What if the house you're buying, selling, or renting had been occupied by someone who had COVID-19? And what if you knew that over the past few months they had hosted parties and entertained hundreds, many unmasked?
President-elect Joe Biden becomes President Joe Biden as of noon, Wednesday, Jan. 20, and the deep cleaning the new tenants give the White House reflects what any property owner can do to make sure their new digs are safe and ready for occupation.
Below, Dr. Bill Lang, a former director of the White House Medical Unit, deputy physician to Presidents Clinton and George W. Bush, and now medical officer for the WorldClinic concierge telemedicine practice, shares some insight.
If you were in charge of the White House medical office as the Biden administration and family moves in, what would you do in terms of COVID-19 cleaning and preparation?
An amazing transformation happens in the White House between the time the departing president and family leaves in the morning until the new president arrives later that afternoon. An army of workers descends on the White House and cleans everything thoroughly. It's one of the few opportunities the facilities management team has to make that happen.
With COVID-19, that's all that's needed -- a good cleaning. As the CDC (U.S. Centers for Disease Control and Prevention) noted in mid-spring, air is more important than surfaces in transmitting COVID-19, so, while surfaces are not unimportant, it's not what we need to be focusing on.
An editorial last month in The Washington Post by environmental engineers from Harvard, Drexel, and Virginia Tech, noted that we don't have a single documented case of surface transmission. Now, it's hard to clearly define the exact source of infection for most cases, but safe enough to say that surfaces are not driving the pandemic, so a good, thorough cleaning, typical to administration change-over practice, is what's needed -- nothing more, nothing less.
How about keeping a space safe after the cleaning and move-in?
More important will be minimizing the risk that people coming into the White House are not COVID-free. The West Wing, especially, is notorious for how tightly packed in most people are in the rabbit warren of offices. After all, it's probably the most exclusive office building in the world, and people accept tight spaces to be there. Relying strictly on testing is a recipe for failure, so, in addition to reducing risk of bringing in infected people, ensuring that people are able to comply with masking and distancing protocols will be challenging but important.
Many staff in the White House will fall under some type of national security priority for vaccination (and rightly so), but that will not apply to everyone.
That does not eliminate the need for masking and social distancing -- at least for now, but being practical, with trying to set up government, there will be times when in-person non-optimally socially distanced meetings will be essential.
Of course, the White House will need to be careful of the optics of designating everyone as essential personnel (the public will not see that everyone in the White House should be prioritized ahead of nursing homes, at-risk people, and health care workers), and those who are not vaccinated will need to be housed in offices outside the West Wing where social distancing can be more guaranteed until they come to their place in line in vaccine distribution.
What would be the protocols you would mandate for the new occupants and for how long?
Following on from the above, in order to minimize risk, essential personnel should be asked to quarantine themselves for at least a week with a PCR test no earlier than five days before they start. This will be difficult as people want to celebrate the inauguration, but the optics of starting the administration with a COVID outbreak would be difficult to recover from!
Beyond that initial entry requirement, I would recommend masks and social distancing to the greatest extent reasonable whenever people are outside of their immediate office (or even in their office if a tight shared space).
The question of periodic testing is still vexing. The more often you can test people, the less time even an unrecognized infected person can infect others. Remember that this is not about risk elimination but risk reduction, so it's important to find a reasonable balance. Weekly testing is commonly used, but during the initial couple of weeks, twice a week might not be a bad idea as even if people are requested to quarantine in the week leading up to the changeover, there are going to be breaks in people's behavior.
Does it matter whether a new house, apartment, or office space someone is moving into has been occupied by someone exposed to, infected with, or actively ill with COVID-19? Why or why not? And if so, for how long?
The experience of the hospitality industry is informative here. Many hotel chains have been following a policy of leaving a room vacant for a day after someone leaves, then cleaning it thoroughly. With this approach, there have not been documented hotel-room-based transmission cases. This "vacant for 24 hours" is a reasonable approach and remains consistent with the CDC guidance for how to handle a location that had a known infected person.
Again, as the Washington Post op-ed writers I referenced above noted, we're still probably overdoing it, but it's not purely about science, as you also have to base some of the guidelines on what makes people feel comfortable. The 24-hour vacant goal (but not absolute requirement) does that well.
And how much effort should someone put into finding out, in your opinion?
If a facility is able to follow the 24-hour vacancy, then I wouldn't even think about it, but if they aren't, the main thing I would ask about is their cleaning protocol. I always tell people to assume anyone they don't know well is COVID-positive, and I would apply that rule to hotel rooms' previous occupants, too.
