UK Covid-19 Inquiry: Professor Clive Beggs

Welcome to another enlightening episode of the Heliox Podcast! Today, we're diving into the fascinating world of viral transmission with a focus on the Covid-19 pandemic. 

We'll explore the groundbreaking expert witness statement by Professor Clive Beggs, presented to the UK Covid-19 Inquiry. Get ready for an eye-opening discussion on how our understanding of virus spread has evolved, the role of airborne particles, and what this means for future pandemic preparedness. 

Whether you're a science enthusiast or simply curious about the world around us, this episode promises to be both informative and thought-provoking. So sit back, relax, and let's unravel the mysteries of viral transmission together!

UK Covid-19 Inquiry Module 3 —
the impact of the Covid-19 pandemic on the healthcare systems of the UK

An expert report on the physical sciences underpinning
Covid-19 transmission and its implications for infection
prevention and control in healthcare settings
https://covid19.public-inquiry.uk/wp-content/uploads/2024/09/11163602/INQ000474276.pdf

Transcript

0:00

Welcome back everyone. Kicking things off today with a deep dive into something I think we've all become a lot more aware of lately how those pesky respiratory viruses actually spread. Definitely top of mind these days. You sent over some really fascinating research from a Professor Clive Beggs. Seems like he spent over 25 years really getting into the weeds on how infections spread. Yeah, Professor Beggs is kind of a triple threat bioengineer, epidemiologist, and a mathematical modeler all in one. Wow, a real Renaissance man of viruses. And his report really digs into some of those traditional assumptions around how these things travel through the air. Like that whole idea of stay succeed apart and you're good. Professor Beggs might have a thing or two to say about that, huh? He does, he does. You see for a long time the thinking was that those larger respiratory droplets, the ones you can actually see when someone sneezes, those were the main culprits. Right, because they're heavy. Exactly. The assumption was that if it was bigger than five micrometers, gravity would just pull it down to the ground before it could travel too far. Hence the six-foot rule. Makes sense, but Professor Beggs is saying that's not the whole story. Let's just say he's adding a whole new dimension to this story. His research shows it's not as simple as big droplets versus tiny aerosols. It's more like a spectrum. A spectrum. Okay, now you've got me interested. Tell me more about the spectrum. So picture this, you cough, right, and a whole bunch of different sized particles get launched into the air. Some are those big heavy hitters that fall quickly, sure, but a lot of them are much smaller. And here's where it gets interesting. As those droplets travel, they evaporate. So they shrink. They become those tiny invisible aerosols we've been hearing so much about. Bingo. And Professor Beggs found that even particles as large as 30 micrometers can stay airborne as aerosols, writing air currents, just want tiny kites. He actually argues that only particles over a hundred micrometers are what he calls "true" droplets. Everything else has the potential to linger. Wow, okay, so that sneeze guard at the checkout counter might not be the impenetrable barrier we thought it was. It's a start, for sure. But it's not the whole picture. And this is where things get even more wild. Professor Beggs highlights the role of those invisible air currents we're talking about. Even something as simple as the warmth coming off our bodies can have an impact. Hold on, are you saying our body heat can create air currents strong enough to carry virus particles? It's true. Think of it like this. We each have this invisible plume of warm air rising from us, kind of like a mini chimney. And these plumes can carry those virus-laden aerosols upwards, which contributes to what's called far-field transmission. Far-field transmission. So much for that six-foot bubble of safety we thought we had. Exactly. Professor Beggs' research suggests that social distancing, while helpful to some extent, isn't a foolproof method. We really need to start thinking about the air itself as a potential pathway for these viruses. Okay, so my mind is already a little blown, but it gets wilder. The report also digs into viral load, basically. How much of the virus is packed into each of these particles? And what Professor Beggs found really flips the script on what we thought we knew. Right. For a long time, we assumed that the amount of virus was basically the same in every particle, regardless of size. But it turns out that's not true at all. Those tiny aerosols, the ones smaller than five micrometers, they're actually carrying the biggest viral punch. And this is true for both SARS-CoV-2 and influenza. Wait, so the smallest particles, the ones most likely to be floating around in the air, are the ones carrying the most virus. You got it. And this leads us to another crucial factor that Professor Beggs highlights, time. Time. You mean how long you're near someone who's sick. Exactly. It's not just about being close to someone who's contagious, it's about how long you're exposed to those tiny virus-filled aerosols. The longer you're breathing them in, the higher your risk of infection. So a quick chat in a well-ventilated space is probably a lot less risky than, say, spending several hours with someone who's contagious in a crowded, stuffy room. Now you're getting it. And this all becomes even more important when we factor in how much asymptomatic transmission plays a role. We're talking about those silent spreaders? Yeah, asymptomatic transmission. That was a real game-changer during the COVID pandemic. For sure. With a significant number of cases, people were contagious before they even felt sick. And we're finding that asymptomatic spread is a major factor for other respiratory viruses, too. So someone could be feeling totally fine going about their day and unknowingly releasing a plume of those tiny virus-packed aerosols into the air. It's a scary thought, but understanding this is crucial for figuring out how to better protect ourselves. And that's what makes Professor Beggs' work so important. He's not just uncovering these kind