Ventilating indoor spaces helps prevent COVID-19 transmission. We investigated self-reported rates of opening windows to improve ventilation in the home, perceived effectiveness of opening windows, and confidence that if you wanted to, you could open windows. One in 6 people reported rarely, if ever, opening windows in their home in the last week. Three in 4 people knew that opening windows to improve ventilation was an effective way to prevent the spread of COVID-19 and 5 in 6 were confident that they could open windows in their home. Official messaging should continue to seek to improve knowledge about the effectiveness of ventilation for reducing COVID-19 transmission, and increase the frequency of window opening

Amlȏt, R

Fear, NT

Michie, S

Potts, HWW

Rubin, GJ

Smith, LE

English

UCL Discovery

https://doi.org/10.1177/11786302211015588Environmental Health InsightsVolume 15: 1–2© The Author(s) 2021DOI: 10.1177/1 786302211015588Creative Commons CC BY: This article is distributed under the terms of the Creative Commons Attribution 4.0 License  (https://creativecommons.org/licenses/by/4.0/) which permits any use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage).LETTER TO THE EDITORCOVID-19 and Ventilation in the Home; Investigating Peoples’ Perceptions and Self-Reported Behaviour (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] Study)Louise E Smith1,2 , Henry WW Potts3, Richard Amlȏt2,4,  Nicola T Fear1,5, Susan Michie6 and G James Rubin1,21Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK. 2NIHR Health Protection Research Unit in Emergency Preparedness and Response, UK. 3Institute of Health Informatics, University College London, London, UK. 4Behavioural Science Team, Emergency Response Department Science and Technology, Public Health England, UK. 5King’s Centre for Military Health Research and the Academic Department of Military Mental Health, King’s College London, London, UK. 6Centre for Behaviour Change, University College London, London, UK.1015588 EHI0010.1177/11786302211015588Environmental Health InsightsSmith et alresearch-article2021RECEIVED: January 18, 2021. ACCEPTED: April 15, 2021.TYPE: Letter to the Editor-COVID-19 and Environmental HealthFUNDING: The author(s) disclosed receipt of the following finan-cial support for the research, authorship, and/or publication of this article: LS, RA and GJR are supported by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Emergency Preparedness and Response, a partnership between Public Health England, King’s College London and the University of East Anglia. HWWP receives funding from Public Health England and NHS England. NTF is part funded by a grant from the UK Ministry of Defence. The views expressed are those of the authors and not necessarily those of the NIHR, Public Health England, the Department of Health and Social Care or the UK Ministry of Defence. The Department of Health and Social Care (DHSC) funded data collection.Surveys were commissioned and funded by DHSC, with the authors providing advice on the question design and selection. DHSC had no role in analysis, decision to publish, or preparation of the manuscript. Preliminary results were made available to DHSC and the UK’s Scientific Advisory Group for Emergencies (SAGE).DECLARATION OF CONFLICTING INTERESTS: The author(s) declared the following potential conflicts of interest with respect to the research, authorship, and/or publication of this article: All authors had financial support from NIHR for the submitted work; RA is an employee of Public Health England; HWWP receives additional salary support from Public Health England and NHS England; no other financial relationships with any organisations that might have an interest in the submitted work in the previous three years; no other relationships or activities that could appear to have influenced the submitted work. NTF is a participant of an independent group advising NHS Digital on the release of patient data. All authors are participants of the UK’s Scientific Advisory Group for Emergencies or its subgroups.CORRESPONDING AUTHOR: Louise E Smith, Post-doctoral Researcher. Department of Psychological Medicine, King’s College London, Weston Education Centre, Cutcombe Road, London, SE5 9RJ, UK. Email: louise.e.smith@kcl.ac.ukABSTRACT: Ventilating indoor spaces helps prevent COVID-19 transmission. We investigated self-reported rates of opening windows to improve ventilation in the home, perceived effectiveness of opening windows, and confidence that if you wanted to, you could open win-dows. One in 6 people reported rarely, if ever, opening windows in their home in the last week. Three in 4 people knew that opening windows to improve ventilation was an effective way to prevent the spread of COVID-19 and 5 in 6 were confident that they could open windows in their home. Official messaging should continue to seek to improve knowledge about the effectiveness of ventilation for reducing COVID-19 transmission, and increase the frequency of window opening.KEYWORDS: COVID-19, ventilation, effectiveness, self-efficacy, confidenceCOVID-19 spreads through droplet and airborne transmission.1 Droplet transmission occurs when an infected individual coughs, sneezes or speaks, releasing droplets into the air that deposit quickly, typically within 2 m. If there is direct air flow from an infected individual, transmission can occur at a greater distance.2 Airborne transmission occurs when smaller aerosols carrying a virus evaporate to form droplet nuclei