The IWBI Special Report Chapter Series: “A Foundation for Action”

Excerpt republished from: Prevention and Preparedness, Resilience and Recovery: An IWBI Special Report

Section 1.1: Translating Research into Action
The rise of COVID-19 has not only brought the relationship between buildings and infectious disease into the spotlight, it has also highlighted the complicated process of translating research to real-world practice, guidance and standards.

How do you create standards when the research is unclear or shifting? How do you balance the need for adaptable, globally applicable standards with specific contexts and populations? What do you include, and what do you leave out? These questions are at the heart of IWBI’s approach to research and the launch of WELL v2, the WELL Health-Safety Rating for Facility and Operations Management, and this report.

Using the socio-ecological model and a holistic approach allows IWBI to draw on the best available evidence that links design, policy and built environment strategies to human health and well- being outcomes for the WELL Building Standard (WELL) and supporting documents such as this special report. The evidence supporting each feature is substantiated by a combination of peer- reviewed scientific literature and academic research; existing design standards, laws or codes; and best practice as identified by researchers, industry experts and public health and other relevant professionals. Each feature is based on the latest evidence and has been chosen due to its potential impact on human health and well-being as well as its feasibility for implementation given current market and technology conditions.

Results from post-occupancy surveys and indoor environmental testing, as well as regular addenda updates, may also help to contribute to further understanding which features are most effective, globally applicable and most commonly implemented. They can also help identify which features may need to be adapted for a global market. This requires a flexible, adaptive approach to translating research to practice and to ongoing feedback from stakeholders, subject matter experts and the projects themselves. The combination of best available research and design and policy best practices, along with continual testing and feedback, enables IWBI to continuously improve and update WELL features based on current, cutting-edge research and practice to support human health and well-being.

Infectious Disease and Design
Building design has long played a role in the history of public health and the fight against infectious diseases, which has led to transformative changes including improved ventilation standards, access to nature and hygiene practices.

An area of public health that has received less attention and has been arguably less effective historically is chronic disease prevention, which includes measures such as ensuring walkable neighborhoods that encourage movement and hence can help decrease the risk of obesity.5 COVID-19 is changing the way the world perceives the link between health and the design of buildings and communities. It has brought these two worlds together: not only is there increased awareness of the role the building plays in either reducing or increasing risk for infectious respiratory diseases, but there is also evidence that those who live in areas with heavy air pollution (often from vehicle traffic) and those with chronic disease, have a higher death rate from COVID-19.

This links health equity and environmental justice, environmental conditions and disease comorbidity in ways that are immediate and urgent. While challenging, this presents an opportunity to showcase the role of healthy building design in infectious and chronic disease mitigation, health equity and overall health promotion….

Read the full section here.

Section 1.2: Deploying Strategies for Prevention and Preparedness, Resilience and Recovery
As WELL v2 was being readied to graduate from pilot, the extensive work of the IWBI team in collaboration with the IWBI Task Force on COVID-19 led to the identification of eight key areas for action in light of COVID-19.

.01 Improve Indoor Air Quality
SARS-CoV-2, the virus that causes COVID-19, is spread from infected individuals to others by close contact and airborne transmission.1-3 Respiratory particles contribute to the transmission of COVID-19 through droplets (which are larger, fall quicker and thus travel shorter distances) as well as in aerosols (which are smaller and travel farther). While the science is still emerging, two factors that influence how far respiratory particles travel are ventilation and relative humidity.

Air stagnation may concentrate airborne viruses, dust or emissions from building materials, so it is critical to maximize outdoor intake and to avoid recirculated air. Furthermore, without proper maintenance and filtration, heating, ventilation and air conditioning systems can build up mold and particulates that can propagate respiratory diseases, especially after periods of inactivity. Viruses, including SARS-CoV-2, can remain in the air for several hours or longer, recirculate through building ducts and infect occupants.

Humidity may play a role in the survival of viruses. Moisture in buildings can influence the survival of viruses and add to occupants’ risk of developing respiratory infections and asthma. One-fifth of United States asthma cases are attributed to excessive indoor moisture and dampness.

Conversely, studies show that low relative humidity may contribute to seasonal influenza because it dries out respiratory tracts, making people more prone to infection. Lastly, indoor spaces with daylight exposure have been shown to have fewer bacteria compared to spaces without any light exposure.

Strategy 1
Improve indoor air quality by providing maximal outdoor air and adequate ventilation and filtration.

Recommendation 1
Increase supply of outdoor air whenever possible. Bring in fresh air from the outside through mechanical and/or natural means to dilute human- and product-generated air pollutants.

Recommendation 2
Avoid recirculating air that may contain airborne viruses exhaled by infected individuals.

Recommendation 3
Maintain air filtration systems.

Strategy 2
Manage humidity and control sources of indoor moisture to reduce risk to building occupants’ respiratory health.

Recommendation 1
Implement design strategies to limit moisture accumulation and the potential of mold growth from water infiltration and condensation within buildings.

Recommendation 2
Limit growth of pathogens and maintain relative humidity levels that are conducive to human health and well-being.

…Other categories with additional strategies and recommendations include:

• Promoting Clean Contact
• Maintaining Water Quality
• Preparing for Emergencies, Managing Risk and Supporting Organizational Resilience
• Supporting Proper Ergonomics, Including Remote Work
• Strengthening Immune Systems
• Fostering Mental Resilience
• Supporting Community Resilience and Recovery

Read the full section with complete recommendations here.