The R&D ecosystem in Singapore has been studying various measures that can help support the safe reopening of the economy as we open up in phases. On top of current safe management measures such as wearing of mask, maintaining safe distancing, limiting social contacts and observing good personal hygiene, these additional solutions will help support a safer resumption of activities.
Picture 1: Overview of preventive measures to reduce fomites, droplet and aerosol transmission
Temasek Foundation, the Agency for Science, Technology and Research (A*STAR) and other research partners such as ITE College East and Temasek Life Sciences Laboratory (TLL), have done extensive scientific studies in collaboration with public agencies, and gleaned insights which could be useful in further reducing the risk of COVID-19 transmission.
Businesses, organisations, as well as families and individuals can explore such insights and customised solutions that best fit their needs and circumstances at work, at play or at home, to supplement the current safe management measures. This is particularly important at a time when various countries and regions around the world are experiencing widespread infections, or second and third waves of the outbreak.
As new COVID-19 variants from the UK, South Africa and Brazil are uncovered, we must not let our guard down even as we strive to re-open our economy. This is especially so given the possibility that these new variants may be more infectious1 than before.
COVID-19 is largely transmitted via respiratory droplets from close interactions with an infected person over extended periods or accumulated from repeated contacts throughout a day. Such interactions would include speech, singing, shouting, and can be exacerbated when the infected person sneezes or coughs into someone else’s face.
To mitigate the risk of large community clusters, it is useful to restrict numbers of people we meet in a day through measures like work from home or limiting the number of people visiting each other. This is one way to create firebreaks to reduce chances for the virus to light an exponentially growing outbreak which we have seen in some countries across the world.
As infected people could be asymptomatic, the wearing of face masks is also essential in protecting ourselves and others. With the two-way protection of face masks, we reduce the overall viral load in the community.
Droplets eventually fall on objects or surfaces to become fomites, which may be contaminated by infectious materials. We can become infected when our hands transmit such fomites to our eyes, nose and mouth, where the virus can take hold of and enter our respiratory system. This is why we encourage regular cleaning of high-touch surfaces and regular hand washing for individuals.
In addition, tiny droplets, known as aerosols, may be formed under certain conditions and stay suspended in the air for hours or be carried by wind or currents from air-conditioners or fans for some distances. This is especially risky in small poorly ventilated spaces, including small spaces using split unit air conditioners which simply recirculates any infected air around and allow infectious particles to build up over time without any regular or frequent change of fresh air.
Unlike most mass transportation modes which have varying rates of air changes and high-performance filter systems in their air conditioning and filtration systems, most automobiles and cars do not have sophisticated air cleaning systems and can be venues of high risk especially if there is prolonged contact.
Hence, drivers of automobiles and other small vehicles are encouraged to open their windows a little to enable continual fresh air inflow and air change in order to reduce transmission risks2. This will help prevent viral loads from accumulating in such vehicles, especially when the drivers and passengers do not belong to the same household.
With the combined efforts from A*STAR’s Institute of Materials Research and Engineering (IMRE) and Institute of High Performance Computing (IHPC), tests have been conducted in various venues such as public transportation, concert theatres, offices and eateries. The research team has actively partnered several public agencies, private sector companies and institutes of higher learning in studies related to droplet and aerosol transmission under different environment settings. For instance, A*STAR worked with the Land Transport Authority (LTA) to model the dissemination of aerosols in public transportation, and developed recommendations to reduce the spread of aerosols. Similar works have been carried out with the Singapore Tourism Board (STB) to facilitate the safe resumption of meetings, incentives, conferences and exhibitions (MICE) activities.
Apart from the above solutions and baseline practices, research findings from the scientific community can enable other preventive or COVID-safe measures as additional layers of defence to reduce transmission risks through fomite, droplet and aerosol routes.
For example, solutions can be employed to improve air quality such as the use of air filters or air ionisers to clean the air in enclosed and poorly ventilated spaces. While safe distancing remains key to reducing risks of transmission, measures such as table-top dividers can be useful during higher risk activities such as eating when masks are removed. It is important to note that these solutions should be used in parallel with regular sanitisation of surfaces to reduce fomite transmission.
Whilst these solutions provide useful scientific evidence, they are based on experimental simulations that may not fully reflect other factors in the real world such as human behaviour. These findings, together with local outbreak investigation data, international research and lessons learnt from other countries, are used to inform public health measures.
A*STAR’s airflow modelling and simulation studies showed that the spread of droplets and aerosols are greatly dependent on different types of ventilation environments, hence there are various risk levels associated with different venues which require different preventive measures to ensure safe management practices.
For instance, air curtains in certain venues are effective in preventing aerosols from spreading, while split air-conditioners could recirculate unfiltered air, which under some conditions might allow aerosol contaminants to build up over time.