So, I would just assume the guest before me was infected and not put any effort into finding out any more about the guest. Just tell me that a standard but thorough cleaning was done and that the room was thoroughly aired out.
What should people do, given the circumstances of today, when they move into a new space, office or residential, in terms of cleaning? What should be cleaned, and how should it be cleaned?
Wipe all "touch points" with a standard cleaning solution. (Detergents effectively disrupt most viruses and help to wash away those that are not disrupted, if any). I would ensure all bedding is changed out and minimize contact with any other soft surfaces at least overnight. (We don't have great data on virus survival on soft surfaces, but fabrics tend to wick away moisture from the virus and thus inactivate it in a relatively short period.)
How about in terms of air quality and circulation? What do you recommend in that regard?
The CDC recommends at least six air changes per hour (12 if possible) to ensure that any concentration of SARS-CoV2 is adequately diluted and dispersed. (Dose is important with COVID so the old adage "the solution to pollution is dilution" comes into play.)
Given that, if I'm coming into a new room or facility, I would want to know that the ventilation has been on consistently while unoccupied and if I don't know that, then I would turn on any ventilation to its highest exhaust setting as well as opening any windows and doors for at least a few minutes. Practically speaking, most people will not be able to determine the number of air changes per hour, but make sure there has been opportunity to exhaust any old air and replace with new air, ideally from outside.
What can the property manager or resident do themselves and what should be left to professionals?
The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) have guided that HVAC systems should be turned to their maximal designed ventilation capacity and maximum fresh air makeup, but not beyond those settings without involvement of an engineer (and they should run constantly when the building is occupied).
Additionally, where the climate supports, doors and windows should be open, as long as the HVAC system supports that. (Many modern systems are NOT designed to support open windows and doors and doing so can actually decrease air exchange.) Additionally, building air filters should be routinely changed and the highest efficiency filters approved for the building's HVAC system should be used.
In areas with known poor ventilation, air filtration systems can be considered, but those are a poor substitute for an optimally functioning building system. Beyond those considerations, an HVAC professional (and likely an ASHRAE certified engineer) should be consulted.
In a residential setting, if you have forced air HVAC, put the fan on continuous run, and if possible (climate and expense considered), open some windows to get more outside air in the residence. A fan blowing air out (not in) adds to helping with the air exchange. For cold locations, if you have a fireplace with a real flue, burning a fire can also help to drive air exchanges because the rising heat of the fire pulls a great deal of exhaust air up the chimney.
What are your overall recommendations, as conditions exist now and going forward, for precautions to take against COVID-19 in our daily lives?
Wear a mask when you are not sure you can maintain six feet of distance in any setting. And I hope this has lessened people's resistance to wearing masks in public so the next time flu season rolls around, people will at least consider wearing a mask if they have cold and/or flu symptoms and are still well enough to be out and about.
Also, minimize travel. Examples of how travel has increased COVID rates include the initial outbreak in Italy; Europe, in general, after the August holidays; and the United States after Thanksgiving.
Avoid places like bars, choir halls, etc., where people are close together, not wearing masks, and often speaking loudly. (Loud talking/singing/shouting aerosolizes more virus if someone is infected.)
When will this all be over and what will that look like?It's not likely going to be an "event," but rather case rates will decrease as more and more people are immune from infection and/or vaccination.
Most areas of the country will likely see easing starting in the spring as the most vulnerable are protected by vaccine and younger, less vulnerable people see less reason to be as careful; this will accelerate throughout the spring.
By late spring, most people will be back to normal activities. I like to think that we're going to have a (mostly) normal baseball season. We'll have fans back in the stadiums, maybe not full like a Fenway Park, but at least as full as Marlins Park.
Because we're Motley Fool, please indulge us with a Foolish question: To you, how does moving into a home where someone had COVID-19 compare with, say, the stigma of moving into a house where someone had, say, killed himself or been murdered?
Well, again, you can't boil everything down to science, unless you're considering the science of human behavior and reactions, too! To me, here's the big difference: "The house where Joe was killed" is going to be "the house where Joe was killed" for at least a generation, if not longer, and many people don't like the idea of living in "the house where Joe was killed." "The house where Joe was when he had COVID-19" isn't going to be a blip on the horizon for more than a couple of weeks (unless Joe dies there; then maybe it might last a while).
The Millionacres bottom line
Dr. Lang provides a lot of practical advice based on experience at the White House and current best practices about the pandemic that can translate to anyone's house, business, or investment property. Keeping property and people as safe from COVID-19 as possible will not only help save lives but can help hasten the end of this global nightmare.