Paul A. Castrucci Architects

Indoor Air Quality Low-Income Communities in the Time of Covid-19

Until we have an effective vaccine or treatment for COVID-19, the home is a critical health infrastructure. Staying home is the most effective way to fight COVID-19. When homes are not healthy, its inhabitants suffer. As we move forward to a post-COVID-19 world, we must address the structural causes of inequalities that have left millions of Americans out of a healthy home (1). 

The situation only grows more magnified in crowded conditions, especially in low-income multifamily buildings. Many people believe - erroneously - that population density drives COVID-19 infection rates: the denser the population, the higher the rate. Yet, according to John Hopkins University, the hardest-hit neighborhoods in New York City are not the densest. As Patrick Condon, professor at the University of British Columbia's School of Architectures, points out (2), high-density areas in central Toronto and Vancouver are not hotspots for COVID-19.

If population density is not the critical factor in COVID-19 infection rates, we need to look elsewhere - at housing, and especially in low-income housing, where the COVID-19 problems are magnified. COVID-19 disproportionately impacts low-income residents and communities of color in the United States, as seen in Louisiana (3), Chicago (4), and New York City (5). 

Many factors contribute to the higher infection rates of lower-income people - for instance, many have higher rates of pre-existing health conditions and poor access to health care. Many are essential workers who must take public transportation (6).  

But we can make a difference, especially in those low-income communities, by properly maintaining ventilation systems; increasing the airflow into living spaces, and regularly maintaining wastewater treatment systems in low-income housing to help mitigate COVID-19 exposure.

First, let’s look at ventilation, which is a critical component of infection. Current evidence shows the primary transfer of the coronavirus is through respiratory droplets, with some transmission also occurring through recirculated air. Joseph Allen, Director of the Healthy Buildings program at Harvard University's T.H. Chan School of Public Health, suggests increasing airflow to help dilute the airborne contaminants. Occupants can increase the airflow rate by simply opening windows. Most large-scale buildings use Variable Air Volume (VAV) systems that recirculate air. Owners must ensure these systems are maintained and filters are properly replaced. Owners must use the highest MERV filters available. Governments can create new programs to train key building staff and require maintenances for ventilation systems, including mandatory filter changes. For building residence without access to adequate air can use air purifiers using HEPA filters (6). Air purifiers can be expensive, but governments can provide assistance similar to the Low Income Home Energy Assistance Program (LIHEAP) for improved indoor air quality.

New buildings, especially those built to Passive House Standards, are more airtight. They use systems like heat recovery ventilators to provide continuous fresh air. Outside air typically needs to be cooled or heated for appropriate indoor temperatures. As conditioning outside air uses a lot of energy, Passive House buildings provide airflow on the lower range of what is acceptable for good indoor air quality. Newer affordable multifamily houses are built to Passive House Standards, thanks to incentives provided by New York State (NYS). But, future research is required looking into ventilation rates in airtight buildings needed to mitigate the spread of COVID-19 and similar pathogens.

Second, air pollution is another factor that increases COVID-19 infection rates. A UCLA report (7) shows the health impact of residential gas appliances that emit a wide range of air pollutants, including fine particulate matters (PM2.5). Lack of maintenance and proper ventilation systems augment the concentration of indoor air pollution. A recent study (8) by Harvard University has shown pre-existing conditions to long-term exposure to air pollutions increase COVID-19 death rates. The research suggests that even a small increase (1 μg/m3) in long-term exposure to PM2.5 leads to an 8% rise in COVID-19 death rates. The health crisis over poor indoor air quality disproportionately impacts low-income communities and communities of color. In recent years, NYS has pushed for electrification of buildings including the adoption of electric stoves to reduce carbon emissions. The State must recognize the health impact of using gas appliances and further push for electrification. Additionally, in existing buildings, governments should create programs to ensure proper ventilation rates for residences using gas appliances. 

Third, wastewater treatment can play a major role in infection. Research suggests COVID-19 may be present in fecal matter (9). Wastewater pipes and vent pipes systems, when properly designed and maintained, remove waste matters, and sewer gases from the premise. Yet, a poorly designed system can allow fecal matter and gases into living spaces, and transmission of disease can occur through the building ventilation systems (10). Owners should regularly inspect the building’s plumbing systems to ensure no leaks and traps are working as intended. 

Policymakers must address gaps in housing, provide funding, and codify design that prevents the spread of pathogens in buildings while also addressing environmental concerns. An improved maintenance protocol for building owners is needed. Owners must regularly inspect and maintain the building systems. Building owners already comply with strict protocols for fire safety. COVID-19 should be a catalyst to acknowledge the importance of key systems that impact residence health and require stricter rules to ensure these systems are kept well. Moving forward, we need a just housing policy.