of hidden pathways of transmission, he's challenging us to rethink how we approach preventing these infections altogether. It's like he's shining a light on this whole invisible world of viruses and air currents, showing us a whole new set of rules that we need to learn in order to stay safe. Absolutely. And that's what we're going to unpack as we dive deeper into his findings. This is already a lot to process, but I'm ready to keep going. Let's take a quick break and then we'll come back and explore Professor Beggs' recommendations for staying safe in this new aerosol-aware world. Okay, so we're back. And I think we can all agree our minds are officially blown. But like we were saying before the break, just knowing about these risks isn't enough. What do we actually do with this information? Thankfully, Professor Beggs has some thoughts on that, too, right? He does. He does. And it's not all doom and gloom once you see the problem. You can actually start to come up with solutions. Exactly. So where do we even begin? Well, he spends a lot of time on masks, which makes sense, right? But one of the things he really stresses is that not all masks are created equal. Right. We've all had our own mask journeys over the past few years. So what's the professor's take on picking the right mask for the job? He really zeroes in on the difference between those surgical masks, the ones we all know and love, and then those more heavy-duty respirators. Okay, makes sense. Surgical masks, they're good for those bigger droplets, right? Like if you sneeze or something. Exactly. They block those bigger particles. But when it comes to those tiny, sneaky aerosols, they're not as effective. Think of it like trying to stop a mosquito with a chain-link fence. Right. Those surgical masks definitely don't form a perfect seal around your face. Exactly. And that's where the respirators come in. Those are the N95, the KN95, the FFP2s. They're designed to filter out even those minuscule particles because they fit much more snugly, creating a better barrier between you and the air you're breathing. So is Professor Begg saying we should all switch to wearing respirators all the time now? Well, he acknowledges that it's not quite that simple. While those N95s with the headbands offer really good protection, they can be, well, let's just say not the most comfortable thing to wear for long stretches. Yeah, I can relate to that. So he actually proposes an interesting alternative. FFP2 masks with ear loops. Now, these might not be as common in some places, but they offer significantly better protection than surgical masks while still being more comfortable for everyday use. So it's kind of a best of both worlds situation. Makes sense. But even if we've all got the perfect mask situation going on, I'm guessing Professor Beggs would say that's only one piece of the puzzle. You're absolutely right. Remember those air currents we talked about earlier? Oh, yeah, those invisible plumes of virus-carrying warmth. Hard to forget. Right. Well, that's where ventilation comes into play as a really powerful tool in our fight against these viruses. Because even if you're wearing a mask, you're still sharing air with everyone around you, right? Exactly. And this is where Professor Begg's research is really pushing for a huge shift in how we think about ventilation. We need to stop seeing it just as climate control, as a way to make the temperature comfortable, and start thinking about it as a public health tool. It's about diluting those viral particles in the air, like flushing out a contaminated space with fresh, clean air. So cracking a window or two could actually make a real difference. It's a great start, for sure. But Professor Beggs takes it a step further. He's calling for a major overhaul of those ventilation guidelines, especially in places like hospitals. Wait, really? Yeah. Turns out a lot of the existing guidelines are based on older science that didn't fully grasp the significance of aerosol transmission. Wow. So what does he propose we do differently? Are we talking some sort of super high-tech air purification system in every room? Well, it doesn't have to be futuristic, but it requires a different way of thinking. For starters, he wants to see ventilation systems designed to actually dilute those viral concentrations, not just in specific areas, but throughout an entire building. And he stresses the importance of regular maintenance to make sure those systems are working as well as they should be. So like giving those ventilation systems a regular checkup, just like you would with your car? Exactly. And there are some really clever ways to monitor how effective your ventilation actually is. Professor Beggs talks about using carbon dioxide levels as a proxy. CO2? How so? Well, think about it. We breathe out carbon dioxide, right? So if you have high CO2 levels in a room, that's a pretty good indication that the ventilation isn't great and those infectious aerosols could be building up. So a CO2 monitor could be a valuable tool in these settings. Absolutely. Professor Beggs suggests making CO2 monitoring a standard part of building protocols, especially in places like schools and hospitals where the risk of transmission is high. Okay, that's super interesting. But what about those older buildings or rooms where installing brand new ventilation systems just isn't really feasible? What's the solution there? That's a great question. And Professor Beggs has some ideas about that, too. He suggests that portable air cleaning devices can be a really valuable stopgap measure. Oh, like those HEPA filters and UVC lamps we talked about earlier? You got it. These devices can be strategically placed in areas with high traffic or poor ventilation to provide an extra layer of protection, supplementing the existing systems, and hopefully making those environments a little bit safer. It's like giving those spaces their own little immune system boost. Exactly. And this is where his research gets really interesting in the context of hospitals. Yeah, because we often think of hospitals as being at the forefront of infection control. So to hear that even they might be behind the curve when it comes to ventilation is a little concerning, to say the least. It definitely highlights how important this research is. So