We know that the UK has a workforce crisis. It is very visible in the NHS, in education, in social care and in most other public services as well as in the private sector, particularly hospitality.
The adverse impact on our economy from the shortage of labour, particularly our ability (or inability) to grow the economy, is now being understood. There is a growing body of evidence that cleaning indoor air – easily, quickly and cheaply – can help address it.
Crisis, what crisis?
The workforce crisis is caused by many factors – lack of planning, immigration, many over 50s deciding to retire early, Brexit. The latest, very visible, cause is sickness – levels of long-term and short-term sickness, mental and physical ill health are at their highest level for many years.
In the UK over a fifth of the estimated 2.2 million people who are experiencing long Covid are unable to work because of it, with the Office for National Statistics stating the disease could be contributing to the downturn in the economy.
On a more global scale, the management consultants McKinsey published a report this month estimating that the impact of short and long-term absence from Covid infections resulted in one billion days of work lost in the USA in 2022, the equivalent of a 2.6% reduction in the workforce and “a burden on productivity that could last for years”.
All this lost time adds up, and time is money!
Recently, many hospitals reported that Covid, flu and norovirus had led to higher than normal staff sickness levels. To cover this loss, Trusts were asking staff to work on their days off and/or employing very expensive locum staff, with the NHS spending £3bn per year on agency staff to cover vacancies and absences.
Prevention is better than cure
The significant impact on their economies is prompting a growing number of governments to seek to achieve a healthier workforce by investing in improved indoor air quality i.e. to clean the indoor air we breathe to reduce airborne viruses like flu and Covid and reduce sickness levels.
The US government has provided hundreds of billions of dollars to improve indoor air quality, including $350bn for state and local governments, as well as $122bn for schools. The French government has new air quality standards for school classrooms to reduce the risk of infections. Belgium has agreed on a “ventilation plan” for all places open to the public such as bars, restaurants, cinemas etc to avoid spreading respiratory diseases.
Australia has just announced investment in air filters for schools the Schools Upgrade Fund, and it has just come to light in the United Kingdom that both the Houses of Parliament and the Ministry of Defence have had their ventilation systems upgraded to clean the air of airborne viruses.
A stitch in time saves nine
We have robust evidence that ventilation and air filtration reduce the risk of Covid and other airborne viruses, making a positive impact on health. However, cleaning air can be costly, especially in buildings which need to be redesigned as applies to many in the UK given its ageing infrastructure.
Science and engineering are coming to our rescue – necessity is the mother of invention – with the development of air filters or purifiers, both commercially manufactured and DIY versions, which use specially designed high-grade filters, of which HEPA (high efficiency particulate) is the best known, to effectively remove a range of airborne particles which carry viruses such as flu and Covid, as well as other aerosol particles such as traffic pollution, pollen, fungal spores and bacteria.
Devices have already been introduced into a few UK hospitals – Addenbrookes Hospital was an early pioneer. Publishing their results, Andrew Turner engineer on the Cambridge University research team, said “we have proved these machines dramatically reduce air borne infections so it makes sense to have many more of them”.
The economic case
Does it pay to do it? Do the benefits outweigh the cost? Well they must do because not only has air cleaning been installed in UK government buildings but at the World Economic Forum in Davos this month air filters were seen in every public space!
But to set out the numbers…
The best known DIY air filter is the Corsi Rosenthal box, one is effective enough to clean the air in a classroom to WHO standards, meets all Department of Education requirements and costs about £120. Commercial air filters can cost between £500 and £1,000 and, depending on the efficacy, a classroom or a hospital ward might need more than one. Many entrepreneurs, including here in the North West, are seeing the commercial opportunity of producing filters with more capability at much cheaper costs.
Prof Cath Noakes and colleagues at the Centre for Applied Educational Research at the University of Leeds consider some of the other things to think about when ‘plugging in’ air filters, such as filter replacement and running costs.
So is there an economic case for this level of investment?
The level of sickness absence in the NHS continues to be high. Whilst mental health issues are the most reported reason, accounting for over half a million days lost and 25% of all sickness absence in August 2022 (latest reported stats), respiratory illnesses accounted for nearly 20% of absences that month, including Covid related absences which are consistently high with the data showing 50,000 to 60,000 staff absent from work in English hospitals every week for the last year.
These absences need to be covered to keep patients safe. An inpatient ward is open 365 days a year and to staff that round-the-clock service will vary depending on many factors such the type of patients, how ill they are, etc. A 24 hour/7 day ward will generally have a team of at least 20 qualified nurses, as well as doctors and support staff, with higher numbers required in areas like intensive care and maternity.
Agency nursing rates are in the region of £300 to £400 per day plus a payment to the company employing them. Locum doctors cost the NHS up to £100 per hour at consultant level. So to cover the cost of one commercial air filter, you may need to save as little as one or so days of nursing absence per year.
Of course, a ward is likely to need more than one air filter, in side rooms for example. Even so, across your team of 20 plus clinical staff the air filters will pay for themselves in a year or so and, with an expected working life over ten years, go on working for years after the NHS has recouped its initial outlay.
Consider a primary school which typically has one teacher in each classroom, though of course other staff such as teaching assistants may be present and admin staff are also employed in the school.
In 2020/21 (latest published data) teachers sickness absence was an average of just under four days for each teacher with the daily cost of a supply teacher being at least £150 to £200 a day. If you invest in a DIY air filter for that classroom at an initial cost of about £120 (plus estimated energy costs of £30 per year), then you only need to save one day of teacher sickness in a year to pay back that investment. Of course, the air filter will last longer than a year – the filters are replaced but the fans have a long life – so even a saving of less than one day per year, or using more expensive commercial filters, will give a short payback period.
It’s very difficult in a short article to set out all numbers in detail which is why, of course, formal research studies are being undertaken in hospitals and schools. The government initiated a trial of air filters in 30 Bradford classrooms which was due to report its findings at the end of 2021. Over a year later nothing has been made public. It is unclear why.
The Chartered Institution of Building Services Engineers (CIBSE) points out that in education “there is a wealth of evidence showing the benefits of good ventilation and indoor air quality that go beyond reducing disease transmission – improving classroom learning, protecting children’s health and futureproofing schools from possible pandemics downstream.”
But whatever your cost-benefit analysis method, this is surely a no brainer!
Better late than never
The UK and other first world economies are suffering a workforce crisis. Other western governments are tackling the issue of sickness and the long-term impact on the economy of the pandemic much faster than the UK.
As fortune favours the brave, in the context of a deteriorating economic situation and a “sick” workforce, surely now is the time for the UK government to invest in proven technology and not “spoil the ship for a halfpenny of tar”.
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