Association of regional Covid-19 mortality with indicators of indoor ventilation, including temperature and wind: insights into the upcoming winter

  1. Christopher T. Leffler
  2. Joseph D. Lykins V
  3. Brandon I. Fram
  4. Edward Yang

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Abstract

Background

Outdoor environmental variables, such as cold temperatures and low wind speed, have been correlated with incidence and mortality from Covid-19 (caused by the SARS-CoV-2 virus). However, as Covid-19 predominantly spreads indoors, the degree to which outdoor environmental variables might directly cause disease spread is unclear.

Methods

World regions were considered to have reliable data if the excess mortality did not greatly exceed reported Covid-19 mortality. The relative risk of Covid-19 mortality for 142 regions as a function of median weekly temperature and wind speed was determined. For instance, Covid-19 mortality following warm weeks in a country was compared with mortality following cold weeks in the same country.

Results

Covid-19 mortality increases with cooling from 20 C to close to freezing (0 to 4 C, p<0.001). The relation of Covid-19 mortality with temperature demonstrates a maximum close to freezing. Below -5 C, the decrease in mortality with further cooling was statistically significant (p<0.01). With warming above room temperature (20 to 24 C), there is a nonsignificant trend for mortality to increase again. A literature review demonstrated that window opening and indoor ventilation tend to increase with warming in the range from freezing to room temperature.

Conclusion

The steep decline in Covid-19 mortality with warming in the range from freezing to room temperature may relate to window opening and less indoor crowding when it is comfortable outside. Below freezing, all windows are closed, and further cooling increases stack ventilation (secondary to indoor-outdoor temperature differences) and thereby tends to decrease Covid-19 mortality. Opening windows and other tools for improving indoor ventilation may decrease the spread of Covid-19.

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  1. ScreenIT

    SciScore for 10.1101/2021.12.05.21267334: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsField Sample Permit: The study was approved by the Office of Research Subjects Protection at Virginia Commonwealth University.
    Sex as a biological variablenot detected.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    No key resources detected.

    Results from OddPub: Thank you for sharing your code and data.

    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.

    About SciScore

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  2. Version published to 10.1101/2021.12.05.21267334 on medRxiv