Based on these studies, customised innovations can be applied to complement safe management measures to reduce the spread of aerosols. Various settings have been modelled through a combination of on-site tests and advanced computational modelling studies, while factoring in environmental conditions such as wind speed and direction, humidity levels and ambient air temperatures, as well as ventilation levels in indoor spaces.
A*STAR’s scientific study3 has confirmed the effectiveness of plant and natural fibre ionisers, and air filters in reducing aerosol concentrations in the air.
Findings include the type and numbers of such plant and natural fibre ionisers and air filters within rooms of specified sizes, to achieve a desired equivalent rate of air change, and thus lower risk of transmission from infectious aerosols. It should be noted that unlike air filters which trap the aerosols, plant and natural fibre ionisers will cause the aerosols and droplets to stick to surfaces such as the floor and on walls and surfaces and hence may increase the risk of fomite transmission, unless surfaces are cleaned regularly and thoroughly as well.
Studies have been done on the effectiveness of various designs and heights of dividers. These were based on the findings from a combination of on-site tests in food court settings and advanced computational modelling, which factored in environmental conditions and the different dimensions and types of dividers.
Dividers are not a replacement for safe distancing measures, rather, to complement the existing safety measures in place. To reduce the risk of fomite transmission, dividers should also be sanitised regularly, and the ventilation of the venue should be enhanced as well. Where communication needs to take place across dividers, audio holes covered with Mylar films can enhance sound transmission while still limiting aerosol spread.
Recommendations on effective and safe UV disinfection to inactivate different types of viruses and bacteria were also derived from research. This includes parameters such as exposure time and intensity from UVC sources, safe zones for humans and the use of robots and automation to make such processes safer.
It should be noted that the typical UV lamps (i.e. 254 – 280nm) are not eye or skin safe, and additional precautions are needed to prevent direct exposure to people, e.g. with ceiling level solution shielded from line of sight for people. Alternatively, solutions can be found to toggle UVC sterilisation in the absence of people, such as in toilets or other specific facilities. Those operating UVC devices should wear appropriate PPE and UV-resistant eye goggles; these solutions are not advised to be used in homes.
Detailed findings and recommendations on the various additional safety measures are available in ANNEX A.
Prof Tan Chorh Chuan, MOH’s Chief Health Scientist said: “COVID-19 is very contagious and the virus can spread through different routes. With targeted multidisciplinary research, we can better understand how such transmission may occur in different settings. In turn, this helps us to improve the effectiveness of different preventive and safe management measures to reduce the risk of viral spread.”
Ms Koh Lin-Net, Chief Executive, Temasek Foundation Nurtures, said: “Wearing masks, practising hand hygiene and keeping safe distancing have become norms. But as the situation continues to evolve, we must also continue to add to our knowledge base. These would not just be useful to reduce COVID-19 transmission risks, but will also give us toolkits which could help reduce our risks during the next unknown Disease X which could have aerosol as its main route of transmission.”
Ms Koh noted, “We are highly privileged to have the opportunity to partner with the Agency for Science, Technology and Research (A*STAR) and other research partners, including ITE College East and Temasek Life Sciences Laboratory (TLL), who have provided answers to some of our questions on additional measures to take, especially in dealing with aerosols. We would like to share this with the wider public, so that we can collectively build a foundation for our future generations to stay prepared, and safeguard our community in the event of a future outbreak.”
Professor Alfred Huan, Assistant Chief Executive, Science & Engineering Research Council, A*STAR, added “One of the pre-conditions for entering phase 3 of reopening our economy is the adherence to safe management measures.”
Prof Huan explained, “By employing a science-based approach to the design of safe management measures, we are able to assess the risks of transmission and advise tangible preventive measures that are built on the foundation of scientific evidence. The multi-disciplinary expertise from across the local research ecosystem leveraged in these studies, make them very valuable for public agencies and businesses.”
Scientists from across Singapore’s research ecosystem continue to work towards increased modelling and empirical methods in these series of studies. Working under the guidance of the Ministry of Health’s Chief Health Scientist, Professor Tan Chorh Chuan, this network of scientists has been researching how transmission of COVID-19 could occur and how much spread could be mitigated. These studies will help to bolster the safe opening of Singapore’s economy and society through the implementation of robust preventive measures.
Project Safeguard is an educational initiative by Temasek Foundation aimed at raising public awareness about such scientific findings from our local R&D ecosystem, plus potential solutions to help reduce the risk of COVID-19 transmission as we carry on economic and social activities.
For more information on Project Safeguard, visit stayprepared.sg/safeguard.
For more information on research findings by A*STAR, visit here.
1. Source: NERVTAG note on B.1.1.7 severity, taken from SAGE Meeting Report (2021)
2. Source: Airflows inside passenger cars and implications for airborne disease transmission, taken from Science Advances (2021)
3. Source: The Efficacy of Plant-based Ionisers in Removing Aerosol got COVID-19 Mitigations – A Study by the Agency for Science, Technology and Research (A*STAR) (2020) https://spj.sciencemag.org/journals/research/aip/2173642/