With the recent vaccine revelations there is light at the end of the tunnel of the Covid-19 pandemic. Despite these impressive results, that tunnel is quite a bit longer than most of us are willing to admit. Inoculation of the general public is months away at best. Distribution of the various vaccines is complicated. All the while, the virus continues to spread threatening to overwhelm the health system.

This is very bad but let’s think for a moment on what is working. Masks, improved indoor air quality through ventilation and filtration, reducing capacity indoors. In New York City, we’ve been able to curtail Covid-19 associated deaths due to the measures we began in April and continue to follow. We know that wearing masks and properly ventilating indoor environments reduces the probability of transmitting Covid-19. We should not stop there. We need to take what works, make it better, and get the solutions to every adult resident now.

Better masks save lives and dollars. What makes a better mask? Filter media (the material that filters particles) and fit (the seal of the mask on your face). Research has shown that masks filter over 95% of particles and do not leak air (think N95) can drive down the probability of transmission below 1%, even in poorly ventilated areas. In three weeks of using high-filtration masks the virus potentially would no longer have hosts on which to prey. There are many variations of these masks in the market today, with more on the way. High-filtration masks are a sound investment. Economists have estimated that one Covid-19 case costs the economy between $18,000 and $55,000. While one disposable N95 equivalent mask costs between $2.00 and $6.00 per mask. Reusable versions of N95 equivalent masks cost between $23 and $70 per mask.

Using these cost assumptions, it would cost Staten Island between $2.9 million and $6.7 million to purchase three disposable N95 equivalent masks for every resident 18 and over. At a seven day average of 150 new Covid-19 cases Staten Island is accruing between $18.9 million and $57.5 million in economic costs per week. Outfitting the highest percentage of adult residents with high-filtration masks, either by direct distribution or incentives, is cost effective.

Ensuring proper indoor ventilation, using the presence of Carbon Dioxide (CO2) in the air and relative humidity, is a solid risk reduction strategy. Evidence shows that when CO2 levels in indoor settings are below 800 particles per million and mask usage is prevalent, risk of transmission recedes. Maintaining relative humidity between 40% and 60% is crucial as well. The virus thrives in very dry and very humid conditions. Inexpensive sensors can measure both of these metrics. We can achieve acceptable ventilation by opening doors, opening windows and utilizing existing HVAC systems. We have already had much success in the New York City public school system.

Air changes per hour (ACH) is an important measurement as well. Maintaining 4-6 ACH will reduce transmission risk. Air filters and purifiers are simple, yet formidable, tools in our arsenal. Adding Merv 13 or higher filters to existing HVAC systems can trap 80% or more of potential particles carrying Covid-19 in the air depending on air flow. Portable air purifiers can help in contained situations. Even a box fan and five Merv 13 filters can achieve suitable results. The necessary tools for protection are available today. The time to act is now.

Governments and nonprofits should work with local partners and community leaders to distribute three high-filtration masks to every adult resident possible. We must pay special attention to those working and residing in nursing homes, prisons, and other essential but poorly ventilated workplaces. Every indoor establishment must maintain CO2 levels below 800ppm and comply 100% with mask usage. We need to incentivize compliance in creative ways - reduction of existing fines, future tax credits, etc. Innovation is our friend.

Together we can maximize our chance of bringing Covid-19 transmission to a swift halt. Remember why we are doing this. It is about realizing our ultimate goal - hugging our grandparents, having date nights, earning a living, and enjoying life as we should. We should not forget this.