that remain suspended in the air for long periods. Ventilation prevents the spread of infection by diluting droplet nuclei in the air and extracting them outdoors where they are dispersed.3 Improving ventilation in indoor spaces reduces transmission of COVID-19.4 This is important in home settings, where other protective measures (eg, physical distancing, wearing a face covering) may be less likely, and in non-domestic settings, where there is increased household mixing. Opening doors or windows also has other health benefits by dispersing airborne pollutants. We investigated self-reported rates of opening win-dows to improve ventilation in the home, perceived effective-ness for opening windows, and confidence that if you wanted to, you could open windows (self-efficacy).2 Environmental Health Insights Data from CORSAIR, a series of nationally representative cross-sectional online surveys conducted by BMG Research on behalf of the Department of Health and Social Care, England, were used (collected 26 October to 2 December 2020; n = 10 207 responses from 10 199 participants). This period spanned the launch of a marketing campaign highlighting the importance of ventilation in reducing the spread of COVID-19 in England on 18 November 2020.5 We asked participants how often in the last 7 days they had “opened windows to improve ventila-tion in [their] home.” Participants were asked to what extent they agreed that opening windows regularly to improve venti-lation in indoor spaces was an effective way to prevent the spread of COVID-19 and they were confident they could open windows regularly to improve ventilation in their home and other indoor spaces. We investigated whether perceptions and behavior changed over time (comparing survey waves). We coded answers of “not applicable” or “don’t know” as missing (self-reported behavior n = 122, 1·2%; perceived effectiveness n = 216, 2·1%; confidence n = 144, 1·4%). This work was con-ducted as part of a service evaluation of the marketing and communications run by the Department of Health and Social Care, and so did not require ethical approval.One in 6 people reported rarely, if ever, opening windows in their home in the last week (Table 1). Only 3 in 4 people agreed that opening windows to improve ventilation was an effective way to prevent the spread of COVID-19 and 5 in 6 were confi-dent they could open windows. There was no difference in self-reported behaviour (χ2(20) = 15·0, P = .78), perceived effectiveness (χ2(20) = 22·3, P = .32) or confidence (χ2(20) = 22·3, P =.32) or con-fidence (χ2(20) = 24·3, P = .23) over time.Table 1. Numbers (n) and percentages (%) of people who reported opening their windows in the last 7 days, and perceived effectiveness of, and confidence for opening windows to improve ventilation.RESPONSE OPTIONSBEHAvIOuR IN LAST 7 DAyS N = 10 085, N (%)RESPONSE OPTIONSPERcEIvED EFFEcTIvENESS N = 9991, N (%)cONFIDENcE N = 10 063, N (%)very frequently 3120 (30.9) Strongly agree 3688 (36.9) 4534 (45.1)Frequently 2783 (27.6) Agree 3970 (39.7) 3945 (39.2)Occasionally 2386 (23.7) Neither 1703 (17.0) 1120 (11.1)Rarely 1066 (10.6) Disagree 394 (3.9) 320 (3.2)Never 730 (7.2) Strongly disagree 236 (2.3) 144 (1.4)Percentages may not sum to 100% due to rounding errors.Opening windows for short periods of time (10 minutes every hour or 2 hours) may be effective at reducing transmis-sion without compromising temperature. The importance of ventilation in preventing the spread of COVID-19 should be emphasised in official messaging to help improve knowledge about the effectiveness of ventilation for reducing COVID-19 transmission and the frequency of people opening windows at home.AcknowledgementsThe authors would like to thank Professor Catherine Noakes for her contribution to the manuscript.ORCID iDLouise E Smith  https://orcid.org/0000-0002-1277-2564REFERENCES 1. The Lancet Respiratory Medicine. COVID-19 transmission-up in the air. Lancet Respir Med. 2020;8:1159. 2. Kwon KS, Park JI, Park YJ, Jung DM, Ryu KW, Lee JH. Evidence of long-dis-tance droplet transmission of SARS-CoV-2 by direct air flow in a restaurant in Korea. J Korean Med Sci. 2020;35:e415. 3. Qian H, Zheng X. Ventilation control for airborne transmission of human exhaled bio-aerosols in buildings. J Thorac Dis. 2018;10:S2295-S2304. 4. SAGE Environment and Modelling Group. Simple summary of ventilation actions to mitigate the risk of COVID-19. October 1, 2020. Accessed February 24, 2021. https://assets.publishing.service.gov.uk/government/uploads/system/uploads /at t achment _ data /fi le /945754/S 0973 _Vent i l at ion _ Act ions _Summary_16122020_V2.pdf 5. New film shows importance of ventilation to reduce spread of COVID-19. November 18, 2020. Accessed Deccember 11, 2020. https://www.gov.uk/gov-ernment/news/new-film-shows-importance-of-ventilation-to-reduce-spread-of-covid-19#:~:text=For%20COVID%2D19%2C%20it%20is,transmission%20to%20other%20household%20members.&text=Remember%2C%20open-ing %20 w indows%20 a longs ide%20 wash ing ,you r %20r i sk %20 of %20COVID%2D19

COVID-19 and Ventilation in the Home; Investigating Peoples’ Perceptions and Self-Reported Behaviour (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] Study)

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COVID-19 and Ventilation in the Home; Investigating Peoples’ Perceptions and Self-Reported Behaviour (the COVID-19 Rapid Survey of Adherence to Interventions and Responses [CORSAIR] Study)

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