Easy improvements to opening business safely during pandemic

The mitigation measures that the govt is relying on are the vaccination programme and SOPs 


THE announcement of further opening of businesses, in particular restaurants for indoor dining, in Phase 1 states across Malaysia brought about rather mixed feelings across the community. Any effort to return to our “makan”-centric lifestyle would, of course be welcomed and one would say critical to rejuvenating our socio-economy. However, rather predictably, the mitigation measures that the government is relying on are the vaccination programme and the standard operating procedures (SOPs). 

In the Delta variant period of this Covid-19 pandemic, these measures may well be wholly inadequate as they stand, especially what constitutes the SOPs. 

The Delta variant has 1,000 times the viral load of previous variants and with the virus being airborne, transmission is even occurring with no direct contact between the carriers and infected. It seems with so much virus being left in suspension in unventilated spaces, unsuspecting uninfected people could be infected after the virus’ carrier has left the space. 

Such infections occurred with cleaners of a plane that just arrived in Nanjing and a person passing through an empty corridor of a quarantine hotel in Sydney. 

And the virus carriers in both cases were vaccinated for travel into China and Australia! These occurrences, as well as failed reopenings of entertainment sectors in Singapore and the Netherlands among other places, has led to a closer look at the risk of Covid-19 infection indoors. 

Note, even with good ventilation and compliance to both masking, as well as social distancing and SOPs, the infection rate is only at a safe level when people in the space are sitting, resting, standing, conversing occasionally…like in a library. 

At least as patrons of a restaurant, we could significantly reduce the risk of infection just by reducing our time there to 30 minutes or an hour, as well as keeping it light and easy. However, this option is not available for a worker at the restaurant working a four-hour shift. 

Their work is likely moderate and occasionally intense, and the model says they have between 15% to 47% chance of being infected with just one infected person sharing the space. 

So, how can we safely open restaurants and resume other indoor activities safely in the new normal? 

Advice from the WHO indicates that surgical masks on their own only removes 56.1% of pathogens such as the Covid-19 virus (Pic MUHD AMIN NAHARUL/TMR)

Double Mask and Social Distance over 2m 

As per the World Health Organisation (WHO), “double-masking” is with a disposable surgical mask on the inside and a tight-fitting cloth mask on the outside. It is applicable to all present in the business premises. 

Advice from the WHO indicates that surgical masks on their own, especially the way it is typically worn in Malaysia, only remove 56.1% of pathogens such as the Covid-19 virus. Double-masking helps remove 85.4% of pathogens! Using disposable N95 masks may be slightly more effective, but they are expensive and more difficult to acquire. The 2m social-distancing practice has also already been instituted in many countries, especially in Europe, the US and Canada. 

Criticality of Ventilation 

Please note, however, the above scenario applies for spaces with excellent ventilation. For situations where the ventilation is poor, even moderate activities would be a challenge, let alone intense ones. Poorly ventilated spaces would be fully enclosed, windowless or with windows kept closed, either with no air conditioning or one that is just left to recirculate the indoor air and without air cleaners. 

Some advice on improving ventilation of indoor spaces have been issued by the Health Ministry together with the Human Resources Ministry. Unfortunately, we have received feedback that some of the recommendations were impractical, especially when businesses are now struggling to survive. Hence, businesses, and in fact the whole community, should be advised to maximise ventilation, to switch off the recirculating function, to maximise the inflow of air and apply other rules of thumb or best practices. 

One such best practice could be the installation of CO2 monitors in indoor spaces as a means to ensure the air is always fresh and free from contaminants. 

Such monitors have been in use by the food and beverages industry in Belgium which recently reopened. Interestingly, the same monitors were already being considered to monitor indoor air freshness in European classrooms and are now being rolled out to mitigate Covid-19 infection risk. 

Relevance to Schools 

Viral outbreaks have increased among children across the globe, even in countries with far higher vaccination rates than ours. Bearing this in mind, it is also critical for the practices mentioned earlier, double-masking, more than 2m social distancing and improved ventilation, should be made part of school policy before schools reopen in October. 

This should ideally be augmented by dedicated Covid-19 safety awareness programmes for all school children to inculcate a safety culture while they are still young to be practiced even outside of school. 

Ideally, the practice of weekly or twice weekly testing for Covid-19, to all that enter the school compound and workplaces, should be instituted. Unfortunately, the cost of Rapid Test Kits is still prohibitive in Malaysia. 

In fact, many truly effective mitigation actions are out of reach these days due to cost, case in fact being the cost of improving ventilation in many buildings, when most building occupants and owners are under financial pressure. Hence, instituting low cost and effective practices that are within our control in the community, like double masking and 2m social distancing is essential to ensure a safe new normal for Malaysia. 

Akhramsyah Sanusi is oil and gas consultant and safety culture advocate and Dr Ariza Zakaria was a former medical officer attached with Clinical Research Centre, Ministry of Health. 

  • The views expressed are of the writers and do not necessarily reflect the stand of the newspaper’s owners and editorial board.