a smaller space a portable HEPA cart with MERV 17 filters and UV lights will purify the air a few times per hour, they are expensive but very effective and are employed in hospitals with great results. If you can research ASHREA standards for hospital spaces and employ the same air change strategies in the space of concern.
ASHREA to my knowledge has not come up with any “hard” recommendations just CDC guided suggestions. One thing for sure is commercial HVAC considerations will forever be changed by this virus. I expect to see a lot more air changes and more outside air being brought in, MAU units and VRV systems will be the norm.
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