let's dig into that. Professor Beggs' work actually uncovered some pretty significant concerns about how hospitals currently handle these airborne illnesses. And it all comes back to those ventilation guidelines we were talking about earlier. So let's dive into that. Professor Beggs' work actually uncovered some pretty significant concerns about how hospitals currently handle these airborne illnesses. And it all comes back to those ventilation guidelines we were talking about earlier. Yeah, it's kind of mind-blowing. When you think about it, we're talking about places that are literally designed to deal with infectious diseases. But their ventilation systems might not even be designed with these tiny, long-lasting, virus-carrying particles in mind. It's kind of scary when you put it like that. It makes you wonder, are those hospitals really as prepared as we think they are? That's exactly the question Professor Beggs is raising. And some of his findings are, well, let's just say they're pretty eye-opening. For example, he found that a lot of hospitals are still relying on guidelines that were written before we fully understood just how important those aerosols really are. Wait, really? We're in 2024. How are we still using outdated guidelines when it comes to something as crucial as hospital ventilation? It seems crazy, right? Yeah. But it's true. And the problem is, those old guidelines, they focused on very specific areas within a hospital, like isolation wards and operating rooms, places where the risk of airborne infection was already considered very high. But when it came to those more general wards and common areas where most patients and staff actually spend their time ventilation, it was often treated as more of a side note. So while they were going all in on protecting those high-risk areas, the rest of the hospital was basically playing catch-up. Pretty much. And it gets worse. Professor Beggs actually found that in a lot of cases, those general areas were being ventilated primarily for odor control, not to actually reduce the spread of airborne pathogens. It's like using a Band-Aid to fix a broken bone. So we're not even talking about apples and oranges here. We're talking about apples and like elephants. It's a completely different ballgame. But OK, so say we update the guidelines. What can hospitals actually do to bridge this gap? I mean, ripping out and replacing those old ventilation systems doesn't exactly sound feasible. You're right. It's not always that simple. But Professor Beggs emphasizes the importance of those regular assessments we were talking about earlier, kind of like a health checkup for the ventilation system. Because what he found is that a lot of times these systems aren't even being checked regularly to see if they're working the way they should be. And even when they are up and running, those old guidelines didn't take into account how the air actually moves within a room. You might have a perfectly functional system that's actually contributing to the problem because it's not designed with those sneaky air currents in mind. So you could have a well-maintained system that's actually making things worse without anyone even realizing it. That's terrifying. It really highlights the importance of staying up to date with the science. But on a more positive note, Professor Beggs offers a really elegant solution, and it goes back to that CO2 monitoring we were talking about earlier. Right. Because we breathe out CO2, so more CO2 in the air means more potentially virus-laden breath. Exactly. Professor Beggs suggests using those CO2 monitors as a real-time indicator of ventilation effectiveness. Think of it like a smoke alarm for stale air. If CO2 levels start creeping up, it's a sign that a room isn't being ventilated properly, and those aerosols might be building up. And that can give hospitals a chance to make adjustments on the fly. So it's all about being proactive, being aware of the problem before it becomes a bigger issue. Exactly. And that can be as simple as opening a few windows, repositioning some fans, maybe even just being more mindful about where you're placing patients within a ward. It's amazing how much of a difference those small changes can make when you actually understand the science behind it. But what about those situations where even those adjustments aren't enough? Like in older buildings where the ventilation system is just, well, outdated. Professor Beggs has a solution for that, too. Remember those portable air cleaning devices we were talking about? The heat pay filters, UV lamps, that whole shebang. Yep. He suggests using those as an extra layer of defense, especially in those older buildings or rooms where upgrading the whole system just isn't feasible. So you're basically supplementing the existing ventilation with these portable devices to create a cleaner, safer environment. Exactly. It's about being smart and adaptable, using all the tools at our disposal. And that's what makes Professor Beggs' work so important. He's not just highlighting the problems, he's giving us practical, actionable solutions that we can implement right now. And it's not just about hospitals either. This applies to schools, office buildings, even our own homes. It really makes you think about those everyday spaces differently, doesn't it? Like, how often do we actually stop and consider the air we're breathing? Right. We take it for granted. But the truth is, the air we breathe can either be a source of life or a source of risk. And understanding the science behind how viruses spread through the air, that's our first line of defense. It's about being informed, being proactive, and maybe just being a little more mindful of those invisible forces that shape our health. So the next time you're in a crowded room or a stuffy office, maybe crack open a window. You never know, it could make all the difference. Absolutely. Knowledge is power. And in this case, knowledge about the air we breathe could be the key to a healthier future for all of us. I love that knowledge as a breath of fresh air. It's been a fascinating deep dive today. And a big thank you to Professor Clive Beggs for his groundbreaking work in this area. And for all of you listening out there, stay curious, stay safe, and we'll catch you next time on the Deep Dive.