During the peaks of the COVID-19 pandemic, governments and public health agencies were guided by data and predictive models, which they used to develop and implement measures to counteract SARS-CoV-2. Now, with the worst seemingly behind us, there is time to reflect on which strategies worked and how they can help steer the course toward the new normal. However, these decisions still need to be driven by evidence, which is why many companies are turning toward in-air pathogen surveillance to provide timely insights into the presence of SARS-CoV-2 and other viruses in indoor environments. This article explores how the onus has shifted to businesses across all industries to not only implement measures to help protect their employees, but also to minimize the impact that future outbreaks will have on their operations.

COVID-19 Strategies When SARS-CoV-2 first emerged, very little was known about its effect on human health, its transmission pathways, or how to curb the rampaging number of cases. As a result, numerous strategies were adopted across the globe, including lockdowns, mandatory testing and mask wearing, social distancing, and remote working. However, it was—and still is—difficult to identify which measure had the biggest impact. Since many government precautions are no longer being enforced, widespread vaccinations may provide a false sense of security. The virus is here to stay, and it is difficult to predict how novel variants will behave and the new symptoms they may induce.

Shift of Responsibility As government health organizations step back in their management of SARS-CoV-2, it is time for companies to increase their own diligence and start to explore the available tools to make more informed decisions to protect their staff and operations. Society-wide population surveillance through extensive asymptomatic testing is no longer a viable or widely accepted solution, especially as the pandemic transitions into an endemic stage. However, as personnel continue to return to physical locations, companies need to find methods to help identify the presence of SARS-CoV-2 and determine the potential risk of an outbreak within their facilities. This can prove extremely difficult, as it can heavily depend on the number of employees, their lifestyle, and numerous other variables that can make this task almost pure guesswork.

Informed Decisions Environmental monitoring offers a potential solution to this issue through detecting the presence of a pathogen in a location. It can be used as an early indicator of the risk of SARS-CoV-2 spread within a facility in the absence of individual testing. Wastewater testing, for example, has long been used for a variety of applications and can potentially help monitor a certain pathogen originating from a specific but large community. However, by the time a spike is identified, it is often too late to implement measures to respond to the threat. Wastewater samples also contain a wide range of contaminants, including PCR inhibitors, that make it a challenging approach for viral surveillance.

Since SARS-CoV-2 is an airborne virus predominantly transmitted via aerosols and droplets, indoor air monitoring could provide the insights needed to act early. This could equip business management with data to make informed decisions, potentially implementing measures before an outbreak can occur to reduce operational downtime. For example, in periods of heightened risk, some businesses have called for temporary mask wearing or increased ventilation in a given area. This data-driven risk management is especially important for people with comorbidities—who may be more vulnerable to SARS-CoV-2—and access to such information could enable individuals to take precautions until the danger has passed.

Effortless Monitoring There are in-air environmental surveillance solutions that deliver easy and seamless ways to monitor the air for pathogens, including SARS-CoV-2, influenza A and B, and respiratory syncytial virus. Some of these systems are small and mobile, and can be moved around to sample the air in strategic locations without causing substantial inconvenience to the staff. These solutions require minimal manual input, benefitting from easy-to-use consumables that can be replaced once the sampling time has elapsed. Air samples can either be tested on site using a rapid PCR test or sent to a third-party laboratory for analysis. If the sample is positive, site managers can assess the risk and decide which precautions should be taken. Furthermore, these measurements can be taken on a regular basis, making it possible to evaluate the success of different strategies.

Tried and Tested Technology Environmental air surveillance technologies have been tested in a variety of busy settings—including hospitals, schools, and retirement communities—to assess their efficacy. Some of the findings from these studies include: 1. The journal PLOS One found that in-air viral detection was consistent and reproducible when tested in a “bench-scale” setting and a full-size laboratory environment.

2. Lower PCR cycle times from air samples suggest this method is more effective at identifying SARS-CoV-2 compared to surface sampling, according to a preprint that appeared in medRxiv.

3. A study published in Scientific Reports found that viral load from 35 COVID-19 subjects correlated with viral load from air samples in their isolation rooms, as did decreasing levels of both values over time.

4. In a study that appeared in Clinical Infectious Diseases, there was an inverse relationship between viral load in aerosols and increased ventilation and room filtration, which was assessed in controlled chambers occupied by COVID-19 subjects.

5. In-air viral detection was used to test the effectiveness of mask wearing in a hospital setting, as described in the journal Infection Control & Hospital Epidemiology.

6. A study published in the American Journal of Infection Control found that in-air sampling coupled with PCR testing showed a 100 percent detection rate of SARS-CoV-2 on three consecutive days.

7. Air sampling results from communal settings provided an early indication of SARS-CoV-2 transmission risk, as shown in medRxiv. Influenza A virus and other respiratory pathogens were also identified from air samples in a variety of settings.

8. SARS-CoV-2 presence in the air was continuous in common areas of three nursing homes during post-vaccination outbreaks, as described in a recent issue of Research Square.

Being Prepared for the Next Pandemic The COVID-19 pandemic has shown the dangers of respiratory viruses to public health and the wider consequences they can have on our way of life. This likely isn’t the last viral outbreak we will encounter, but through these difficult times, vital innovations may enable better preparation for future challenges. Environmental air surveillance technologies have provided valuable information to allow us to adapt to the challenges the pandemic has created, helping businesses reopen and people return to work across numerous industries. As we settle into this new world, managers must weigh the potential risks to employees’ well-being and comfort with how to keep operations running as smoothly as possible. Environmental monitoring through indoor air surveillance promises to be an invaluable tool moving forward, providing the data managers need as governments phase out population testing.

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