COVID-19 lessons from PMA

You may have heard about the COVID-19 outbreak in the Philippine Military Academy (PMA) in Baguio City. The newspaper reports vary in the numbers, but the Department of Health’s figure was 53 cadets.

Newspaper reports seem to be based on statements from PMA officials, who said the reported infections included food handlers, and were apparently the source of the infections.

It will be important to conduct more rigorous contact tracing and to look at how the infections spread. After all, PMA cadets have been under strict lockdown all these months—that is, they all live inside the campus in the PMA dorms and are not allowed to leave the PMA premises.

If the outbreak started with food handlers who live outside the campus, then it shows how difficult it is to create “bubbles” or “pods.” The idea with these bubbles is to have people stay together as isolated as possible from the outside world and to be extra vigilant with protective measures when they do go out: masks, handwashing and sanitizers, physical distancing.

The problem, though, is that the slightest lapse in these precautionary measures, especially if they occur in a crowd or an enclosed space where someone already has the infection, can mean you become Patient X who will start a new cluster when you get home to your “pod” or “bubble.”

In the case of the PMA, I suspect the dorms facilitated the spread among the cadets, as has been happening in other countries that started face-to-face classes and dorm living. Because of prolonged exposure, with several cadets sharing a room for several hours each night, infections would have spread quickly.

The PMA can reduce the risks of future outbreaks with stricter screening of faculty and staff who live out. I see too many lapses in the screening as weary people scribble illegible information on the contact tracing forms. More important is public education, so people learn to stay home if they are experiencing symptoms — fever, cough and, now considered very important, loss of the senses of smell and taste.

That, of course, is easier said than done, especially for people who depend on wages paid by the day. Moreover, the PMA cases seem to reflect a pattern of asymptomatic cases, which has become quite common in the Philippines; people are shocked to find out they are positive when mass testing is done in larger institutions.

Unfortunately, too, we have been weak when it comes to tackling an important variable with COVID-19 infections: ventilation. Because I’ve been helping a college with their construction of a new campus, I’ve had to learn as much as I can, from other countries’ experiences, about ventilation. With the school I’ve been helping, I’ve been practically begging them to reduce their occupancy ratios for dorm rooms and also to make sure ventilation is adequate. I was able to recruit UP Diliman’s Dr. Menandro Berana, who is an engineer specializing in HVAC (heating, ventilation, air conditioning) to advise the school. He explains that with COVID-19 and other infectious diseases, all our buildings and rooms must have provisions for exhaust fans as well as input fans to bring in fresh air.

The German government has officially included the periodic airing of rooms as a way to prevent COVID-19. The more people have been together in a room for a prolonged period of time, the more important it will be to ventilate.

Air conditioned rooms will need to be ventilated even more frequently because most air conditioning units only recirculate the air, in effect allowing the virus to stay suspended inside a room for a prolonged period.

If we are to start face to face classes in the next school year, government will need to come up with guidelines for ventilation, especially for classrooms, cafeterias, libraries, and, most of all, dorms. Beyond ventilation, there may even have to be rules for dorm rooms being reserved only for sleeping, because long conversations and singing, a favorite pastime, will help spread the virus if someone is already infected.

Here’s a YouTube video from Japanese engineers for improvised room ventilation: COVID-19: Clearing the Air Effectively

And here’s an online guide produced by the Massachusetts Institute of Technology to calculate the optimum number of people in rooms — you input such variables as the size of the room and what the room will be used for, and they calculate the number of occupants that can safely stay together and for how long: COVID-19 Indoor Safety Guideline.

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